Provides adult day program, respite, adaptive medical equipment and supplies, fiscal intermediary, individual directed goods and services, assistive technology, chore services, environmental modifications, expanded community living supports, home delivered meals, non-medical transportation, personal emergency response system, preventive nursing services, and private duty nursing services to individuals ages 65 or older and individuals with physical disabilities ages 21-64 years who meet a nursing facility level of care. This waiver operates with a concurrent 1915(b)(1), 1915(b)(2), and 1915(b)(4) authority.