A grant of just over $4.75 million to initiate Home Community Base Services (HCBS) for seniors and, those with disabilities, and other key services has been awarded to the University Center for Excellence in Developmental Disabilities (UCEDD), a program hosted by the American Samoa Community College (ASCC). The Centers for Medicare and Medicaid (CMS) have awarded the funds to UCEDD for a Money Follows the Person (MFP) planning grant. The MFP model supports the initial planning and infrastructure needed to improve availability and access to home and community-based services as an alternative choice to institutional care.

American Samoa currently does not have Home Community-Based Services (HCBS).  The purpose of the MPF grant is to establish a comprehensive roadmap system for eligible individuals receiving Long-Term Support Services (LTSS) and give them the option to transition back into the community rather than remain in an institution.  “The institutionalization may involve disabilities, a need for around-the-clock medical supervision, advanced age without adequate family support, or some other reason,” explained UCEDD State Director Tafa Tua-Tupuola. “The long-term goal of the MFP project is to promote community-based alternatives for these individuals.” Locally, the LTSS designation applies to eligible individuals who have remained at LBJ Tropical Medical Center or Hope Hose for at 60 days or longer. 

Nationally, the MFP demonstration project is an effort to rebalance LTSS systems from institutional to home and community-based care (HCBC). The program provides flexible funding opportunities to help states and territories develop and test the processes, tools, and infrastructure to advance these reforms. “In the US mainland, as well as here in American Samoa, we’ve seen a rise in the number of individuals entering institutions for the care they need,” reflected Tua-Tupuola. “This increase places stress upon these institutions. At the same time, many of those institutionalized would prefer a more community-based environment if it were available. With the MFP grant, we will begin the process of making HCBS an option here in the Territory. It’s a collaborative process that needs to involve community stakeholders who would also like to see HCBS become a reality here in the Territory.”

The period of performance for the project will run through September 30, 2026. Tua-Tupuola explained that the local MFP project will begin with lead to the development of a GAP Analysis and the development of a comprehensive road map during its first and second years.  During this initial stage, an HCBS committee will be established to assist in the design of the project system.  Data collected will determine planning needs and capacity-building activities for years two to three.  Capacity-building may include activities to support home health care; nursing care; physical, speech, and occupational therapies; and dietary management. The project is expected to be fully implemented by its third through the fifth year.  

According to Tua-Tupuola, UCEDD itself will not provide specific services.  Rather, it will connect the individual needs to the services available in the community such as Independent Living and other home health care services, to enable smooth transitions for eligible beneficiaries. Services and infrastructure that do not currently exist to support HCBS must be identified and added to the agenda of capacity-building.  “With the individuals, we hope to assist, every case will be different and must be responded to according to the person's needs,” said Tua-Tupuola.  The project will collaborate with the Department of Commerce Emergency Rental Assistance Program to assist with housing.  The MFP can cover temporary food security, housing assistance, and home modification if necessary.  The terms of the grant stipulate that any support cannot exceed 365 days.

Tua-Tupuola emphasized that with the development of HCBS in American Samoa will come opportunities for those trained in the health care field, as well as individuals interested in creating a space where qualified HCBS can be provided. With the MFP project still in its very early stages, more information on its progress will be forthcoming as the time for community involvement approaches. “At the moment, there are no services being offered,” said Tua-Tupuola, “but in the coming months, we will be forming committees and seeking to fill the key organizational positions that go with this project. In the meantime, I want to express my gratitude to our many community partners who also believe in the necessity and value of a project like this, and to ASCC and its president Dr. Rosevonne Pato for their support of UCEDD.”

To find out more about UCEDD and its many activities, visit its Facebook page at: https://www.facebook.com/UCEDDAmericanSamoa.