Some families need to place their disabled child in long term out of home care, due to a high care burden. Foster family care is increasingly the only option available. While published research is sparse, there is evidence that rostered staff models of care are more appropriate for some children, and the potential gains from family care are overstated. Questions are raised about foster care successes overseas and locally, particularly as care options are restricted to in home support or alternative family models. Rostered staff models can promote a child’s involvement with the birth family, and should be developed further. Planners need to foster diversity, which allows flexibility and promises new knowledge.