This renewal incorporates by reference updates to the Waiver for Technology Dependent/Medically Fragile Individuals, effective 07/01/2018. These updates include: the addition of High-flow Nasal Cannula dependence as an equivalent therapy to Bi-level Positive Airway Pressure and Continuous Positive Airway Pressure dependence as a qualifying technology to meet target group criteria; Removal of Family-Directed Support as a distinct service as this support will be provided through the scope of Financial Management Services and Waiver Case Management; and quality improvement performance measures were revised to better align with waiver assurances and sub-assurances.