Provides adult daily living, employment skills development, job coaching, personal assistance services, residential habilitation, respite, structured day habilitation, counseling services, home health aide, nursing services, occupational therapy, physical therapy, specialized medical equipment and supplies, speech and language therapy, assistive technology, behavior therapy, benefits counseling, career assessment, chore services, cognitive rehabilitation therapy, community integration, community transition services, home adaptations, home delivered meals, job finding, non-medical transportation, nutritional consultation, participant-directed community supports, participant-directed goods and services, personal emergency response system, pest eradication, telecare, and vehicle modification 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.