Whether or not they are developmentally ready, when youth with complex health conditions turn 18, they leave familiar pediatric health and social systems and enter adult health services where the providers and systems are markedly different. It feels like falling off a cliff. When these youth enter adult services without adequate preparation, they may experience more health problems and co-morbidities, lose their usual health and social supports and experience social isolation. Using a public health approach, my research is focused on the health and well-being of youth with complex medical conditions to ensure they receive the health care and support they need to achieve their young adult goals that include attending post-secondary education, finding meaningful work or vocation and living independently or with their family and friend.