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?

To create a custom action plan, select the items below that are relevant to you or someone you support. To get to the next page of the form, select previous or next at the bottom of the page. The last page of the form will allow you to add additional action plan items if needed.

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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

Explore Work Together NC’s library of healthcare services

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

Resources: Healthcare/Mental Health Services

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

Approximate Age: 12-13 | Who can help: Individual and Family/Guardian

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 and with the doctor.

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

Resources: Pediatric to Adult Health Care Transition

Provide the individual with their own health insurance card.

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

Consider acquiring a medical information ID card for emergencies

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

Learn more about your health and what to do in case of an emergency.

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

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

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

Approximate Age: 13 | Who can help: Individual, family/guardian, and MCO

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

Approximate Age: 18 | Who can help: Individual

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

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

Consider applying for Medicaid

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

Resources: Medicaid

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 (i.e., 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

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

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: Advocacy Assistance

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/Mental Health Services

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

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

Complete a needs assessment with your managed care organization

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

Resources: NC-SNAP

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

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

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

Getting documents in order

Acquire a state identification card at the DMV

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

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

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

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

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

Navigating NC Medicaid

Establish residency in NC

Approximate Age: N/A | Who can help: Individual and guardian/family

Apply for Medicaid. Consider submitting an appeal if denied.

Approximate Age: As early as possible | Who can help: Individual and guardian/family

Resources: NC Medicaid

Contact your local managed care organization (MCO) to assess the child’s eligibility for servicesr. 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

Resources: Intellectual and Developmental Disabilities, 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. [see Adult Services checklist for information]

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

Resources: Accessing Intellectual and Developmental Disabilities Services

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

Resources: Community Alternatives Program Referral Process

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

Re-contact your care coordinator/MCO to check your child’s status on the waitlist (If applicable) and share any updated medical or behavioral changes

Approximate Age: Annually | Who can help: Individual and guardian/family ” target=”_blank”>

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 Standard Plan, Medicaid Direct and Tailored Plan, NC Medicaid Division of Heath Benefits, 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: Wellness Visits, and Diagnostic and Treatment Services

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:

Resources: NC Medicaid Obtains Approval of the 1915(i) State Plan Amendment, 1915(i) Services Start July 1

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

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

Resources: 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.

Who can help: Individual, Family/Guardian

Navigating Social Security

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

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

Resources: Social Security Office Locator

Become familiar with SSI and the application process.

Approximate Age: 16 | Who can help: Transition Facilitator/IEP Team, Family/Guardian

Resources: Supplemental Security Income (SSI)

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

Resources: Social Security Office Locator, Disability Benefits

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

Resources: Treatment of Married Couples in the SSI Program

Learn about resource/asset limits and consider opening an ABLE account. Seek out benefits counseling through Service Source 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: About ABLE Accounts, 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: North Carolina Benefits Counseling Services, Work Incentives and Benefits Counseling

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: North Carolina Benefits Counseling Services, 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: North Carolina Benefits Counseling Services, 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

Learn about money: why is it important, how does it work?, What do typical items cost?, How do you get money?, How do you pay for items?

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

Resources: broken link, Financial Wellness Tools

Consider strategies for practicing use of money: an allowance for doing chores, starting with a simple neighboorhood “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: How to Teach Money Management for Independent Living with Autism

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

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

Resources: New money management lessons for adults with disabilities – MI Money Health, Financial Wellness Tools

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

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

Resources: Your Money, Your Goals Focus on People with Disabilities

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

Approximate Age: 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 Financial Wellness. What does this mean? What does it look like for individuals with disabilities?

Resources: Meet the Faces of Financial Wellness – National Disability Institute, Videos con Subtitulos en Español

Learn about money safety, how to say spot scams and how to say “no” to requests for money

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

Resources: Identity Theft & Scams, Beware of Scams – MI Money Health (msu.edu)

Consider opening an ABLE account.

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

Resources: ABLE Resource Center, ABLE Accounts, Cuentas ABLE

Consider estate planning, living trust and special needs trust. Seek out a lawyer that 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

Revisit your will

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

Write a letter of intent for your special needs trust

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

Learn about paying taxes

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

Resources: Taxes & Tax Preparation – National Disability Institute

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

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

Resources: STAR Goal Setting Worksheet

Explore online money management tools.

