Dear Editor,

EPIC extends our deepest thanks to Keniseli Lafaele for his thoughtful advocacy and clearly articulated concerns regarding the importance of preserving American Samoa’s Medicaid local match. His points underscore how directly this funding affects access to healthcare for elderly residents, adults with disabilities, medically fragile individuals, and low-income families.

EPIC opened American Samoa’s first community-based Adult Day Services site in Vailoa on April 14, 2026, with capacity to serve up to 10 elderly adults and/or adults with disabilities, with sites in Amouli and Tualauta to follow. We also have a team of 16–18 HCBS caregivers providing in-home support to families across the island. We maintain an extensive list of individuals who need these services but cannot afford private fees.

Medicaid is the primary payer for long-term care services and supports for low-income families throughout the country. For that reason, I was shocked and deeply disappointed when the Medicaid Director informed EPIC that the office could not enroll additional Personal Care and Home Health providers, despite CMS approval of these services.

CMS approval should lead to actual access—not an approved benefit that exists only on paper. Preserving and properly allocating the local match is essential to protecting healthcare access for our most vulnerable community members and to allowing qualified community providers to respond to urgent needs.

Thank you again, Keniseli, for speaking clearly on behalf of families who need these services. Your advocacy is deeply appreciated.

Respectfully,
Kathryn McCutchan
Executive Director / Project Director
Empowering Pacific Island Communities