How can I make sure the transition to adulthood goes smoothly?

Action Plans > How can I make sure the transition to adulthood goes smoothly?

How can I make sure the transition to adulthood goes smoothly?

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1Healthcare

2Adult Services

3Financial Well-Being

4Transportation

5IEP

6Additional Items

Healthcare

Youth with disabilities are encouraged to take an active role in their healthcare, as early as possible. It is important to understand how to navigate Medicaid or other insurance options, how to find doctors and specialists that meet your needs, and how to access assessments/evaluations when needed.

Acronym key: MCO = Managed Care Organization

Physical Health

Consider applying for Medicaid. See the adult services action plan for more information on how to navigate Medicaid IDD services.

Approximate Age: As early as possible | Who can help: Individual and Family/Guardian

Resources: Medicaid.gov Adult services action plan

Explore Work Together NC’s library of healthcare services.

Approximate Age: As early as possible & ongoing | Who can help: Individual and Family/Guardian

Resources: WTNC healthcare service library

Consider acquiring a medical information ID card for emergencies.

Approximate Age: As early as possible | Who can help: Individual and Family/Guardian, Doctor

Resources: Medical ID card

Ask doctor if and at what age they no longer care for young adults.

Approximate Age: 45273 | Who can help: Individual and Family/Guardian

Resources: Getting ready for healthcare at the age of majority Healthcare transition guide for youth and families

Identify adult health care providers and become informed about sexuality and family planning options.

Approximate Age: 13 | Who can help: Individual, Family/Guardian, and MCO

Resources: Finding adult healthcare Find a family planning clinic

Learn what your teen knows about their health, health care, and family medical history. The individual and parent/caregiver can take Got Transition’s Transition Readiness Assessments* and discuss this together or with a doctor.

Approximate Age: 14-15 | Who can help: Individual, Family/Guardian, Doctor

Resources: Family toolkit on pediatric to adult healthcare

Learn what your teen knows about potential healthcare accommodations and, if needed, assist them in creating a personalized accommodations report.

Approximate Age: 14-15 | Who can help: Individual, Family/Guardian, Doctor

Resources: Healthcare accommodations tool

Provide the individual with their own health insurance card.

Approximate Age: 14-15 | Who can help: Individual and Family/Guardian

Prepare the individual for what to do in case of a health emergency.

Approximate Age: 14-15 | Who can help: Individual and Family/Guardian

Resources: What to do in a medical emergency toolkit

Practice making a doctor’s appointment and ordering prescription refills (either by phone, online, or through an app).

Approximate Age: 14-15 and ongoing | Who can help: Individual and Family/Guardian

Resources: Teaching phone skills at home

Work with your teen and the doctor to make and share a medical summary.

Approximate Age: 16-17 | Who can help: Individual and Family/Guardian, Doctor

Resources: Creating a medical summary

Before your teen turns 18 and becomes a legal adult, figure out if they will need help making health care decisions. See the “Supported Decision Making & Guardianship” section for more information. *Unless other arrangements have been made (ie., healthcare power of attorney), at age 18, the individual is a legal adult and legally responsible for their care. You cannot access their medical information or be in the doctor’s visit unless your young adult agrees or certain legal forms have been completed.

Approximate Age: 16-17 | Who can help: Individual and Family/Guardian, Doctor

Resources: Supported decision making action plan

Talk with your teen about the age they want to transfer to a new doctor for adult care.

Approximate Age: 16-17 | Who can help: Individual and Family/Guardian

Resources: Healthcare transition resources

Review health insurance coverage: inform insurance company of child’s disability and investigate rider of continued eligibility.

Approximate Age: 17 | Who can help: Individual and Family/Guardian

Resources: Child riders on life insurance info

If appropriate, assume additional responsibility for health care needs (making appointments, etc).

Approximate Age: 18 | Who can help: Individual

Resources: 5 important daily living skills Basic life skills for adults with disabilities

Request/advocate for an updated educational psych eval from the school, which may be useful when entering adult services or postsecondary programs.

Approximate Age: Within last 2 years of leaving high school | Who can help: Individual and Family/Guardian, School/IEP Team

Resources: Parent advocacy assistance: ECAC

Mental Health

Explore Work Together NC’s library of mental health services.

Approximate Age: As early as possible & ongoing | Who can help: Individual and Family

Resources: Healthcare services library

Explore options for peer support and other community-based resources.

