#### Material transmitted

Instruction 595-1, Physicians' Comparability Allowance

##### Material superseded

Instruction 595-1, Physicians' Comparability Allowance (all), dated
January 30, 1996

###### Background

The Department's new Physicians' Comparability Allowance (PCA) plan has
been approved by the Office of Management and Budget (OMB). The revised
plan incorporates the new maximum \$30,000 annual limit on total PCA for
any given individual. Previously, the statutory maximum was \$20,000.

####### Filing Instructions

Remove superseded material and file new material. Post receipt of this
transmittal to the HHS Check List of Transmittals and file this
transmittal in sequential order after the check list.

Evelyn M. White

Deputy Assistant Secretary

for Human Resources

INSTRUCTION 595-1

DISTRIBUTION: MS (PERS): HRFC-001

Subject: PHYSICIANS' COMPARABILITY ALLOWANCE

HHS 595-1-00 Purpose and Legal Authorities

10 Definitions

20 Coverage and Exclusions

30 Authorities and Responsibilities

40 Policy

50 Establishing Additional PCA Payment Classes

60 Annual Review Requirements and Reporting Procedures

70 Procedures for Requesting Waivers of Repayment

Exhibit 595- l-A Definitions

Exhibit 595- l-B Format for Documenting Recruitment and Retention
Problems

Exhibit 595- l-C Tables for Computing Maximum PCA Allowance Payments

Exhibit 595- l-D Appointment and Pay Authorities for Which PCA May be
Paid

Exhibit 595- l-E Creditable Service as a Government Physician

Exhibit 595- l-F Sample Agreement

0.  PURPOSE AND LEGAL AUTHORITIES

######## Purpose

######## The Federal Physicians' Comparability Allowance Act of 1978, as amended, authorizes payment of special allowances to enhance the recruitment and retention of physicians. Physicians' Comparability Allowance (PCA) payments may be authorized only to solve severe recruitment and retention problems that can be documented. The law specifies that an agency must determine the categories of physicians where conditions indicate that recruitment and retention problems exist and set an allowance, that, when coupled with other pay and benefits, is the minimum amount needed to alleviate these problems. Agencies may enter into agreements with physicians which require that the physician complete a specified period of service in return for payment of an allowance. 

########  {#section .unnumbered}

######## This Instruction provides policy and guidance for implementing the PCA Program in the Department of Health and Human Services.

B.  [Legal Authorities]{.underline}

    1.  Title 5 U.S.C. §5948, Physicians' Comparability Allowances;

    2.  5 CFR 595, Physicians' Comparability Allowances.

[595-1-10]{.underline} DEFINITIONS

See Exhibit 595-1-A for definitions and terms used in this plan.

[595-1-20]{.underline} COVERAGE AND EXCLUSIONS

A.  This plan is intended to cover eligible physicians assigned to all
    Operating Divisions (OPDIVs) of the Department of Health and Human
    Services (HHS).

B.  There are several conditions which must be satisfied before a
    physician may be considered eligible to receive PCA. Some factors
    relate to the position to which the physician is assigned, while
    others relate to the physician. In all cases, the position occupied
    by the physician must be in an approved PCA Payment Class before the
    physician may be offered the opportunity to receive PCA.

    1.  [Positions Eligible for Coverage]{.underline} Positions that
        [may]{.underline} be considered for application of PCA include
        those which:

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a.  are classified in the Medical Officer, 0602 occupational series;
    and,

b.  satisfy one of the criteria for determination as a Government
    physician for purposes of paying PCA \[see Exhibit 595-l-D\].

    1.  [Positions Excluded from Coverage]{.underline} Excluded from
        eligibility are:

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a.  positions which do not require the services of physicians who fully
    meet OPM qualification standards;

b.  positions classified as interdisciplinary;

c.  residency or internship positions; and

d.  positions established under any appointment or pay authority
    identified in Exhibit 595-l-E as being ineligible for PCA.

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3.  [Individuals Eligible for Coverage]{.underline} Physicians who are
    on permanent or temporary appointments of at least one year and who
    are employed full-time, or on a part-time work schedule of at least
    40 hours per pay period are eligible for coverage.

4.  [Individuals Not Eligible for Coverage]{.underline} The following
    individuals are not eligible to receive PCA:

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a.  physicians in the EX pay plan;

b.  reemployed annuitants;

c.  employees fulfilling scholarship obligations;

d.  physicians in the PHS Commissioned Corps;

e.  physicians receiving Physician Special Pay (PSP); and

f.  physician members of the Senior Biomedical Research Service (SBRS)

> \[NOTE: loan repayment obligees are eligible to receive PCA; however,
> the amount of PCA must be reduced by the amount of the loan obligation
> that falls within the time period of the PCA service agreement.\]

[595-1-30]{.underline} AUTHORITIES AND RESPONSIBILITIES

A.  [Authorities]{.underline}\
    \
    Heads of Operating Divisions, including the Assistant Secretary for
    Management and Budget for the Office of the Secretary, have the
    authority to establish programs for the payment of PCA to eligible
    physicians within their organizations. This authority, which may be
    redelegated, includes:

    1.  certifying that a physician is required in a position, and that
        board certification is or is not required relative to the
        payment of PCA;

    2.  establishing a PCA payment class within a PCA category and
        subcategory for a position or group of positions, based on a
        determination that recruitment and retention problems are
        significantly hindering the organization\'s programs and
        objectives (NOTE: The determination of whether a recruitment and
        retention problem exists will be based on a thorough analysis of
        relevant information as prescribed in Exhibit 595-l-B);

    3.  approving and issuing PCA agreements and determining actual
        allowances to be paid to physicians;

    4.  approving payment of PCA to former members of the uniformed
        services who retired with 20 or more years of service but less
        than 30 years of service and who do not have a break of service
        of at least one year; or who resigned their commission and do
        not have a break-in-service or service in a civilian position
        for at least 90 days; or any combination of a continuous
        break-in-service and civilian service of at least 90 days;
        \[this approval authority must be exercised, as a minimum, by an
        official who reports directly to the OPDIV Head\];

    5.  approving repayment waiver requests when an employee terminates
        a PCA service agreement for acceptable reasons;

    6.  establishing additional PCA subcategories.

