With advances in medical care, children with chronic medical conditions are living longer lives. They, their families, and their health care professionals are faced with new challenges: transition from pediatric care into adult medical care and meeting the vocational, educational, and other social needs to make this transition of children and youth with special health care needs successful. This article identifies problems and proposed solutions to start to make this transition more successful, including the results of working meetings of representatives from Texas, Oklahoma, New Mexico, and Arkansas.