The Children's Special Health Care Services (CSHCS) Program began in 1911 with 12 beds reserved for children with special needs. The funding sources, administrative agencies, name, and delivery of services have all changed. In 1935 the Federal Social Security Act provided funding to locate, diagnose, and provide care for children with orthopedic conditions. Other conditions and illnesses were not covered. In 1936 Title V Federal funds and Indiana established a program to administer services to children with special needs. The program was administered by the Department of Public Welfare and care was provided exclusively at Riley Hospital for Children. Eventually other treatment centers were added: Evansville, Fort Wayne, Gary, Richmond, South Bend and Terre Haute. In 1989 the program's name was changed to Children's Special Health Care Needs, and administration was transferred to the Indiana State Department of Health. New rules and policy changes came in May 1991. On May 12, 1993, children who were already on the program were grandfathered, regardless of their eligible diagnosis or income level. All new applications for the program taken after May 12 had to meet revised medical and financial guidelines. The outsourcing of care coordination services started in 1997. Emphasis was placed on existing Maternal and Child Health Projects and grew to include other child service organizations. It proved to be a successful venture, so successful that the participants grew from around 3,000 to more than 8,500 in a little less than 3 years. In 1999, a more comprehensive and organized approach to training was developed and implemented. In June 2001, local care coordination was centralized within the Indiana State Department of Health. CSHCS has gone from covering a few diagnoses to providing coverage for well over a thousand specific conditions. The caseload has grown from the original 12 to more than 8,500 participants in the short span of nine decades. The CSHCS Program continues to serve its current participants, while seeking out additional children with special needs to help.