Approximate Age: As early as possible & ongoing | Who can help: Individual, School, Adult service providers

Resources: NAMI

If appropriate, assume additional responsibility for mental health care needs (making appointments, etc).

Approximate Age: 16 | Who can help: Individual with help of others

Resources: 5 important daily living skills Basic life skills for adults with disabilities

Complete a needs assessment with your managed care organization.

Approximate Age: 17 | Who can help: Individual, Family, and MCO

Resources: NC SNAP LME MCO directory

Review insurance coverage for mental health services: inform insurance company of child’s disability and investigate rider of continued eligibility.

Approximate Age: 17 | Who can help: Individual and Family

Resources: Child riders on life insurance info

Adult Services

Service systems become more complicated as youth enter adulthood. It is important to learn how to use these systems so that the exit from high school doesn’t feel like a “drop off” in support!

Acronym Key: MCO = Managed Care Organization | DMV = Department of Local vehicles | CAP = Community Alternatives Program | SSI = Supplemental Security Income | SSDI = Social Security Disability Insurance | IDD = Intellectual and Developmental Disabilities | TBI = Traumatic Brain Injury | DHHS = Department of Health and Human Services

Getting documents in order

Acquire a state identification card at the DMV.

Approximate Age: 16 | Who can help: Individual and/or Guardian

Resources: NC DMV: state IDs

Start a folder of your child’s important documents (Social Security Card, Birth Certificate, Diagnosis paperwork).

Approximate Age: 16 | Who can help: Family/Guardian

Approximate Age: 18 | Who can help: Individual and/or Guardian

Resources: How to register to vote How to register for selective service

Obtain an updated psychological evaluation and adaptive behavior assessment. Documentation of IDD or TBI is required to access adult IDD services.

Approximate Age: Within 2 years of applying to access adult services | Who can help: Family/Guardian, Licensed Clinical Psychologist

Navigating NC Medicaid

Establish residency in NC.

Approximate Age: N/A | Who can help: Individual and Guardian/Family

Resources: Info to apply for Medicaid

Apply for Medicaid. Consider submitting an appeal if denied.

Approximate Age: As early as possible | Who can help: Individual and Guardian/Family, NC Department of Health and Human Services

Resources: NC Medicaid

Contact your local managed care organization (MCO) to assess the child’s eligibility for services. If eligible, ensure the child is added to the Registry of Unmet Needs (also known as the “waitlist”) for the NC Medicaid Waiver.

Approximate Age: If eligible for the waiver, get on the registry of unmet needs as early as possible– infancy is not too young! | Who can help: Individual and Guardian/Family, MCO

Resources: NC DHHS IDD services LME MCO directory NC innovations waiver

Contact your local MCO to ask about eligibility for home and community services. Even if an individual is still on the registry of unmet needs, they may qualify for other services.

Approximate Age: Contact MCO at least once a year, starting at 14 (there are oftentimes updates in policies/services available) | Who can help: Individual and Family, MCO

Resources: Accessing IDD resources

If medically fragile/physically disabled, contact your local MCO to assess the child or adult’s eligibility for the Community Alternatives Program (CAP).

Approximate Age: As early as possible– children and adults may be eligible | Who can help: Individual and Guardian/Family, MCO

Resources: Community Alternatives Program

Care coordinators are assigned to help MCO clients and their families. If you do not know how to contact your assigned care coordinator, contact your MCO’s help line.

Approximate Age: As early as possible | Who can help: Individual and Guardian/Family, MCO

Resources: LME MCO directory

Become familiar with the difference between a Medicaid standard plan versus tailored plan, and in collaboration with your MCO, determine which option is most appropriate for your child. Most people with IDD will qualify for the tailored plan.

Approximate Age: Once enrolled in Medicaid | Who can help: Individual, Family/Guardian, MCO

Resources: Comparison of NC Medicaid plans NC Medicaid plans What is care management?

If your child is (a) medicaid-eligible and (b) between the ages of 0-21, become familiar with the “Early Periodic Screening, Diagnostic and Treatment Medicaid Services for Children” (EPSDT) and ask your child’s case manager about it.

Approximate Age: As early as possible | Who can help: Individual, Family/Guardian, MCO

Resources: NC Medicaid health check

Ask your care coordinator about whether your child is eligible for 1915(i) services, which includes supported employment, respite, and community living supports. Having the waiver is NOT required to receive these services!