######### Responsibilities

######### The Deputy Assistant Secretary for Human Resources (DASHR) is responsible for:

a.  Establishing and disseminating Department PCA policies and guidance;
    and

    1.  Coordinating the collection, analysis and dissemination of
        information to OPDIVS and other interested organizations outside
        the Department.

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    2.  OPDIV personnel offices for their respective organizations,
        including the Program Support Center (PSC) personnel office for
        OS, are responsible for:

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a.  Formulating plans for the administration of the PCA;

b.  Establishing and disseminating additional guidance, as necessary;

    1.  Providing recommendations to the OPDIV Head concerning the
        appropriate PCA category, subcategory and payment class for a
        position or group of positions;

    2.  Assigning PCA payment class identifiers and maintaining a
        listing of titles and definitions of assigned PCA payment
        classes;

    3.  Selecting the most appropriate, established PCA payment class
        within a category and subcategory for a position and/or
        recommending a new PCA payment class for a position(s) within a
        category and subcategory;

    4.  Determining employee eligibility to receive PCA and the
        appropriate PCA amounts for eligible employees based on: (1) the
        PCA category, subcategory and payment class of the position to
        which the employee is assigned and the relevant characteristics
        of the employee including creditable experience; (2) board
        certification if required by the position; (3) service
        obligation that would make an employee ineligible to receive
        PCA; (4) offset for loan repayments; and (5) other appropriate
        requirements;

    5.  Assuring the service agreement has been signed by the physician,
        notarized, and signed by the management official and personnel
        official before issuing an SF-50, Notification of Personnel
        Action;

    6.  Assisting the physician in developing and forwarding request for
        waiver of repayment when the reason for termination is beyond
        the physician\'s control (see Section 595-1-40. P., below); and

    7.  Preparing periodic reports and other information as requested by
        the DASHR.

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    3.  Physicians receiving PCA are responsible for:

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a.  Providing the personnel office with accurate, complete and timely
    information necessary to determine eligibility for PCA payment class
    and PCA amount;

    1.  Notifying the personnel office when circumstances occur that may
        affect the terms and conditions of the service agreement.

    2.  Repaying the Government when a service agreement is terminated
        voluntarily by the physician or when the physician is removed
        from his/her position due to misconduct; and

    3.  Initiating a written request for waiver of repayment when the
        physician believes that the circumstances leading to the
        termination of the service agreement were beyond his/her control
        (see Section 595-1-40. O., below).

[595-1-40]{.underline} POLICY

A. [Rationale for Paying PCA]{.underline}

1.  PCA is authorized only for the purpose of addressing demonstrated
    recruitment and retention problems. For the purpose of this
    allowance, recruitment and retention problems are considered to
    exist if all of the following conditions exist:

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a.  history of long-lasting vacant positions;

b.  high turnover rates in positions requiring well-qualified
    physicians;

c.  applicants do not have the superior qualifications necessary for the
    position; and

d.  existing vacancies cannot be filled with well-qualified candidates
    without the use of PCA.

    1.  Recruitment and retention problems must be thoroughly
        documented, following the guidelines contained in Exhibit
        595-l-B.

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A.  [Payment of PCA]{.underline}

    1.  Physicians' comparability allowances must be based on the
        minimum amount required to prevent recruitment and retention
        problems. Accordingly, the amount should be based on such
        considerations as relative earnings, responsibilities, expenses,
        workload, working conditions, and benefits for comparable
        physician positions inside and outside the Federal government.
        Within this Department, this is accomplished by applying the
        following factors: category and subcategory of work performed;
        mission-specific factors; board certification; and grade of the
        physician. Other considerations, such as management\'s ability
        to authorize additional compensation under other discretionary
        pay authorities, may also come into play when deciding if
        payment of PCA is the most effective method of addressing
        recruitment and retention problems.

    2.  The categories and subcategories of work established in this
        Department for which physicians may receive PCA are summarized
        below. OPDIV heads may authorize the use of additional
        subcategories as needed to cover unique work situations.
        Detailed descriptions can be found with the Definitions in
        Exhibit 595-1-A.

+---+------------------+--------------------------------------------+---+
| 1 | **Category**     | **Subcategory**                            |   |
| . |                  |                                            |   |
|   |                  |                                            |   |
|   |                  |                                            |   |
+---+------------------+--------------------------------------------+---+
| I | Clinical         | a\. Shortage Specialty                     |   |
| . |                  |                                            |   |
|   |                  | b\. Locale                                 |   |
|   |                  |                                            |   |
|   |                  | c\. Duties                                 |   |
+---+------------------+--------------------------------------------+---+
| I | Research         | a\. Research                               |   |
| I |                  |                                            |   |
| . |                  | b\. Research in Specific Health Problems   |   |
|   |                  | Related to Food, Drugs and Devices         |   |
|   |                  |                                            |   |
|   |                  | c\. Epidemiology and Occupational Research |   |
+---+------------------+--------------------------------------------+---+
| I | Occupational     | a\. Shortage Specialty                     |   |
| I |                  |                                            |   |
| I | Health           | b\. Locale                                 |   |
| . |                  |                                            |   |
|   |                  |                                            |   |
+---+------------------+--------------------------------------------+---+
| I | Disability       | a\. Disability Evaluation                  |   |
| V | Evaluation and   |                                            |   |
| . | Administration   | b\. Administration                         |   |
|   | of Health and    |                                            |   |
|   | Medical Programs |                                            |   |
+---+------------------+--------------------------------------------+---+

1.  Mission-Specific Factors may be used to provide up to \$10,000
    additional allowance as authorized by Public Law 105-266 (Federal
    Employees Health Care Protection Act of 1998). These criteria are
    structured to alleviate severe retention problems and to enable
    OPDIVs to target additional payments under the Act to address their
    most critical program needs. Mission-specific allowances are used to
    retain expertise in areas such as scientific research, science
    administration, or public health administration. Illustrative
    examples would include the prevention and alleviation of illness,
    disease, and the most intractable threats to the nation's health;
    and assuring the health care security and improving health outcomes
    for the nation's beneficiaries under the Medicare, Medicaid, and
    related programs. OPDIVs may target funds to positions determined to
    be most essential or urgent to these needs. OPDIVs must develop
    explicit, written criteria for these factors, linked to the mission
    of the employing organization. The criteria should reflect
    considerations such as critical mission, special legislative
    mandate, or highly visible or controversial approach to public
    health problems.

