The purpose of this study was to explore the differences in experiences of children with and without special health care needs in the child welfare system, specifically within foster care and adoption services. The study further explored differences in characteristics of families willing to provide foster and adoptive homes for children with and without special health care needs. The results found significant differences in all areas explored including, but not limited to, children's experience entering the foster care system, their experience while in the foster care system, and their experience exiting the foster care system. Significant differences were also found between families who choose to foster and adopt children with and without special health care needs. Continued research is recommended to determine how to better recruit foster and adoptive families in order to provide consistent and permanent families for children with special health care needs within the foster care system. Implications for social work practice are discussed.