This report presents the findings of a study which examined the service delivery system for adolescents with chronic illness, through a survey of 248 directors of public agencies and programs of the 50 states and the District of Columbia, with a 73 percent response rate. The seven programs surveyed within each state were Maternal and Child Health Programs, Children with Special Health Care Needs Programs, Adolescent Health Coordinators, Departments of Special Education, Mental Retardation/Developmental Disabilities Programs, Developmental Disabilities Councils, and Vocational Rehabilitation Services. Study findings are analyzed in terms of which services are currently available to adolescents, which programs are emphasized, which agencies should provide services to adolescents with chronic illness or disability, identification of major issues, and preparation for the future. Key findings include: (1) adolescents are not considered a priority either for funding or programming; (2) specialty medical services appear to be universally available but primary health care and psychosocial and health promotion services are not; and (3) the three most important factors limiting successful transition to adulthood were insufficient transition planning, transportation/location of service, and vocational training. Seven policy recommendations are offered. (JDD)