; (ii) during the period that ends on the day before the first day of the first calendar quarter beginning on or after the date that is 5 years after the date of the enactment of this subsection, an individual who, as of such date of enactment, is receiving or has been determined to be eligible for, home and community-based services under this title under a waiver or State plan option in effect under section 1915 or 1115, provided that the individual continues to meet any level of care requirement applicable under such waiver or plan option; or (iii) an individual who is eligible under the State plan or waiver and is under the age of 21. (B) Functional impairment For purposes of subparagraph (A), the term functional impairment means, with respect to an individual the inability of such individual to perform, without assistance— (i) 2 or more activities of daily living (as described in section 7702B(c)(2)(B) of the Internal Revenue Code of 1986); (ii) 2 or more instrumental activities of daily living (as defined for purposes of section 1915(k)(1)(A)); or (iii) 1 activity of daily living (as so described) and 1 instrumental activity of daily living (as so defined). (C) Health care provider State approval For purposes of subparagraph (A)(i), a process described in this subparagraph is a process established by the State to approve health care providers to make determinations described in such subparagraph that meets such standards as the Secretary may prescribe. (4) Individualized assessment (A) In general For purposes of paragraph (1), an individualized assessment described in this paragraph is an independent assessment, with respect to an eligible individual— (i) to determine a necessary level of services and supports to be provided, consistent with an individual’s functional impairments, to facilitate an individual’s community integration, self-determination, and well-being; (ii) to prevent the provision of unnecessary or inappropriate care