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C.  [Length of Service as a Government Physician\
    ]{.underline}

    1.  Exhibit 595- l-D summarizes appointment and pay authorities that
        are qualifying for determining the length of service as a
        Government physician. The employee\'s length of service as a
        Government physician is used to determine the maximum amount
        that he/she earns under the law on a per annum basis. All
        periods of qualifying service are counted toward the total,
        including non-continuous service. Periods of leave without pay
        (LWOP), absence without leave (AWOL), suspension, or other
        non-paid absences do not count toward the length of service as a
        government physician.

    2.  Physicians who have 24 or fewer months of service as a
        government physician may be paid no more than \$14,000 per annum
        as determined by the effective date and termination date of the
        service agreement. Physicians with more than 24 months of
        service as a government physician may be paid no more than
        \$30,000 per annum.

D.  [Amount of PCA]{.underline}

    1.  The amount of PCA authorized should be the minimum amount
        required to prevent or ameliorate to the extent practical the
        recruitment and retention problem.

    2.  The Tables for Comparability Allowances presented in Exhibit
        595- l-C reflect the maximum PCA amounts that may be paid for
        various categories and subcategories of positions throughout the
        Department. OPDIV Heads may further specify payment amounts for
        newly-established subcategories which do not exceed existing
        maximums.

E.  [Offering PCA to Physicians Occupying Positions in Approved PCA
    Payment Classes]{.underline}

    1.  PCA is a position-based pay authority. Once positions have been
        approved for receipt of PCA and are assigned to a PCA Payment
        Class, any physician occupying a position in that payment class
        must be offered the opportunity to receive PCA.

    2.  The withholding of PCA from an individual physician for reasons
        of performance, misconduct, or other reason unrelated
        specifically to the position is inappropriate. Other appropriate
        personnel provisions (e.g., performance based action or adverse
        action) should be used to address these issues. However, this
        does not preclude the use of exemplary performance as a factor
        in awarding mission-specific pay as provided in Appendix C.

F.  [Relationship of PCA to Basic Pay]{.underline}

    1.  PCA is not considered basic pay for purposes of premium pay (5
        U.S.C. Chapter 55), payment for accumulated and accrued leave
        (Chapter 55, Subchapter VI), severance pay (5 U.S.C. § 5595),
        compensation for work injuries (5 U.S.C. Chapter 81), retirement
        (5 U.S.C. Chapters 83 and 84), or life insurance (5 U.S. C.
        Chapter 87).

    2.  PCA payments are made on a pay period basis.

G.  [Relationship of PCA to Other Delegated or Discretionary Pay
    Authorities]{.underline}

    1.  [Other Delegated Pay Authorities]{.underline} The Department
        also compensates certain physicians under additional pay
        authorities. These include Physician Special Pay (PSP) under
        Title 38, and the Senior Biomedical Research Service (SBRS)
        under Title 42. Physicians paid under either of these
        authorities are not eligible to receive PCA. OPDIV heads will
        determine which pay system is most appropriate for use within a
        given organization to best address recruitment and retention
        problems and overall mission requirements.

    2.  [Other Discretionary Pay under Title 5]{.underline} Physicians
        who receive PCA may also receive other forms of discretionary
        pay under Title 5, such as Recruitment and Relocation Bonuses
        and Retention Allowances (5 U.S.C. 5773 and 5774). However,
        every effort must be made to ensure that additional compensation
        is authorized for a physician under these authorities only in
        extreme cases, and, after the OPDIV head has determined that
        failure to approve additional compensation will result in the
        organization\'s inability to meet critical mission requirements.
        Total PCA amounts normally payable to a position may be reduced
        for an employee when it is determined that total compensation,
        including any discretionary pay, exceeds that needed to address
        the recruitment and/or retention problems which exist.

H.  [Payment of PCA to Former Members of the Uniformed
    Services]{.underline}

    1.  The allowance will not normally be paid to former members of the
        uniformed services. An allowance may be paid when the former
        member is the only qualified candidate for the position, or is
        eminently qualified for the position. In such cases, written
        justification must be attached to the PCA service agreement.

    2.  No additional approval (to that above, i.e., only qualified
        candidate or eminently qualified candidate) is required to pay
        PCA to former members of the uniformed services who meet the
        following criteria: (a) retired after competing 30 years of
        service; (b) retired after reaching age 64; (c) retired under
        disability retirement provisions; (d) retired after achieving 20
        years of service but fewer than 30 years of service and have a
        break-in-service of at least one calendar year from the
        effective date of termination; or, (e) resigned and have at
        least a 90 day break-in-service from the effective date of the
        termination, or have service in a civilian position for at least
        90 days after the date of termination for the uniformed service,
        or any combination of a continuous break-in-service and civilian
        service of at least 90 days.

    3.  Written approval by the OPDIV Head or an official who reports
        directly to the OPDIV Head must be obtained before PCA may be
        paid to former members of the uniformed services, (1) who retire
        with at least 20 years of service but fewer than 30 years of
        service and who do not have a break of service of at least one
        calendar year from the effective date of termination, and (2)
        who resign and do not have a break-in- service of at least 90
        days, etc., as in paragraph 2 above. The written justification
        must explain: why the services of the former member are
        required; the probable consequences if PCA is not authorized
        including the impact to the agency; the attempts made to try to
        recruit other candidates to the position. This approval must be
        attached to the service agreement.

I.  [Employee Service Agreements]{.underline}

    1.  Service agreements of one, two or three years are required for
        physicians who receive PCA[^1]. An Employee Service Agreement
        (PHS Form 6106, or other locally-developed document containing
        the required information and signatures) must be used to execute
        PCA service agreements. A sample agreement, which may be
        modified as needed for local use, is included as Exhibit
        595-l-F. The following provisions apply when establishing
        service agreements:

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a.  Physicians may normally choose to sign a one, two or three-year
    agreement. However, an authorized management official may limit the
    service agreement to one or two years if he/she determines that the
    recruitment and retention problem will end after that period and the
    PCA Payment Class will be canceled at the end of this period.

b.  Acceptance of the agreement does not alter the conditions or terms
    of employment.

c.  Entitlement to the allowance must be based solely on the position to
    which the physician is assigned and not associated with the
    physician\'s performance or conduct. Accordingly, the agreement will
    not preclude or limit management\'s right to take corrective action
    or disciplinary actions as appropriate.

