The alternate assessment based on alternate academic achievement standards (AA-AAAS) is designed for students with the most significant cognitive disabilities. The 2015 reauthorization of the Elementary and Secondary Education Act (ESEA), known as the Every Student Succeeds Act (ESSA), placed a 1% cap for states on student participation in the AA-AAAS. This meant that states, districts, and individualized education program (IEP) teams needed to carefully consider which students should be included in these assessments. In this analysis more restrictive environment was computed by summing the percentage of students in the following educational environment placement categories: (1) inside the regular class less than 40% of the day; (2) separate school, residential facility; (3) homebound/hospital; (4) correctional facility; and (5) parentally placed in private school. This study found that states with higher percentages of students in more restrictive environments tended to have higher percentages of students participating in the AA-AAAS for both mathematics and reading. This suggests that in states where a higher percentage of students with disabilities were taught in inclusive settings, the students may have had access to more rigorous academic standards-based content, and thus IEP teams in those states may have been more likely to decide that a student with disabilities on the border between the alternate assessment and the general assessment met participation guidelines for the general assessment. The report concluded with a discussion of several components identified in Lazarus et al. (2019) as important drivers in creating and sustaining systems change efforts that support more inclusive educational practices: (1) a common vision; (2) a common understanding of and a commitment to the change process; (3) effective formalized structures for top-down, bottom up, and sideways communications; (4) meaningful data; and (5) coordinated efforts at multiple levels.