Approximate Age: As early as possible | Who can help: Individual, Family/Guardian, MCO

Resources: NC Medicaid 1915(i)1915(i) services

If your child does not have Medicaid, ask your managed care organization what services they may qualify for.

Approximate Age: As early as possible | Who can help: Individual, Family/Guardian, MCO

Resources: NC DHHS service definitions

If the person is eligible for SSDI as a child (so, parent is retired, deceased, or disabled), the person will be eligible for Medicare and should learn how to navigate it. Medicare will be their primary healthcare funding, whereas Medicaid would be secondary.

Approximate Age: Circumstantial | Who can help: Individual, Family/Guardian, Medicare help line

Resources: SSDI and Medicare

Navigating Social Security

Become familiar with SSI and the application process.

Approximate Age: 16 | Who can help: Individual, Family/Guardian, Social Security Administration, Benefits Counseling Services

Resources: SSI

Become familiar with the benefits reductions that could happen if you get legally married OR live with a long term partner, due to income/resource limits.

Approximate Age: 16 | Who can help: Individual, Family/Guardian, Social Security Administration, Benefits Counseling Services

Resources: Treatment of married couples

Find your Social Security Administration office by searching your zip code (linked in resource column).

Approximate Age: 17.5 | Who can help: Individual, Family/Guardian

Resources: SSA office locator

Upon turning 18, SSI is based on the disabled individual’s income rather than the family income. So, apply or seek out a re-evaluation. *Be aware, an individual with more than 2000 in assets will be penalized (car and home are not counted).

Approximate Age: 18 | Who can help: Individual, Family/Guardian, Social Security Administration, Benefits Counseling Services

Resources: SSA office locator SSI

Learn about resource/asset limits and consider opening an ABLE account. Seek out benefits counseling through ServiceSource or Vocational Rehabilitation.

Approximate Age: For the ABLE account, have to be diagnosed with a disability before the age of 26. An ABLE account or Special Needs Trust can be opened at any age. | Who can help: Family/Guardian, Benefits Counseling Services

Resources: What is an ABLE account?Cuentas ABLE

If the parent becomes deceased, disabled, or retired, it will impact the adult child’s benefits. “Disabled adult child” benefits will be triggered. Seek out benefits counseling to learn about what this will mean for your family. Additionally, notify your MCO care coordinator.

Approximate Age: When applicable | Who can help: Family/Guardian, Benefits Counseling Services

Resources: ServiceSource benefits counseling services NC DHHS work incentives and benefits counseling How to qualify for disability benefits

Learn about social security programs such as the Ticket to Work and Benefits Counseling and policies such as Work Incentives (i.e., Student Earned Income Exclusion).

Approximate Age: Age Limit to access Student Earned Income Income Exclusion is 22 | Who can help: Family/Guardian, Benefits Counseling Services

Resources: ServiceSource benefits counseling services NC DHHS work incentives and benefits counseling

If receiving multiple benefits from multiple funding streams (i.e., Medicaid AND SSI, SSI and Section 8), seek out benefits counseling and counseling from your SSI case manager to learn how these interact with each other and prevent losing your benefits.

Approximate Age: When applicable | Who can help: Family/Guardian, Benefits Counseling Services

Resources: ServiceSource benefits counseling services NC DHHS work incentives and benefits counseling

Financial Well-being

Teaching individuals skills that further their economic self-sufficiency and ability to control personal finances is vital to their success as adults. Learning with practice needs to start as early as possible. Families play an important role in financial planning for the future.

Acronym Key: PASS = Plan for Achieving Self Support | ABLE = Achieving a Better Life Experience

Managing money

Consider strategies for practicing earning and using money, for example: an allowance for doing chores or a simple neighborhood “job” such as walking a neighbor’s dog or helping to clean in a neighbor’s yard.

Approximate Age: As early as possible & ongoing | Who can help: Individual, Family/Guardian

Resources: Teaching money management

Learn about budgeting and “needs versus wants” as this fits for different ages. Learn how goals work with budgeting.

Approximate Age: As early as possible & ongoing | Who can help: Individual, Family/Guardian, School/IEP Team

Resources: Money management lessons Financial toolkit

Explore options with your bank (e.g., joint bank account) to learn about money and money management.

