Under federal law, the state must develop permanency plans for all children who are removed from their homes due to neglect or abuse. Central to permanency planning is the belief that all children belong with families Permanency planning secures for children permanent family placements as opposed to temporary foster care or institutional placements. For children with disabilities who are voluntarily placed in institutions by their parents because their parents can no longer take care of them at home, no such permanency planning is generally required. In this Article, the author argues that two recent policy developments that serve to protect the best interests of children generally should be expanded to address the needs of families who require support to keep their children with disabilities at home rather than placing them in institutions. These two recent policy developments are permanency planning for children who have been neglected and abused and the expansion of the definition of legal parenthood, in the context of surrogacy, same sex families, step-families, and children born to unmarried adults.