Paraprofessionals have increasingly served as a support service for students with disabilities. Yet, scholars have urged caution in the overuse of assigning paraprofessional supports. Furthermore, it is unclear how states provide guidance to local stakeholders in determining the best use of paraprofessionals. Thus, in this study, we conducted a state-by-state analysis of documents depicting guidance for paraprofessional supports. We identified states that offered comprehensive frameworks to support practitioners while allowing teams to maintain the autonomy to make decisions on a case-by-case basis. However, we also found that few states offered guidance, particularly with regard to navigating tensions between student need and potential risks. We rely on a Disability Studies framework to discuss implications for policy, practice, and future research, particularly in how states might provide robust guidance that assists schools in building an accommodating and inclusive environment rather than focusing solely on student characteristics framed as deficits.