Approximate Age: As early as possible & ongoing | Who can help: Individual, Family/Guardian

Resources: Your money, your goals Lesson materials on money management

Learn about money safety, how to spot scams, and how to say “no” to requests for money (when needed).

Approximate Age: As early as possible & ongoing | Who can help: Individual, Family/Guardian

Resources: Avoiding identity theft Beware of scams

Consider estate planning, living trusts, and special needs trusts. Seek out a lawyer who specializes in special needs trusts.

Approximate Age: As early as possible & ongoing | Who can help: Family/Guardian, Lawyer

Resources: Special needs trust Fideicomiso para necesidades especiales Living trust Fideicomiso en vida

Consider estate planning, living trusts, and special needs trusts. Seek out a lawyer who specializes in special needs trusts.

Approximate Age: As early as possible & ongoing | Who can help: Family/Guardian, Lawyer

Resources: Special needs trust Fideicomiso para necesidades especiales Living trust Fideicomiso en vida

Write a letter of intent for your special needs trust.

Approximate Age: As early as possible | Who can help: Family/Guardian, Lawyer

Resources: Letter of intent planning guide Special needs letter of intent

Revisit your will.

Approximate Age: Every 8 years | Who can help: Family/Guardian, Lawyer

Learn about Financial Wellness. What does this mean?, What does it look like for individuals with disabilities?

Approximate Age: Middle school & ongoing | Who can help: Individual, Family/Guardian, School/IEP Team

Resources: Financial wellness video series Videos en Español

Consider obtaining a debit card and/or credit card, with safeguarding strategies and monitoring as needed (i.e., prepaid cards, spending limits).

Approximate Age: Middle to high school | Who can help: Individual, Family/Guardian

Resources: Green light debit card Comparison Chart of Types of Cards to use for Purchases

Learn about paying taxes.

Approximate Age: High school | Who can help: Individual, Family/Guardian

Resources: Taxes and tax preparation assistance

Ask about including financial well-being goals in transition plan portion of IEP.

Approximate Age: High school | Who can help: Individual, Family/Guardian, School/IEP Team

Resources: STAR goal setting worksheet

Explore online money management tools.

Approximate Age: High school | Who can help: Individual, Family/Guardian

Resources: Online money management tools 10 questions to ask when selecting an online money management tool

Accessing Financial Support

Seek out benefits counseling services.

Approximate Age: As early as possible | Who can help: Individual, Family/Guardian, Benefits Counseling Services

Resources: NC DHHS work incentives and benefits counseling ServiceSource benefits counseling Disability benefits counseling services

Learn about financial rights for individuals with disabilities.

Approximate Age: Middle school | Who can help: Benefits Counseling Services, Attorneys, Local Banks

Resources: Financial inclusion 101 Financial wellness training webinar

Figure out the areas in which support is needed by taking a financial well-being assessment.

Approximate Age: 16 | Who can help: Individual, Family/Guardian

Resources: Financial well being assessment

Determine the need for government-based financial support (Supplemental Security Income, Social Security Disability Insurance, Medicaid, Medicare). See Adult Services action plan for more details.

Approximate Age: 16 | Who can help: Individual, Family/Guardian

Resources: Adult services action plan

Consider establishing a Representative Payee for Social Security Benefits/Medicaid/Medicare, if appropriate.

Approximate Age: 18 | Who can help: Individual, Social Security Administration (SSA) Representative, Benefits Counselor, Attorney

Resources: FAQ for representative payees Social security benefits rep payee program

Consider other sources of Income and Savings: Savings Accounts, PASS Accounts, Individual Development Accounts.

Approximate Age: High school | Who can help: Individual, Family/Guardian, Social Security Administration (SSA) Representative, Benefits Counselor

Resources: Comparison chart of checking, savings, and ABLE account Examples of types of accounts to keep your money safe Plan to Achieve Self Support

Contact NC financial assistance programs such as First in Families, Temporary Assistance for Needy Families, community colleges, and religious organizations.

Approximate Age: When needed | Who can help: Individual, Family/Guardian

Resources: Assistance programs in NC First in families NC

Transportation

Transportation is a key barrier to employment and community participation for many individuals with disabilities. Accessible transportation options, like paratransit and public transit, can help break down these barriers and offer a gateway to opportunity and adventure in adulthood.

