Faleomavaega Eni Faʻauaʻa Hunkin VA Clinic

American Samoa has one VA community-based outpatient clinic, no VA medical center, and one Vet Center. That is the whole VA footprint on the island, and knowing its shape saves a lot of wasted travel. The clinic is the Faleomavaega Eni Faʻauaʻa Hunkin VA Clinic, named by act of Congress for the territory's longtime delegate. It sits in the Fiatele Teo Army Reserve Building in Pago Pago and is open Monday through Friday, 7:30 a.m. to 4:00 p.m. What it offers on site: primary care, an advice nurse, geriatrics, laboratory and pathology, a My HealtheVet coordinator, patient advocates, telehealth, and women veteran care. VA Pacific Islands Health Care System announced in January 2025 that it was expanding the mental health clinic and adding specialty care and laboratory services in American Samoa, saying the expansion "will help deliver more care directly to Veterans in American Samoa, reducing the need for travel to Oahu and the mainland United States." What it does not offer is most specialty care. The Government Accountability Office put it plainly in 2024: specialty care available at the outpatient clinics in American Samoa, Guam, and the Northern Mariana Islands is limited, and specialty care from VA providers is generally delivered by telehealth, by providers travelling from other VA Pacific Islands facilities, or by referring the veteran to the Honolulu VA medical center. There is a second thing worth understanding about Honolulu. The VA medical center there has no inpatient hospital. VA Pacific Islands meets that gap through resource sharing agreements with the Defense Department, chiefly Tripler Army Medical Center next door in Honolulu and U.S. Naval Hospital Guam. So a referral off American Samoa can land you at a military treatment facility rather than a VA hospital, and that is normal rather than a mistake. Community care is coordinated from Honolulu. Staff at the Honolulu VA medical center handle referrals for veterans living in American Samoa, Guam, and the Northern Mariana Islands through VA's Community Care Network Region 4. In fiscal year 2023 that office completed 85,598 primary, mental health, and specialty care referrals to community providers, 6,681 referrals to Tripler, and 1,622 to Naval Hospital Guam. The cost of getting to any of it is the real constraint, and it has its own entry here on beneficiary travel. Read that one before you accept a referral off island. Separately, and not a veterans benefit: the territory runs its own Off-Island Medical Referral Program through the LBJ Tropical Medical Center, funded in part by the two percent wage tax at Code 11.0607, which directs half the accumulated proceeds to LBJ operations and half to a special account used to support that referral program. A working veteran in American Samoa pays into that program through the wage tax whether or not they use VA. It is worth asking the American Samoa Government Office of Veterans and Military Affairs how the two referral routes interact in a specific case. Enrollment is the ordinary VA health care enrollment; there is no separate American Samoa application. VA Pacific Islands reported roughly 7,200 enrolled veterans across its three territorial outpatient clinics in fiscal year 2023, out of 57,195 enrolled with the system overall.