    1.  The agreement must contain a notarized employee signature, and
        be approved by authorized management officials before the
        effective date of the service agreement.

    2.  Service agreements may be renegotiated at any time it is
        mutually agreeable to both the physician and management
        providing that the period of the agreement is within the limits
        of the applicable legislation and Office of Management and
        Budget approval of the HHS PCA plan. A new period of obligated
        service is incurred each time a service agreement is
        renegotiated.

    3.  Service agreements must be renegotiated when the physician moves
        from one position to another as outlined in 595-1-40. L, below.

    4.  Service agreements may be renegotiated at the option of
        management when the physician becomes board-certified and the
        duties and responsibilities of the position require the skills
        and knowledge associated with the physician\'s
        board-certification.

    5.  Service agreements may be renegotiated at the option of
        management when the physician acquires more than 24 months of
        service as a government physician.

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J.  [Effective Dates]{.underline}

    1.  An agreement will normally commence on the first day of the
        first pay period following approval of the agreement unless
        another date has been specified. However, an agreement shall
        always commence on the first day of a pay period. This is
        required because allowances are paid on a pay period basis and
        not as a lump sum. PCA agreements will end on the last day of
        the 26th pay period after commencement for a one-year service
        agreement, the 52nd pay period after commencement for a two year
        agreement, or the 78^th^ pay period after commencement for a
        three-year agreement.

    2.  Service agreements shall not be made effective after the
        termination date specified in statute (i.e., the Public Law
        specifying the periods of operation) or in the Office of
        Management and Budget\'s authority to operate the PCA program;
        under current law this authority extends through September 30,
        2000.

K.  [Administrative Errors]{.underline}

    1.  There may be circumstances when PCA should have been offered to
        a physician, but due to an administrative oversight, was not.
        When the error is discovered, the physician should be offered
        the opportunity to receive PCA as if the administrative error
        had not occurred. This means that the effective date of the
        service agreement will be the date that the agreement would have
        been effective had the error not occurred. A written statement
        describing the circumstances of the error must be signed and
        dated by the servicing personnel officer. This statement should
        be attached to the PCA service agreement. The error must be
        communicated to the appropriate payroll representative to
        initiate the necessary process to pay PCA retroactively.

    2.  If, due to an administrative error, a physician received a PCA
        amount that was less than the PCA amount that should have been
        offered, the current PCA agreement should be terminated and a
        new service agreement with the correct amounts executed. The
        effective date and the termination date of the new service
        agreement will be the same as the dates on the erroneous service
        agreement. The error must be communicated to the appropriate
        payroll representative to initiate the necessary process to pay
        the difference.

    3.  If it is determined that a physician\'s PCA amount is greater
        than the amount to which he/she is entitled, the current PCA
        agreement should be terminated and a new service agreement with
        the correct amounts executed. The effective date and the
        termination date of the new service agreement will be the same
        as the dates on the erroneous service agreement.

L.  [Effect of Position Change Actions]{.underline}

    1.  When a physician who is receiving PCA moves by reassignment,
        promotion, or other personnel action from one PCA-covered
        position to another PCA-covered position within HHS, the
        original service agreement must be terminated and a new service
        agreement established with a new one, two, or three year time
        limit. This is the case even for management-initiated actions. A
        response to a merit promotion announcement is a
        management-initiated action when the area of consideration is
        not severely limited (see 59 Comp. Gen. 699 and B-220793,
        December 27, 1985). The physician may retain the portion of PCA
        already received before the position change was effected in
        either of these instances.

    2.  When a physician who is receiving PCA moves from a PCA-covered
        position within HHS to another position within HHS for which PCA
        has not been approved, the original service agreement must be
        terminated. The physician may retain that portion of the PCA
        already received.

    3.  When a physician who is receiving PCA transfers from a
        PCA-covered position to a PCA-covered position in another
        Federal agency, the original service agreement must be
        terminated. The physician is responsible for repayment of PCA as
        described in 595-1-40.O., below.

    4.  When a physician who is receiving PCA is detailed from a
        PCA-covered position to a PCA-covered position PCA payments may
        continue. A physician who is receiving PCA may not be detailed
        to a non-covered position.

    5.  When a physician who is receiving PCA moves from a PCA-covered
        position requiring board certification to another PCA-covered
        position for which board certification is not required, a new
        agreement must be negotiated, since the physician may no longer
        receive the portion of the allowance granted for board
        certification.

M.  [Effect of Intergovernmental Personnel Act (IPA)
    Assignments]{.underline}

    1.  There is no legal authority to pay allowances to physicians who
        are assigned out of HHS under an IPA, except as stated in
        paragraph 4. below. Performing long-term assignments outside the
        agency negates the physician\'s agreement which provides for a
        specified period of service in return for an allowance. For a
        physician on a PCA Agreement who goes on an IPA assignment,
        he/she may retain the allowance already received. A waiver of
        repayment is not required.

    2.  Individuals on IPA assignments who are appointed to HHS
        positions and paid by the Federal Government under appropriate
        pay authorities may receive an allowance if they are assigned to
        positions approved for PCA. The service period under the PCA
        agreement must be consistent with the length of the IPA
        assignment and the requirements in this Instruction.

    3.  Employees detailed into HHS under an IPA are not eligible to
        receive PCA.

    4.  For IHS physicians who are assigned under special purpose IPAs
        to perform work for tribal organizations under the Indian
        Self-Determination Act, P.L. 93-638, there is no legal objection
        to payment of PCA.