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

Resources: Top Picks for Online Money Management Tools & Online Financial Education Games

Accessing Financial Support

Learn about finanical rights for individuals with disabilities. Advocate for policies to improve Financial Inclusion

Resources: Blog: Financial Inclusion 101 – National Disability Institute

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

Approximate Age: 16Individual and family/guardian

Resources: Financial Well-Being Assessment

Determine the need for 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 and family/guardian

Seek out benefits counseling services

Approximate Age: As early as possible

Resources: Work Incentives and Benefits Counseling, VR Benefits Counseling Services for SSI/SSDI beneficiaries, Disability Benefits Counseling Services

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

Approximate Age: 18 | Who can help: Individual

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

Approximate Age: High school | Who can help: Individual and family/guardian

Resources: PASS = Plan for Achieving Self SupportComparison Chart of Checking, Savings and ABLE Accounts, Examples of types of accounts to keep your money safe

Contact NC financial assistance programs such as First in Families, Temporary Assistance for Needy Families, Community colleges, Religious organizations

Approximate Age: When needed | Who can help: Individual and family/guardian

Resources: Financial assistance programs North Carolina., First In Families of North Carolina

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: VR = Vocational Rehabilitation

Finding ways to get around

Explore Work Together NC’s database of transportation options and services

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

Resources: Transportation Services

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, family, and school

Practice using Google Maps or other map apps

Approximate Age: As early as possible and ongoing | Who can help: Individual, family, and school

Obtain driver’s training and license, if appropriate.

Approximate Age: 15 or later | Who can help: Individual, family, and community agencies

Explore/practice other 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 with help of others

Resources: Paratransit: FAQ

Ask about including transportation goals in transition plan portion of IEP

Approximate Age: High school | Who can help: Individual and family

Ask your Vocational Rehabilitation counselor about funding for a driver assessment and training

Approximate Age: 15 or later | Who can help: Individual, family, VR counselor

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 contingencies (have a plan B/backup plan – plainer language than saying contingencies)

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, family with support from school/transition facilitator and community agencies

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: Transportation Services

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

Approximate Age: 15 | Who can help: Individual, family, and school

Resources: Transportation Resources Transportation Toolkit

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 parent/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: Student, Family, School/IEP Team

Resources: I’m Determined

Complete age-appropriate transition assessments that help identify needs, preferences, 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: Student, family, school/IEP Team, vocational rehab

Resources: Overview of Transition section 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, school/IEP Team, vocational rehab

Resources: Pre-Employment Transition Services

Outline accommodations and modifications required for student to access their education

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

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

Approximate Age: K-12 | Who can help: IEP team

IEP Meeting Considerations

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

Approximate Age: k-12 best practice | Who can help: student, 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.

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

Resources: High School Graduation Requirements

Note: *once student is in a course of study, changing it happens in unique circumstances. There are implictions for graduation timelines.

Attend IEP meeting 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, school/IEP Team, vocational rehab

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

Approximate Age: K-12 | Who can help: Individual, family, school/IEP Team, vocational rehab, managed care organization

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

Approximate Age: Age 17 | Who can help: Individual, family, school/IEP Team, vocational rehab

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, School/IEP Team

Discuss desired age of exit (18, 19, 20, 21 or year of 22nd birthday) based on the students’ progress and goals. Note, anyone with an IEP can advocate for extended time in school after turning 18.

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

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.

IEP Team should refer the individual to get evaluated for VR adult services

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

Note: Evaluation for VR adult services could risk in school VR services if student is deemed ineligible for “competitive integrated employment”

During the re-evaluation cycle (required every 3 yrs), team should discuss need for specific evaluations necessary for enrollment in adult services (i.e. VR, Medicaid (Home & Community Based Services), SSI, SSDI) and postsecondary education (see postsecondary education and adult services checklist)

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

What other supports are available 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

Resources: Transition Planning Services

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: Family

Resources: Exceptional Children’s Assistance Center

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Disclaimer: This checklist is 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. Have a suggested correction or addition to this checklist? Email worktogethernc@med.unc.edu.