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This paper describes the key learning outcomes that came from the examination of the experience of eight American community-based agencies that altered their service practices from an exclusive reliance on group and fixed models of service, to models of service that were exclusively individualised for the entirety of the people they served. It examines the key lessons learned as to what drove this process and what did not, as well as what some of the critical comparative outcomes were. A significant core factor cited repeatedly was values based leadership from within the agency concerned and a key result was that individualised services for every person served were very cost competitive in the systems they were in.