The Children’s Hospital of Wisconsin / Medical College of Wisconsin Special Needs Program (SNP) is dedicated to improving access to and coordination of care for medically complex and fragile Children and Youth with Special Health Care Needs (CYSHCN). Bridge to Independence seeks to determine whether adding systematic competency-based care coordination education for families and patient-specific care coordination tools for PCPs to our nationally recognized care coordination program will empower the families and PCPs to better ensure sustained medical and non-medical care coordination for this population. Bridge to Independence has been funded by the Department of Health and Human Services Health Resources and Services Administration’s Maternal and Child Health Bureau for 3 years. Specific Aim 1: Develop, implement, and evaluate a systematic, competency-based care coordination education curriculum for families of medically complex and fragile CYSHCN. Specific Aim 2: Develop, implement, and evaluate patient-specific care coordination tools for PCPs of medically complex and fragile CYSHCN. Specific Aim 3: Evaluate sustainability of this Tertiary Center / Family / Primary Care Partnership and develop and disseminate materials needed to enhance its replicability. The new care coordination education will be developed using standard curriculum design methods. Multiple teaching formats will be created and its impact compared with current ad hoc education by measuring family satisfaction, quality of life, and autonomy (through self-assessed comfort and competency surveys, SNP use, and length of time to complete care coordination tasks). PCP Tools will be developed and evaluated through a combination of content expert and PCP user input. Their impact will be assessed by comparing autonomy in PCPs receiving current ad hoc communication and those receiving the new Tools. Sustainability and replicability of this new Tertiary Center / Family / PCP Partnership model will be further evaluated by comparing family and PCP satisfaction with SNP services, child health maintenance and access to care, and SNP return on investment and capacity for the Control and Intervention Groups. Thus, Bridge to Independence will address barriers to care coordination and Medical Homes, fill gaps in the literature, and provide groundwork for future multi-center studies designed to identify best practices in care coordination of medically complex and fragile CYSHCN.