Title II, SEC. 2103. INDIVIDUALS WITH DISABILITIES DEFINED. 
      (a) In General. In this subpart, the term ``individual with 
    disabilities'' means any individual within one or more of the following 4 
    categories of individuals: 

        (1) Individuals requiring help with activities of daily living. An 
      individual of any age who 

          (A) requires hands-on or standby assistance, supervision, or cueing 
        (as defined in regulations) to perform three or more activities of 
        daily living (as defined in subsection (c)), and 

          (B) is expected to require such assistance, supervision, or cueing 
        over a period of at least 100 days. 

        (2) Individuals with severe cognitive or mental impairment. An 
      individual of any age 

          (A) whose score, on a standard mental status protocol (or protocols) 
        appropriate for measuring the individual's particular condition 
        specified by the Secretary, indicates either severe cognitive 
        impairment or severe mental impairment, or both; 

          (B) who 

            (i) requires hands-on or standby assistance, supervision, or cueing 
          with one or more activities of daily living, 

            (ii) requires hands-on or standby assistance, supervision, or 
          cueing with at least such instrumental activity (or activities) of 
          daily living related to cognitive or mental impairment as the 
          Secretary specifies, or 

            (iii) displays symptoms of one or more serious behavioral problems 
          (that is on a list of such problems specified by the Secretary) which 
          create a need for supervision to prevent harm to self or others, and 

          (C) whose is expected to meet the requirements of subparagraphs (A) 
        and (B) over a period of at least 100 days. 

        (3) Individuals with severe or profound mental retardation. An 
      individual of any age who has severe or profound mental retardation (as 
      determined according to a protocol specified by the Secretary). 

        (4) Severely disabled children. An individual under 6 years of age who 

          (A) has a severe disability or chronic medical condition, 

          (B) but for receiving personal assistance services or any of the 
        services described in section 2104(d)(1), would require 
        institutionalization in a hospital, nursing facility, or intermediate 
        care facility for the mentally retarded, and 

          (C) is expected to have such disability or condition and require such 
        services over a period of at least 100 days. 

      (b) Determination. 

        (1) In general. The determination of whether an individual is an 
      individual with disabilities shall be made, by persons or entities 
      specified under the State plan, using a uniform protocol consisting of an 
      initial screening and assessment specified by the Secretary. A State may 
      collect additional information, at the time of obtaining information to 
      make such determination, in order to provide for the assessment and plan 
      described in section 2104(b) or for other purposes. The State shall 
      establish a fair hearing process for appeals of such determinations. 

        (2) Periodic reassessment. The determination that an individual is an 
      individual with disabilities shall be considered to be effective under 
      the State plan for a period of not more than 12 months (or for such 
      longer period in such cases as a significant change in an individual's 
      condition that may affect such determination is unlikely). A reassessment 
      shall be made if there is a significant change in an individual's 
      condition that may affect such determination. 

      (c) Activity of Daily Living Defined. In this subpart, the term 
    ``activity of daily living'' means any of the following: eating, toileting, 
    dressing, bathing, and transferring in and out of bed.