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APHA Scientific Session and Event Listing

Carol Murry, DrPH, Social Science Research Institute, University of Hawaii at Manoa, 2424 Maile Way, Room 704, Honolulu, HI 96822, 8089567360, murry@hawaii.edu, D. William Wood, MPH, PhD, Sociology, University of Hawaii at Manoa, 2424 Maile Way, Room 247, Honolulu, HI 96822, Toetasi Fue Tuiteleleapaga, JD, Office of the Governor, Chief Legal Counsel, Government of American Samoa, 3rd Floor, Executive Office Building, Utulei, Pago Pago, 96799, American Samoa, and Pat Galea'I, MA, Office of the Governor, Department of Commerce, Government of American Samoa, 2nd Floor, Executive Office Building, Utulei, Pago Pago, 96799, American Samoa.

As part of a federal planning grant to address health coverage in AS - Coverage for All in American Samoa (CAAS) - University of Hawaii Social Science Research Institute and collaborators are providing research results to guide policy decisions through household survey, qualitative interviews, and economic analyses. CAAS will implement a unique policy planning process involving traditional leaders to develop community-specific plans for integration to a territory-wide plan. Health coverage issues of U.S. territories differ from those of states in that Medicaid reimbursements are capped; however American Samoa (AS) is unique in basing its reimbursement on estimation of the population percentage below federal poverty rate, rather than individual eligibility. Although its coverage is estimated at less than 10%, it has “virtual” universal access to care through government facilities for relatively low fees with essentially no private providers The problem is that AS can no longer afford to support costs of uncompensated services. Moreover, many AS citizens believe they were promised free education and health services at the time of cessation and past attempts to raise fees have engendered vehement opposition from the public and Legislature. Involving traditional leaders to engage their communities in health policy planning provides AS with an ongoing planning capacity and assures inclusion of Samoan traditional values that affect every aspect of life. Having traditional leaders facilitate data collection and planning is a culturally-based solution for American Samoa that may provide a model for other groups who experience disparity in health status, access to care, and coverage.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• List three differences in public coverage options between the territory of American Samoa and their own state.
• Articulate one approach to developing territory or state policy through integration of community-level planning.
• Describe traditional values in American Samoa that affect policy development.

Keywords: Health Insurance, Policy/Policy Development

Presenting author's disclosure statement:

Not Answered