Our purpose in this article is to contend that organizational change from sheltered to integrated employment is not only possible but necessary, and a federal Employment First agenda must be advanced. Findings are reported from interviews with senior managers from 10 organizations that have shifted their service delivery to community employment, and recommendations are provided based on these findings. Results reveal the commonalities among a diverse group of agencies, suggesting the viability of transformation of our current systems with the support and leadership of state and federal agencies and programs.