Acronym Key: EIPD = Division of Employment and Independence for People with Disabilities

Finding ways to get around

Explore Work Together NC’s library of transportation options and services.

Approximate Age: As early as possible and ongoing | Who can help: Individual and Family

Resources: WTNC transportation service library

Review Work Together NC’s guide to transportation options for people with IDD in NC.

Approximate Age: As early as possible and ongoing | Who can help: Individual and Family, School/IEP Team

Resources: WTNC’s guide to transportation services, programs, and solutions

Practice community safety skills (i.e., identifying signs, using crosswalks, being aware, etc.).

Approximate Age: As early as possible and ongoing | Who can help: Individual and Family, School/IEP Team

Resources: Courses for parents to teach community safety skills Community signs

Practice using Google Maps or other map apps.

Approximate Age: Middle school and ongoing | Who can help:

Resources: Google Maps

Explore/practice transportation options (public, paratransit, uber/lyft). Consider factors such as cost, safety, and level of support needed.

Approximate Age: As early as possible and ongoing | Who can help: Individual and Family, School/IEP Team, Community agencies, EIPD Counselor

Resources: Paratransit FAQ

Obtain driver’s training and license, if appropriate.

Approximate Age: 15 or later | Who can help: Individual, Family, and Community Agencies

Resources: Official NCDMV: Online Services

Ask your EIPD counselor about funding for a driver assessment and training.

Approximate Age: 15 or later | Who can help: Individual, Family, EIPD Counselor

Ask about including transportation goals in transition plan portion of IEP.

Approximate Age: High school | Who can help: Individual and Family, School/IEP Team

Using public or paratransit

If interested in public transit, download apps for your local area.

Approximate Age: As early as possible and ongoing | Who can help: Individual with help of others

Create a personal transportation plan, including your chosen mode(s) of transportation and any “Plan B”/back up plan options.

Approximate Age: As early as possible and ongoing | Who can help: Individual and Family

If appropriate, apply for paratransit.

Approximate Age: 15 | Who can help: Individual and Family with support from School/IEP Team/Transition Facilitator and Community Agencies

Resources: Your rights and responsibilities for paratransit

Utilize the toolkits and instructional videos in the transportation section Work Together NC’s resource library.

Approximate Age: Starting at age 15 | Who can help: Individual, Family, and School

Resources: Transportation resources Transportation Toolkit

Seek out public or paratransit training, ideally through a peer mentorship model. The transportation section of Work Together NC’s service library lists several transit training programs designed for people with IDD.

Approximate Age: 16 | Who can help: Individual, Family, Community Agencies

Resources: WTNC transportation service library

IEP

When the youth with an IEP turns 16 years of age they will actively engage in individualized transition planning. This process helps youth learn about themselves, make decisions, set goals, and interact with their IEP team to identify objectives and activities.

Items to include in the IEP

Develop parents’/student’s vision for future (after high school).

Approximate Age: Age 16 (state required) Age 11-14 (best practice) K-6 (recommended) | Who can help: Individual, Family/Guardian, School/IEP Team

Resources: I’m Determined

Complete age-appropriate transition assessments which help identify needs, preferences, and interests for post-school goals.

Approximate Age: Age 16 (state required) Age 11-14 (best practice) K-6 (recommended) | Who can help: School/IEP Team

Resources: Indiana Secondary Transition Resource Center

Develop the secondary transition goals on the IEP (education/training, employment, and independent living).

Approximate Age: Age 16 (state required) Age 11-14 (best practice) K-6 (recommended) | Who can help: Individual, Family/Guardian, School/IEP Team, EIPD

Resources: Overview of Transition section of IEP (DPI)

Determine transition activities and instruction needed to reach secondary transition goals. At minimum, 1 measurable annual goal should be related to a transition goal.

Approximate Age: Age 16 (state required) Age 11-14 (best practice) K-6 (recommended) | Who can help: Individual, Family/Guardian, School/IEP Team, EIPD

Resources: Pre employment transition services Path to Adulthood – Secondary Transition to North Carolina

Outline accommodations and modifications required for student to access their education.

Approximate Age: K-12 | Who can help: Student, Family/ School/IEP Team

Resources: Neurodivergent affirming IEP accommodations Adaptations and modifications Ultimate list of IEP accommodations

If applicable, identify related services and service delivery frequency (SLP, OT, PT, etc).

