THE SECRETARY OF VETERANS AFFAIRS
WASHINGTON

March 23, 2020

United States Senate
Washington, DC 20510
Dear Senator:
We have received many Congressional inquiries regarding the Department of
Veterans Affairs (VA) fourth mission and the process for requesting VA support
attendant with that mission. I write to clarify these matters.
VA is prepared to take on our fourth mission of assisting certain non-VA health
care systems and communities if they reach their full capacity to care for patients.
However, there is a formal process for requesting VA fourth mission and other Federal
support.
America’s response to the coronavirus (COVID-19) outbreak is one that is
federally supported, state managed, and locally executed. As such, requests for all
Federal support should come from the states when they have determined that the
maximum capacity of intrastate or interstate resources have been exhausted.
In that event, states may request assistance from the Federal Government
through their local Department of Health and Human Services (HHS) Regional
Emergency Coordinator (REC), as part of the Federal Emergency Management Agency
(FEMA) National Response Coordination Center. Counties, cities, and other
municipalities should route all requests for Federal support through their respective
states.
FEMA is now leading Federal operations on behalf of the White House
Coronavirus Task Force, which oversees the whole-of-Government response to the
COVID-19 pandemic, and HHS is now integrated into FEMA’s National Response
Coordination Center.
VA cannot receive direct requests for assistance from state and local
governments. The established central coordination function of FEMA and HHS will
ensure that an integrated and effective response is provided to those communities that
need assistance the most; but that assistance is dependent upon the availability of
resources and funding, and consistency with VA’s mission to provide priority services to
Veterans.

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VA has defined roles in both the National Disaster Medical System and the
National Response Framework in the event of national emergencies. Our COVID-19
emergency preparedness exercises began weeks before the first case was confirmed in
the United States, and VA has plans in place to protect everyone who gets care, visits,
or works at one of our facilities.
VA has taken a number of significant steps over the past few weeks to maximize
capacity and resources so that the Department will be ready if called upon by FEMA
and HHS to provide assistance to select non-VA health care systems and communities.
These steps include the following:
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Maximizing the use of telehealth and virtual care for routine appointments;
Canceling elective surgeries; and
Pre-screening all patients and visitors for COVID-19 symptoms before they enter
VA facilities.

We ask for your assistance in encouraging non-VA medical facilities in your
states and districts to take similar steps in order to ensure local health care systems are
best equipped to help stop the spread of COVID-19, and to handle as many COVID-19
patients as possible.
To request Federal Government assistance, please contact your State’s HHS
REC at https://www.phe.gov/Preparedness/responders/rec/Pages/default.aspx. More
information on VA’s COVID-19 response activities, updates can be found at
https://www.publichealth.va.gov/n-coronavirus.
Sincerely,

Robert L. Wilkie