What is HCBS?

Home and Community-Based Services (HCBS) are health and personal-care services delivered in someone’s home or local community — instead of in a hospital or nursing facility. They can include personal care, home nursing visits, respite for family caregivers, durable medical equipment, home modifications such as ramps or grab bars, and transportation to medical appointments.

Family Centered Care

In American Samoa, the home is already where most long-term care happens, and family members are already the primary caregivers. In the Samoan way of life (Fa’aSamoa), the ‘aiga is one — we care for our elders and loved ones because they belong to us. But love alone cannot pay for a wheelchair ramp, train a caregiver, or replace income lost when someone leaves a job to provide care. HCBS is how Medicaid can help share that work.

Why HCBS matters

Part of the Commission’s job is to recommend the Medicaid policy changes needed so these services can be offered and paid for here. This work is supported by the federal Money Follows the Person (MFP) initiative, which helps shift long-term care toward home and community settings. The Medicaid State Agency retains sole authority over all final State Plan decisions.