Caring for children with special health care needs (SHCN) is a challenge that has been faced with commitment and concern in this country. However, by the late 1970s, it was clear to some that an analysis of the efficacy of the existing structure of care was long overdue. As scrutiny of the current processes began to unfold, new and improved ideas were emerging throughout the United States. A continuous theme through that process was the need and desire to create care systems that were family-centered, aimed at coordinating care, and were close to the child and family's community. These activities provided a conceptual background from which Michigan began to redesign existing programs and develop new initiatives. Simultaneously, Michigan's experiences were influencing national efforts to create family-centered, community-based, coordinated care structures for children with SHCN. This article highlights key national efforts and individuals who influenced program development for children with SHCN in Michigan. In addition, specific family-centered efforts that occurred in the state since the early 1980s, and that continue to date, are described.