The Ventilator Assisted Care Program has provided case management services to 36 youths and their families throughout Louisiana It has served to link tertiary care centers with community-based service systems for the comprehensive care management of children and adolescents who use ventilators The hospitalbased, state-licensed service has been funded by Louisiana's Medicaid and Handicapped Children's Services Programs on a fee for service basis It was originally funded by a grant from the Bureau of Maternal and Child Health The service planning, coordination, and monitoring activities for individual families have usually begun predischarge and have been continued throughout the home care experience The child and family have been considered to be the center of the care matrix, actively directing the service systems as well as service development.