One of the primary challenges in developing effective accountability systems is determining how best to include students with disabilities. The purpose of this paper is to report on the initial implementation of one option for including students with disabilities into the accountability system in the United States. In 2007, federal guidance allowed states to develop an Alternate Assessment based on Modified Academic Achievement Standards (AA-MAS) for a small group of students with disabilities. An evaluation of the development and implementation of this assessment within one state, Pennsylvania, is presented. Lessons learned and recommendations are offered for educational leaders considering developing an alternate assessment as a method to include additional students with disabilities into accountability systems. (Contains 2 figures.)