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(c)In this section, an individual is “functionally disabled” if the individual— (A) is unable to perform without substantial assistance from another individual at least 2 of the following 3 activities of daily living: toileting, transferring, and eating; or (B) has a primary or secondary diagnosis of Alzheimer’s disease and is (i) unable to perform without substantial human assistance (including verbal reminding or physical cueing) or supervision at least 2 of the following 5 activities of daily living: bathing, dressing, toileting, transferring, and eating; or (ii) cognitively impaired so as to require substantial supervision from another individual because he or she engages in inappropriate behaviors that pose serious health or safety hazards to himself or herself or others.

(2)If a State has elected to provide home and community care under this section, upon the request of an individual who is 65 years of age or older and who meets the requirements of subsection (b)(1)(C) (or another person on such individual’s behalf), the State shall provide for a comprehensive functional assessment under this subparagraph which— (i) is used to determine whether or not the individual is functionally disabled, (ii) is based on a uniform minimum data set specified by the Secretary under subparagraph (C)(i), and (iii) uses an instrument which has been specified by the State under subparagraph (B). (B) The State shall specify the instrument to be used in the State in complying with the requirement of subparagraph (A)(iii) which instrument shall be— (i) one of the instruments designated under subparagraph (C)(ii); or (ii) an instrument which the Secretary has approved as being consistent with the minimum data set of core elements, common definitions, and utilization guidelines specified by the Secretary in subparagraph (C)(i).

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(D) An assessment under subparagraph (A) and a review under subparagraph (D) must be conducted by an interdisciplinary team designated by the State.In this title, the term “home and community care” means one or more of the following services furnished to an individual who has been determined, after an assessment under subsection (c), to be a functionally disabled elderly individual, furnished in accordance with an individual community care plan (established and periodically reviewed and revised by a qualified community care case manager under subsection (d)): (1) Homemaker/home health aide services. (9) Such other home and community-based services (other than room and board) as the Secretary may approve. (4) Nursing care services provided by, or under the supervision of, a registered nurse. (6) Training for family members in managing the individual. (8) In the case of an individual with chronic mental illness, day treatment or other partial hospitalization, psychosocial rehabilitation services, and clinic services (whether or not furnished in a facility).The defendant may contest the default in his or her home state.Service of process must be distinguished from service of subsequent documents (such as pleadings and motion papers) between the parties to litigation.




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