N.  [Effect of LWOP and Work Schedule Changes]{.underline}

    1.  Employees will not receive PCA for LWOP and other non-pay hours
        in a pay period.

    2.  PCA will not be paid for any pay period in which the number of
        paid hours falls below 40 hours.

O.  [Failure to Complete a Service Period (for Reasons Other than
    Reduction-in-Force]{.underline})

    1.  Physicians who, voluntarily or because of misconduct, fail to
        complete at least one full year of service (i.e., 26 pay
        periods) in a position entitling them to receive an allowance
        will refund the entire amount of the allowance received. The
        OPDIV Head may determine that the individual\'s failure to
        complete the period of service is due to circumstances beyond
        the physician\'s control. A full year is the period from the
        first day of the pay period payment starts to the last day of
        the 26th pay period thereafter.

    2.  Employees who voluntarily leave their positions or are
        terminated from their positions due to misconduct and fail to
        complete the second or third year of a multi-year agreement in a
        position entitling them to an allowance will refund the amount
        of the allowance received under the agreement for the 26 weeks
        of service immediately preceding the termination. The OPDIV Head
        may determine that the individual\'s failure to complete the
        period of service is due to circumstances beyond the
        physician\'s control.

    3.  Authorized OPDIV officials may waive repayment of PCA funds
        received by physicians who fail to complete their service
        agreements if it is determined that such failure is due to
        circumstances beyond the physician\'s control. An example of
        such a circumstance is when a physician retires under disability
        retirement.

P.  [Failure to Complete a Service Period in Reduction-in-Force
    Situations]{.underline}

    1.  Physicians in those organizations undergoing a
        Reduction-in-Force (RIF) may terminate their PCA agreements,
        without penalty of repayment, under the following conditions:

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a.  Where it is known that all medical officer positions in the same
    competitive area are being abolished, physicians leaving HHS after
    receiving a general notice of RIF are not required to repay any
    portion of the allowance received;

b.  Physicians receiving a specific RIF notice which results in their
    separation from Federal service prior to completion of the period of
    service agreed upon are not required to repay any portion of the
    allowance received.

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1.  Physicians who are receiving an allowance, and who are reassigned or
    moved through RIF procedures to positions not approved for PCA, may
    retain the portion of the allowance already received. Under these
    circumstances, the agreement for the former position becomes void
    and the allowance is terminated on the effective date of the move or
    reassignment.

    1.  Physicians who are receiving an allowance, and who, as a result
        of RIF procedures, are assigned to another position covered by
        PCA that is lower in grade or in a lower PCA payment class may
        continue to receive the allowance for which they were entitled
        prior to their assignment to the new position. The agreement
        relating to the former position remains in effect until its
        completion, and the allowance amount may be continued through
        the original period of the agreement. Any new agreement must
        reflect the approved allowance for the PCA payment class for the
        position to which the physician is assigned.

    2.  In situations when it is known that all medical officer
        positions in a competitive area are being abolished, no new
        agreements may be entered into in that competitive area.

[595-1-50]{.underline} ESTABLISHING ADDITIONAL PCA PAYMENT CLASSES

OPDIV personnel offices for their respective organizations, and the PSC
personnel office for OS, must develop a plan for establishing PCA
payment classes and PCA amounts within the categories and subcategories
to be paid to physicians who sign a service agreement. The plan must
specify the amount of the PCA payment that a physician who signs an
agreement will receive.

60. ANNUAL REVIEW REQUIREMENTS AND REPORTING PROCEDURES

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A.  Each OPDIV must review all approved positions and categories
    annually to determine if recruitment and retention problems still
    exist. If the OPDIV head determines that PCA is no longer required
    to address the recruitment or retention needs of a position or group
    of positions, the allowance must be rescinded. Existing PCA
    agreements for rescinded positions are to remain in effect until
    scheduled expiration dates.

B.  OPDIV personnel officers shall provide periodic reports according to
    criteria and time periods specified by the DASHR.

[595-1-70]{.underline} PROCEDURES FOR REQUESTING WAIVERS OF REPAYMENT

Written requests for waivers of overpayment shall be initiated by the
physician or a management official, depending on the circumstances,
outlining the circumstances leading to the termination of the service
agreement. Requests will be forwarded through management channels to the
official designated by the OPDIV Head, who will approve or disapprove
the request based on full consideration of all available information.

DEFINITIONS

A.  [Categories of Work]{.underline}. The categories and subcategories
    of work established in this Department for which physicians may
    receive PCA are defined as follows:

> Category I Clinical
>
> Includes positions primarily involving the practice of medicine as a
> direct service to patients, including the performance of diagnostic,
> preventive, or therapeutic services to patients in hospitals, clinics,
> public health programs, diagnostic centers, and similar settings.
>
> Within Category I, the following subcategories are used for
> determining individual allowances:

1.  [Shortage specialties]{.underline} are those recognized by the
    Department of Health and Human Services, the U. S. Department of
    Labor, the American Medical Association, or other recognized
    organizations.

    1.  [Locale]{.underline} includes special and unusual situations in
        which the geographical location or physical work environment
        causes unusual recruitment and retention problems.

2.  [Duties]{.underline} include situations in which the physician is
    assigned duties over and above those normally performed. These may
    be duties with administrative, training, and/or supervisory
    responsibilities. For example, service chiefs who have these
    responsibilities may be considered for allowances on the basis of
    duties. Allowances may also be granted for hazardous duty situations
    and maximum-security settings.

> Category II Research
>
> Includes positions that involve research and investigative assignments
> in one of the following sub-categories:

1.  [Research]{.underline} Physician positions that primarily involve
    performing, planning, and evaluating experimental work in the
    causes, prevention, control, or treatment of diseases or the factors
    that influence health and disease. Physician positions that
    primarily involve performing research and experimental work relating
    to the physical limitations imposed by conditions other than
    disease, including environmental factors.

2.  [Research in Specific Health Problems Related to Food, Drugs, and
    Devices]{.underline}

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a.  Physician positions that are primarily responsible for investigating
    the effects of biological, radiological, toxicological, chemical,
    nuclear, or other physical agents on the health of specific
    populations or the general public and for recommending corrective,
    protective, or therapeutic procedures.

b.  Physicians involved in the use of epidemiological and biostatistical
    principles to evaluate the efficacy and the benefit/risk of
    therapeutic, diagnostic, or prophylactic products or procedures.

