The adoption and expansion of supported employment for people with severe disabilities has evolved steadily, if unevenly, across the United States since first defined in the Developmental Disabilities Act in 1985. In that year, this expansion was initiated in the context of systems-change incentives offered by the federal government. States were offered a financial incentive to "change the system" from sheltered work and segregated day programs to integrated supported employment in community jobs with individualized supports. While novel to the rehabilitation field, the concept of systems change in the implementation of progressive public policy has been used with a number of social issues for a number of decades. This article describes factors that influence state implementation of public policy, discusses political cultures that vary across states, and describes disability policy orientations that affect disability policy implementation. These elements are discussed in order to define the context of the emergence of supported employment.
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