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A child with special health care needs is defined as having, or are at increased risk for, a chronic physical, developmental, behavioral, or emotional condition that requires health and related services of a type or amount beyond that required by children generally. In Wisconsin nearly 14% of children are identified as having or being at risk for special health care needs. Healthy People 2010 and the federal Child Health Maternal Bureau have challenged each state to "assure access to ongoing comprehensive health care through a medical home" for all children with special health care needs. A medical home is defined as "an approach to providing continuous and comprehensive primary pediatric care." States are challenged to translate the concepts of medical home to clinical practice activities. This article discusses Wisconsin's participation in a national Medical Home Learning Collaborative and Wisconsin's replication of the Collaborative as a means to develop practical strategies for practice implementation of a medical home.