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3.  [Epidemiology and Occupational Research]{.underline} Physician
    positions that primarily involve the use of epidemiological
    principles or procedures to investigate the cause, public health
    significance, and transmission or other causation of disease or
    health problems and to recommend and carry out control procedures.

Category III Occupational Health

> Includes physician positions primarily involving the evaluation of
> physical fitness, the provision of initial treatment of on-the-job
> illness or injury, or the performance of pre-employment examinations,
> preventive health screenings, or fitness-for-duty examinations.
> Approved subcategories used for determining individual allowances are
> Shortage Specialty and Locale (see definitions for Clinical).
>
> Category IV Disability Evaluation and Administration of Health and
> Medical Programs

Includes two subcategories:

> 1\. [Disability Evaluation]{.underline} includes physician positions
> that primarily involve disability evaluation.
>
> 2\. [Administration]{.underline} includes physician positions
> primarily involved in the administration of medical and health
> programs, as exemplified below:

a.  A chief of professional services or senior medical officer who is
    immediately responsible for the overall medical care in the
    hospital, clinic, or center, and for the management and supervision
    of all clinical aspects of medical care, including its quality and
    the medical disposition of patients. This involves decisions
    regarding the medical care given by other senior physicians. In
    addition, the chief manages, through department heads, the
    physicians on the staff of the facility and evaluates the staff and
    the quality of medical care given by that staff.

> Depending on the size of the installation or program and its
> associated workload, a chief of professional services may require one
> but not more than three additional medically qualified assistants or
> deputies who may be included in this category.

b.  A physician program director who is responsible for the medical
    aspects of existing or developing health programs for which medical
    knowledge and expertise are a prerequisite to the development of
    policies. The term "program" means any functional Federal health
    program of any size and involves problem identification, planning,
    administering, and program evaluation. The program director provides
    overall coordination and continuity and makes decisions on a
    day-to-day basis. The planning, policy developed, and decisions made
    by the physician program director have direct effect on clinical
    activities or may affect the delivery of health services at the
    Federal, state, or local levels. These leadership positions require
    a combination of clinical knowledge and program expertise for
    efficient and successful functioning of the program being
    administered.

> Depending on the size of the installation or program and its
> associated workload, a physician program director may require one or
> more medically qualified assistants or deputies who may be included in
> this category.

c.  A physician advisor who renders medical advice and consultation to
    developmental and operational health programs within OPDIVs and to
    local, state, Federal, private, or international organizations. The
    advice and consultation are based upon the medical knowledge and
    experience which a physician possesses.

> The physician advisor synthesizes the findings of scientists and other
> physicians and renders programmatic advice based upon medical
> considerations relating to patient care, community health programs,
>
> health planning, health system design, and health profession manpower
> development.
>
> Providing medical advice may be the sole medical function of the
> physician advisor or it may be combined with other medical functions.
> The position of physician advisor can exist at any level of the
> organization. The advice given may be generated on the initiative of
> the physician advisor in response to observed need or it may be in
> response to specific requests from within or outside the organization.

B.  Board Certification is conferred to a physician who has one or more
    current specialty certificates or subspecialty certificates from the
    American Board of Medical Specialties or by the Advisory Board for
    Osteopathic Specialists.

C.  Demonstrated Recruitment and Retention Problem is a recruitment and
    retention problem that can objectively be measured and shown to
    adversely impact the ability of an agency to accomplish its mission.
    Objective measures should be quantifiable and may include such
    measures as: vacancy rates; average length of time to fill
    positions; turnover rates and cost of turnover; cost of contracting
    due to inability to staff positions; etc. These quantitative
    measures must be part of a completed recruitment and retention
    analysis when requesting the establishment of a new PCA Payment
    Class (see Exhibit 595-1-A, Documentation of Recruitment and
    Retention Problems).

D.  Mission-Specific Factors are job-related factors that may be used to
    award up to \$10,000 to eligible physicians at GS-13 and above under
    PL 105-266. They are targeted to address the most critical agency
    needs, and must be explicitly linked to OPDIV missions and programs.

E.  Scholarship Service Obligation is a defined period of paid service
    that a physician must satisfy to repay an academic scholarship under
    a specified government program. An example of such a program is the
    National Health Services Corps Scholarship Program, authorized by
    the Health Professions Educational Assistance Act of 1976 (P.L.
    94-484). Employees fulfilling scholarship obligations may not
    receive PCA.

F.  Uniformed Services means the Army, Navy, Air Force, Marine Corps,
    Coast Guard, Commissioned Corps of the National Oceanic and
    Atmospheric Administration, and the Commission Corps of the Public
    Health Service (see 37 U.S.C. subsection 101).

Format for Documenting Recruitment and Retention Problems

Date: \_\_\_\_\_\_\_\_\_\_\_\_

Organization:

Location:

Grade Level(s):

Check one Category [AND]{.underline} appropriate subcategories as they
apply to the position(s) under consideration.

+-------------------------------------+--------------------------------+
| Categories                          | Subcategories                  |
+-------------------------------------+--------------------------------+
| I. Clinical                         | Shortage Specialty             |
|                                     |                                |
|                                     | Locale                         |
|                                     |                                |
|                                     | Duties                         |
+-------------------------------------+--------------------------------+
| II\. Research                       | Research                       |
|                                     |                                |
|                                     | Research in Specific Health    |
|                                     | Problems Related to Food,      |
|                                     | Drugs and Devices              |
|                                     |                                |
|                                     | Epidemiology and Occupational  |
|                                     | Research                       |
+-------------------------------------+--------------------------------+
| III\. Occupational Health           | Shortage Specialty             |
|                                     |                                |
|                                     | Locale                         |
+-------------------------------------+--------------------------------+
| IV\. Disability Evaluation and\     | Disability Evaluation          |
| Administration of Health and\       |                                |
| Medical Programs                    | Administration                 |
+-------------------------------------+--------------------------------+

You will need to answer some or all of the questions on the following
pages to document

specific recruitment and retention problems pertaining to the
position(s) under consideration. Answer in the space provided after each
question, or use separate sheets as needed.

1\. Title, grade and description of position(s)

2\. List any selective factors above the minimum qualifications required
by the GS-0602 qualification standard that are used when recruiting for
the position(s).

