McGehee presented the idea of a charitable group that fulfills the wishes of children with terminal conditions to local business leaders, including Hugh Jones, chairman of Barnett Bank; Jay Stein and Jack Williams of Stein Mart; and Dr. Roy Baker, chairman of University Medical Center.

At the time, McGehee owned television station channel 47, and the charity began work in an empty office there.

According to Suzanne Crittenden, former DCT associate director, "His promise to every child was that 'if you have a life-threatening illness, you will have a dream come true.'

[2] In 2010, Karen Brune Mathis returned to reporting as the managing editor for the Jacksonville Financial News and Daily Record.

The organization serves children from 2+1⁄2 up to age 18 who have a life-threatening illness such as AIDS, cancer, cystic fibrosis, heart disease, leukemia, muscular dystrophy or kidney dysfunction.

Other activities have included swimming with dolphins, meeting celebrities, big game fishing, seeing the volcanoes of Hawaii, a glacier in Alaska, going on a shopping spree, taking a cruise and touring Washington, D.C. or New York City.

[citation needed] Each child can only be granted one dream, but the organization invites past recipients to special events, such as their "Children of Christmas" Party.

[7] In 2009, Dreams Come True received Charity Navigator's highest 4-star rating for sound fiscal management for the fifth consecutive year.

There have been more than 30 schools, clubs and youth groups from civic, religious and service organizations that raised and donated funds.