Data reveal that insufficient progress has been made in increasing the number of students with severe disabilities who are educated in general education classes. Agran et al. asked why this is happening and discussed determinants that may be affecting placement decisions that serve to segregate students from their peers. This article is a review of the circumstances that have facilitated the movement of students with both severe disabilities and complex health care needs from hospitals and homes, and into school buildings. It also extends Agran et al.'s discussion to placement decisions that may be affecting this specific group of students. [For "Why Aren't Students with Severe Disabilities Being Placed in General Education Classrooms: Examining the Relations among Classroom Placement, Learner Outcomes, and Other Factors," by Agran et al., see EJ1246688.]