3\. If the [Shortage Specialty]{.underline} subcategory is to be used
when determining the PCA payment amount, describe the current staffing
situation in this speciality. List any factors which affect your ability
to recruit and retain physicians in this speciality. When possible,
include relevant turnover data as well as current private sector
salaries. Also indicate whether the speciality or geographic area have
been designated as shortage areas for health professionals by the
Department or other Federal entity.

4\. If the [Locale]{.underline} subcategory is to be used when
determining the PCA payment amount, describe how the work location
affects your ability to recruit and retain physicians. Discuss any
special or unusual circumstances where the location or physical work
environment has caused problems which are beyond the norm.

5\. If the [Duties]{.underline} subcategory is to be used when
determining the PCA payment amount, describe those duties that are over
and above those normally performed, or that are performed under
hazardous conditions, and indicate how these duties affect your ability
to recruit and retain physicians.

6\. Provide the following documentation for the position/subcategory
described above:

a.  Number of current physician positions:

Filled \_\_\_\_\_\_\_\_

Vacant\_\_\_\_\_\_\_\_

Average length of time position(s) have been vacant\_\_\_\_\_\_\_\_\_

b.  Number of positions filled during the past 12 months by:

Scholarship-obligated physicians \_\_\_\_\_\_\_\_\_\_

Individuals in loan repayment programs \_\_\_\_\_\_\_

Other means \_\_\_\_\_\_\_\_\_

7\. Describe the impact of vacant physician positions on the mission of
the organization.

8\. Describe your recruitment efforts to fill the position(s)

9\. Describe any factors which inhibit your recruitment efforts.

10\. What is the average number of physician applications which must be
screened before

well qualified candidates can be found? \_\_\_\_\_\_\_\_\_\_

11. What is the average number of qualified physicians referred for each
    position actually filled? \_\_\_\_\_\_\_\_\_\_

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a.  Of those interviewed per position, how many are found unacceptable?
    \_\_\_\_\_\_\_\_\_

    1.  List reasons for finding interviewed physicians unacceptable:

12\. a. What is the average number of qualified physicians who reject
valid employment offers for each position filled? \_\_\_\_\_\_\_\_\_\_

b.  List reasons given for rejecting offers:

13\. a. How many physicians in the position/category have resigned
during the past 12 months? \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

b\. List reasons given for resignation(s)

14\. Describe your efforts to enhance retention of physicians in this
position/category:

15\. Include any additional information which you feel may be helpful in
describing your overall

recruitment and retention problems.

