In the United States, 397,000 children received foster care services in 2012. Some states successfully achieved permanent homes for children with diagnosed disabilities who exited care while others were less successful. Using change theory and social ecological theory as the foundations, the purpose of this study was to determine the impact that diagnosed disabilities had on permanent home placements among Pennsylvania's foster care children who were discharged and were between ages of 0 to 6 years in 2012. Hernandez's and Hodges's theory of change was used to evaluate the 1982 standards that license foster care agencies, while Stokol's ecological theory provided the framework to assess whether there were measurable increases in child welfare outcomes for permanent placements among children with diagnosed disabilities. Following a retrospective, nonexperimental, quantitative design, data were acquired from a purposive sample of 344 archived foster care files across the state. These data were analyzed using bivariate correlation procedures to evaluate the strength of the relationship between medically diagnosed conditions and permanent placement. The findings indicated a statistically significant association between medically diagnosed conditions and permanent placements (p=0.01). Additionally, length of stay in care was also found to be statistically associated with permanent placement (p=0.019). The theoretical constructs evaluation with a theory of change found the 1982 standards were outdated to authorize the licensing of foster care agencies; the social ecological theory identified evidence for change to achieve the intended goal. Findings of this study may provide guidance to policymakers in term of improving standards related to oversight and licensing foster care agencies in order to better support permanent placement of children with disabilities.