Provides adult day health, respite, supports coordination, specialized medical equipment and supplies, fiscal intermediary, goods and services, supports brokerage, assistive technology, chore services, community health worker, community living supports, community transportation, counseling, environmental accessibility adaptations, home delivered meals, nursing services, personal emergency response system, private duty nursing/respiratory care, residential services, training, and vehicle modifications services to individuals ages 65 or older and individuals with physical disabilities ages 18-64 years who meet a nursing facility level of care. This waiver operates with a concurrent 1915(b)(1) and 1915(b)(4) authority.