PUBLIC LAW 109–365—OCT. 17, 2006
120 STAT. 2525
unable to perform at least 2 activities of daily living without substantial assistance (including verbal reminding, physical cuing, or supervision) and is determined by the State involved to be in need of placement in a long-term care facility. ‘‘(46) The term ‘civic engagement’ means an individual or collective action designed to address a public concern or an unmet human, educational, health care, environmental, or public safety need. ‘‘(47) The term ‘elder justice’— ‘‘(A) used with respect to older individuals, collectively, means efforts to prevent, detect, treat, intervene in, and respond to elder abuse, neglect, and exploitation and to protect older individuals with diminished capacity while maximizing their autonomy; and ‘‘(B) used with respect to an individual who is an older individual, means the recognition of the individual’s rights, including the right to be free of abuse, neglect, and exploitation. ‘‘(48) The term ‘fiduciary’— ‘‘(A) means a person or entity with the legal responsibility— ‘‘(i) to make decisions on behalf of and for the benefit of another person; and ‘‘(ii) to act in good faith and with fairness; and ‘‘(B) includes a trustee, a guardian, a conservator, an executor, an agent under a financial power of attorney or health care power of attorney, or a representative payee. ‘‘(49) The term ‘Hispanic-serving institution’ has the meaning given the term in section 502 of the Higher Education Act of 1965 (20 U.S.C. 1101a). ‘‘(50) The term ‘long-term care’ means any service, care, or item (including an assistive device), including a disease prevention and health promotion service, an in-home service, and a case management service— ‘‘(A) intended to assist individuals in coping with, and to the extent practicable compensate for, a functional impairment in carrying out activities of daily living; ‘‘(B) furnished at home, in a community care setting (including a small community care setting as defined in subsection (g)(1), and a large community care setting as defined in subsection (h)(1), of section 1929 of the Social Security Act (42 U.S.C. 1396t)), or in a long-term care facility; and ‘‘(C) not furnished to prevent, diagnose, treat, or cure a medical disease or condition. ‘‘(51) The term ‘self-directed care’ means an approach to providing services (including programs, benefits, supports, and technology) under this Act intended to assist an individual with activities of daily living, in which— ‘‘(A) such services (including the amount, duration, scope, provider, and location of such services) are planned, budgeted, and purchased under the direction and control of such individual; ‘‘(B) such individual is provided with such information and assistance as are necessary and appropriate to enable such individual to make informed decisions about the individual’s care options;
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