April 21, 2020

Dr. Alyshia Smith

Interim Medical Center Director
Phoenix VA Health Care System
650 E Indian School Road
Phoenix, AZ 85012

Dear Dr. Smith,

I appreciate the regular pandemic preparedness updates that your office has provided my
office, but I have heard anecdotes that contradict aspects of those reports I write regarding 1) the
specific policies that the Phoenix VA Health Care System is using to provide VA employees
with the personal protective equipment (PPE) that they need to keep themselves and veteran
patients safe; and 2) whether you plan on providing frontline VA employees with hazard pay.

Personal Protective Equipment

As you know, there are nation-wide shortages of PPE and my office has been heavily
involved in ensuring that Arizona hospitals, long-term care facilities, firefighters, first
responders, and others have the equipment they need to keep themselves and others safe. Unlike
many other hospitals, your health care system has told my office that it has sufficient PPE during
this crisis and has not communicated any concerns with PPE to me. On April 21, 2020, the
Phoenix VA told our office during the regularly scheduled Arizona delegation call that
employees with direct patient contact receive one N95 mask each day while other employees
receive new masks every week.

However, I have heard anecdotal reports that Phoenix VA frontline health care workers
who provide direct patient care have been required to re-use disposable N95 masks after
sanitization, in some cases for weeks. The Centers for Disease Control and Prevention (CDC) is
clear that this type of extreme crisis capacity strategy to preserve N95s is not commensurate with
U.S. standards of care and should only be used when inventory is severely limited1. But the
Phoenix VA has not said that such a lack of N95s exists. I have also heard reports of Phoenix

1
Strategies For Optimizing the Supply Of N95 Respirators: Covid-19
https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/index.html
VA staff being required to share powered air purifying respirator (PAPR) hoods even though I
similarly haven’t heard of a shortage of such equipment at the Phoenix VA.

My goal is to ensure that the Phoenix VA, along with other hospitals, has the PPE that it
needs to uphold standards of care without resorting to crisis capacity strategies. That is why it is
important that you answer the following questions:

• Are you currently or have you ever required VA frontline health care workers to share
PAPR hoods?
• If so, are you sanitizing PAPR hoods between uses by sperate employees?
• How many PAPR hoods do you have?
• Since the President has declared the National Emergency, have employees ever been
required to reuse N95 masks?
• If so, how is the Phoenix VA sanitizing N95s for reuse and how many times does the VA
require employees to reuse a mask before employees are given a new one?
• How many N95 masks do you have?
• What types of PPE, if any, does the Phoenix VA Health Care System need more of to
ensure it does not have to resort to crisis capacity strategies?
• It is our understanding that the Phoenix VA provided updated PPE policies to all
employees sometime during the week of April 13, 2020. Please provide this document to
my office and confirm the date that it was distributed to staff.

Hazard Pay

I strongly support providing hazard pay to all essential workers, including grocery store
workers, post office employees, transit employees, first responders, and health care workers who
are risking their lives and the lives of their loved ones every day. Do you support and will you
provide hazard pay or Title 38 incentive pay to VA health care workers that provide direct
patient care? If so, when will employees expect to receive their pay, how much will they receive
by position, and how long will they receive it?

Thank you for your attention to these issues, and I stand ready to help in any way that I
can. I look forward to hearing your reply.

Sincerely,

Ruben Gallego
Member of Congress