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VHA Office of Emergency Management

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Fourth Mission

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VA’s Fourth Mission is to improve the Nation’s preparedness for response to war, terrorism, national emergencies and natural disasters. Actions ensure continued service to Veterans, and support national, state and local emergency management efforts.

VA's Fourth Mission is not a mechanism that is activated or button that is pushed, but rather it is a statutory requirement and commitment sustained daily. The Veterans Health Administration (VHA) Office of Emergency Management (OEM) supports the Fourth Mission through policies, processes, programs and systems providing mission assurance of services while building a culture of preparedness and resilience.

Read VA's Fourth Mission FAQ for more information.

VA's Fourth Mission is accomplished by the following four primary vehicles:

  • VA / DoD contingency: The VA/DoD Health Resources Sharing and Emergency Operation Act (Public Law 97–174) passed on May 4, 1982. This law gave VA its Fourth mission: to serve as the primary backup for any health care services needed by DoD in the event of war or national emergency that involves armed conflict.
  • National Response Framework (NRF): A guide on how the nation responds to all types of disasters and emergencies. Coordinated by FEMA, the NRF includes Support Annexes and Emergency Support Functions providing greater detail.
  • National Disaster Medical System (NDMS): NDMS is a federally coordinated health care system and partnership of the United States Departments of Health and Human Services, Homeland Security, Defense and Veterans Affairs. VA’s responsibilities under the NDMS are to:
    • Coordinate receipt, distribution and medical care of civilian casualties through Federal Coordinating Centers (FCCs).
    • Coordinate receipt, distribution and medical care of prioritized military casualties in support of the VA-DoD Contingency Plan during armed conflicts or national emergencies.
  • Other humanitarian assistance: VA Medical Center Directors and VHA facility services have the authority to provide health care to civilians under a humanitarian basis if necessary.