This site visit report reviews activities of Monadnock Developmental Services, Inc., a program serving people with developmental disabilities in one New Hampshire region. The report focuses on the development of employment services in the state and region, including system change strategies, practices being used to support people in jobs, and current issues and dilemmas. Sections of the report address: the development of integrated employment in New Hampshire through the 1980s; state and regional funding structures for employment; and the development of employment opportunities in Region V of the state, utilizing such principles as closure of sheltered workshops, tying of funding directly to people needing services (rather than providers), person-centered planning and individualized job placements, development of natural supports on the job, and facilitation of school-to-work transition. Three Region V agencies were visited, and three individuals being served by the program are described. Specific issues are identified, including low staff salaries, transportation needs, the requirement that 6 hours of service be provided each day, waiting lists, and possible overselling of supported employment. (DB)