; or (B) a skilled nursing facility as defined in section 1819(a) of such Act ( 42 U.S.C. 1395i–3(a) ). (31) Older individual The term older individual has the meaning given the term in section 102 of the Older Americans Act of 1965 ( 42 U.S.C. 3002 ). (32) Personal or home care aide (A) In general The term personal or home care aide means an individual who helps older individuals and people with serious illness, physical disability, cognitive impairment (including Alzheimer’s disease or other dementias, a developmental disability, or another disability involving a mental impairment) to live in their own home or a residential care facility (such as a nursing home, assisted living facility, or any other facility the Secretary of Health and Human Services determines appropriate that is not described in subparagraph (B)(i)) by providing personal care services for compensation. (B) Personal care services For purposes of subparagraph (A), the term personal care services means assistance or services— (i) provided to an individual who is not an inpatient or resident of a hospital or institution for mental disease; and (ii) that enable the recipient to accomplish activities of daily living or instrumental activities of daily living. (33) Secondary school The term secondary school has the meaning given such term in section 8101 of the Elementary and Secondary Education Act of 1965 ( 20 U.S.C. 7801 ). (34) Self-directed care professional The term self-directed care professional (also known as an independent provider )— (A) means a direct care professional who is employed by an individual who is an older individual, a person with a disability, or a representative of such older individual or person with a disability, and such older individual or person with a disability has the decision-making authority over certain supports and services provided by the direct care professional and takes direct responsibility to manage those supports and services