Approximate Age: K-12 | Who can help: Student, Family/ School/IEP Team

Resources: Transitions for children/youth: how OT can help School based PT best practice resources

IEP Meeting Considerations

Student should be invited and encouraged to attend IEP meetings (regardless of their Course of Study). Student should be supported to express their interests, needs, and goals for the IEP. Best practice is to prepare the student before the IEP meetings.

Approximate Age: K-12 (best practice) | Who can help: Individual, Family/Guardian, School/IEP Team

Resources: 10 ways to involve young adults in their IEP meetings

Review course of study options (i.e., certificate versus diploma pathways) to ensure best fit. Present levels and assessment data should inform this decision. *Note once student is in a course of study, changing it happens in unique circumstances. There are implications for graduation timelines.

Approximate Age: Age 11-14 (before high school) | Who can help: Individual, Family,/Guardian School/IEP Team

Resources: DPI High school graduation requirements Heading to HS: choosing a course of study

Attend IEP meetings and discuss transition goals and services.

Approximate Age: Age 16 (state required) Age 11-14 (best practice) k-6 (recommended) | Who can help: Individual, Family/Guardian,School/IEP Team, EIPD

Resources: Transition goals in the IEP

A representative from any agency likely to be responsible for providing/paying for transition services can attend IEP meeting(s) with parent consent (if student is not 18 already).

Approximate Age: K-12 | Who can help: Individual, Family/Guardian, School/IEP Team, EIPD, Managed Care Organization

Discuss transfer of rights one year prior to 18, when rights to make decisions for the IEP will fully transfer to the student (unless alternatives to guardianship have been established).

Approximate Age: Age 17 | Who can help: Individual, Family/Guardian, School/IEP Team, EIPD

Resources: DRNC Guardianship Info

Discuss progress towards graduation requirements. This includes IEP goals.

Approximate Age: As early as possible & ongoing | Who can help: Individual Family/Guardian, School/IEP Team

Discuss desired age of exit (18, 19, 20, 21 or year of 22nd birthday) based on the student’s progress and goals. Note, anyone with an IEP can advocate for extended time in school after turning 18. *Note: FRC and OCS students who choose to exit at year 5 (i.e., instead of year 4) will need to follow district policy for graduation requirements. Specific pacing of scheduling core courses will be necessary for student to be enrolled.

Approximate Age: Throughout high school | Who can help: Individual, Family/Guardian, School/IEP Team

Resources: When your child with an IEP turns 18: Your parental rights (understood.org)

IEP Team should refer the student to get evaluated for adult services through the NC Division of Employment and Independence for People with Disabilities. *Note: Evaluation for EIPD adult services could risk in school EIPD services if the student is deemed ineligible for “competitive integrated employment”.

Approximate Age: FRC/OCS – Age 17-18 AC: Age 21 | Who can help: School, EIPD, Family/Guardian

Resources: Transition Planning – DRNC (disabilityrightsnc.org)

During the re-evaluation cycle (required every 3 yrs), the IEP team should discuss the need for specific evaluations necessary for enrollment in adult services (i.e., EIPD, Medicaid–see Healthcare Checklist, SSI, SSDI and postsecondary education–see PSE–Postsecondary Education and Adult Services Checklists).

Approximate Age: K-12 | Who can help: School/IEP Team

Resources: WTNC adult services action plan

Other supports for transition planning, outside of school based services

Explore Work Together NC’s library of transition planning services.

Approximate Age: As early as possible | Who can help: Individual, Family/Guardian

Resources: WTNC transition planning services library

Contact the Exceptional Children’s Assistance Center for help understanding and advocating for your rights within the school system.

Approximate Age: When needed | Who can help: Individual, Family/Guardian

Resources: ECAC Parent Center A Parents’ Guide to Special Education in North Carolina | Children’s Law Clinic Resources (duke.edu)

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Disclaimer: These action plans are for informational purposes only. It is not intended to be comprehensive, and should not be taken as legal advice. Services and programs mentioned may vary by county. Please consult with professionals with expertise in this topic area for guidance specific to you, your family or student/client’s situation. The “approximate age” listed with each item is a general recommendation for when to get started on an action item; however, everyone has a different timeline and for many of the items, it’s never too late to take action! Have a suggested correction or addition to this checklist? Email worktogethernc@med.unc.edu.