This report is based upon a review of current Idaho policies, laws, regulations, and practices that have affected the lives of people with developmental disabilities, interviews with a sample of administrators and staff members representing government, voluntary agencies, self-advocacy groups, and provider agencies, and insights gained from various meetings and presentations on self-determination. It begins by explaining the four basic principles of self-determination: freedom, authority, support, and responsibility. The growing self-advocacy and parent advocacy movements within Idaho are described, along with the movements towards supported employment, deinstitutionalization, supported living, early intervention, and greater family support. Barriers to people achieving self-determination are identified, and recommendations are made to improve the lives of people with developmental disabilities. Recommendations include: (1) look at ways to strengthen the collaboration among people who care about individuals with developmental disabilities; (2) take what has been learned about how people with developmental disabilities can create the lives they want within their communities and find ways to pilot additional opportunities for learning; (3) make individuals with developmental disabilities and their families partners in creating the policies which guide the system of support they rely on; and (4) revise Medicaid-funded developmental disabilities services. (CR)