Tables for Computing Maximum PCA Allowance Payments

<table>
<colgroup>
<col style="width: 20%" />
<col style="width: 2%" />
<col style="width: 4%" />
<col style="width: 0%" />
<col style="width: 7%" />
<col style="width: 5%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 14%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 8%" />
<col style="width: 0%" />
<col style="width: 0%" />
</colgroup>
<tbody>
<tr class="odd">
<td></td>
<td colspan="8"><strong>Physicians with 24 Months or Less
Service</strong></td>
<td colspan="10"><strong>Physicians with More than 24 Months
Service</strong></td>
</tr>
<tr class="even">
<td></td>
<td colspan="3"><strong>GS-11</strong></td>
<td><strong>GS-12</strong></td>
<td><strong>GS-13</strong></td>
<td colspan="2"><strong>GS-14</strong></td>
<td><strong>GS-15/SE</strong></td>
<td><strong>GS-11</strong></td>
<td colspan="2"><strong>GS-12</strong></td>
<td colspan="2"><strong>GS-13</strong></td>
<td colspan="2"><strong>GS-14</strong></td>
<td><strong>GS-15/SE</strong></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td>Category</td>
<td colspan="3"></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>I: Clinical</td>
<td colspan="3"></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td>a. Shortage Speciality</td>
<td colspan="3">$1,500</td>
<td>$2,000</td>
<td colspan="2">$2,500</td>
<td>$3,000</td>
<td>$3,500</td>
<td>$3,000</td>
<td colspan="2">$4,000</td>
<td colspan="2">$5,000</td>
<td colspan="2">$6,000</td>
<td>$7,000</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>b. Locale</td>
<td colspan="3">$1,500</td>
<td>$2,000</td>
<td colspan="2">$2,500</td>
<td>$3,000</td>
<td>$3,500</td>
<td>$5,000</td>
<td colspan="2">$6,000</td>
<td colspan="2">$8,000</td>
<td colspan="2">$10,000</td>
<td>$11,000</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td>c. Duties</td>
<td colspan="3"></td>
<td></td>
<td colspan="2">$2,000</td>
<td>$3,500</td>
<td>$5,000</td>
<td></td>
<td colspan="2"></td>
<td colspan="2">$3,000</td>
<td colspan="2">$6,000</td>
<td>$10,000</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>II: Research</td>
<td colspan="3"></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td>All subcategories</td>
<td colspan="3">$2,000</td>
<td>$3,000</td>
<td colspan="2">$5,000</td>
<td>$6,000</td>
<td>$8,000</td>
<td>$3,000</td>
<td colspan="2">$4,000</td>
<td colspan="2">$6,000</td>
<td colspan="2">$12,000</td>
<td>$16,000</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>III: Occupational Health</td>
<td colspan="3"></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td>a. Shortage Speciality</td>
<td colspan="3">$1,500</td>
<td>$2,000</td>
<td colspan="2">$2,500</td>
<td>$3,000</td>
<td>$3,500</td>
<td>$1,500</td>
<td colspan="2">$2,000</td>
<td colspan="2">$2,500</td>
<td colspan="2">$3,000</td>
<td>$3,500</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>b. Locale</td>
<td colspan="3">$1,000</td>
<td>$1,500</td>
<td colspan="2">$2,000</td>
<td rowspan="2">$2,500</td>
<td rowspan="2">$3,000</td>
<td rowspan="2">$1,500</td>
<td colspan="2">$2,000</td>
<td colspan="2">$2,500</td>
<td colspan="2">$3,000</td>
<td>$3,500</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="7"><p>IV. Disability Evaluation</p>
<p>and Administration</p></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>a. Disability Evaluation</td>
<td colspan="3"></td>
<td></td>
<td colspan="2">$2,000</td>
<td>$3,000</td>
<td>$4,000</td>
<td></td>
<td colspan="2"></td>
<td colspan="2">$2,000</td>
<td colspan="2">$4,000</td>
<td>$6,000</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td>b. Administration</td>
<td colspan="3"></td>
<td></td>
<td colspan="2">$8,000</td>
<td>$9,000</td>
<td>$10,000</td>
<td></td>
<td colspan="2"></td>
<td colspan="2">$8,000</td>
<td colspan="2">$12,000</td>
<td>$16,000</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td><p>All Categories</p>
<p>Mission-specific factors</p></td>
<td colspan="3"></td>
<td></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"><a href="#fn1" class="footnote-ref" id="fnref1"
role="doc-noteref"><sup>1</sup></a></td>
<td colspan="2"><a href="#fn2" class="footnote-ref" id="fnref2"
role="doc-noteref"><sup>2</sup></a></td>
<td><a href="#fn3" class="footnote-ref" id="fnref3"
role="doc-noteref"><sup>3</sup></a></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td>Board Certification<a href="#fn4" class="footnote-ref" id="fnref4"
role="doc-noteref"><sup>4</sup></a></td>
<td colspan="3"></td>
<td></td>
<td colspan="2">$3,000</td>
<td>$3,000</td>
<td>$3,000</td>
<td></td>
<td colspan="2"></td>
<td colspan="2">$3,000</td>
<td colspan="2">$3,000</td>
<td>$3,000</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td>Two-Year Contract<a href="#fn5" class="footnote-ref" id="fnref5"
role="doc-noteref"><sup>5</sup></a></td>
<td colspan="3">$2,000</td>
<td>$2,000</td>
<td colspan="2">$4,000</td>
<td>$4,000</td>
<td>$4,000</td>
<td rowspan="3">$2,000</td>
<td colspan="2" rowspan="3">$2,000</td>
<td colspan="2" rowspan="3">$4,000</td>
<td colspan="2">$4,000</td>
<td>$4,000</td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="7">The maximum allowance for Categories I, II, and IV-B is
$14,000</td>
<td colspan="5"><p>The maximum allowance for Categories I, II, and
IV-B</p>
<p>is $30,000</p></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="7">(One-year contracts limited to $10,000)</td>
<td colspan="5">(One-year contracts limited to $24,000)</td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
<td></td>
<td colspan="2" rowspan="3"></td>
<td colspan="2" rowspan="3"></td>
<td colspan="2"></td>
<td colspan="3"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2"></td>
<td colspan="7">The maximum allowance for Categories III and IV-A is
$7,000</td>
<td colspan="6">The maximum allowance for Categories III and IV-A is
$15,000</td>
</tr>
<tr class="odd">
<td colspan="2"></td>
<td colspan="7">(One-year contracts limited to $5,000)</td>
<td colspan="6">(One-year contracts limited to $12,000)</td>
</tr>
</tbody>
</table>
<aside id="footnotes" class="footnotes footnotes-end-of-document"
role="doc-endnotes">
<hr />
<ol>
<li id="fn1"><p>See page C-2 for guidance on allocating mission-specific
pay.<a href="#fnref1" class="footnote-back"
role="doc-backlink">↩︎</a></p></li>
<li id="fn2"><p><sup>2</sup><a href="#fnref2" class="footnote-back"
role="doc-backlink">↩︎</a></p></li>
<li id="fn3"><p><sup>2</sup><a href="#fnref3" class="footnote-back"
role="doc-backlink">↩︎</a></p></li>
<li id="fn4"><p><sup>3</sup> Amounts shown for Board Certification and
Two-year Contract are mandatory. All other amounts represent maximum
allowable allowance, and can be fixed at any level up to that amount.<a
href="#fnref4" class="footnote-back" role="doc-backlink">↩︎</a></p></li>
<li id="fn5"><p><sup>3</sup><a href="#fnref5" class="footnote-back"
role="doc-backlink">↩︎</a></p></li>
</ol>
</aside>

CRITERIA FOR ALLOCATING "MISSION-SPECIFIC" FUNDS

1.  OPDIVs must develop explicit mission-specific criteria linked to the
    organization's mission; a physician must meet these criteria to be
    considered for mission-specific pay.

2.  To be eligible for a mission-specific allowance, a physician must
    sign a two-year service agreement.

If items 1 and 2 are met, a maximum allowance based on grade and
length-of-service as a government physician may be awarded using the
following matrix:

+-----------------+-----------------+-----------------+-----------------+
| ## Grade        | **2-5 years**   | **5-8 years**   | **More than 8   |
|                 |                 |                 | years**         |
+-----------------+-----------------+-----------------+-----------------+
| 13              | ### Up to 1,000 | ### Up to 3,000 | ### Up to 5,000 |
+-----------------+-----------------+-----------------+-----------------+
| 14              | ### Up to 2,000 | ### Up to 5,000 | ### Up to 8,000 |
+-----------------+-----------------+-----------------+-----------------+
| 15/SES          | ### Up to 4,000 | ### Up to 7,000 | #               |
|                 |                 |                 | ## Up to 10,000 |
+-----------------+-----------------+-----------------+-----------------+

> NOTE: These are the *maximum* amounts payable for the grade and
> service shown. They are **not** mandatory; OPDIVs may authorize lesser
> amounts within the limits stated, or extend waiting periods beyond the
> minimum. Further, an amount initially awarded is not guaranteed for
> subsequent agreements; when the agreement is renegotiated, it may be
> reduced if the original amount is found no longer to be essential to
> retention of an adequate physician staff. In **no case** may the
> [total]{.underline} PCA exceed the statutory maximum of \$30,000.

1.  In unusual circumstances, physicians may be authorized
    mission-specific allowances higher than those shown in the above
    matrix, up to a maximum of \$10,000, to acknowledge special
    circumstances as shown below. These exceptions must be approved by
    the OPDIV head on a case-by-case basis, and the total number of such
    exceptions shall not exceed 15 percent of an OPDIV's physicians
    receiving PCA. However, OPDIVs having fewer than 25 physicians
    receiving PCA may have up to 4 physicians in this category. Reason
    for the approval must be fully documented, and must show how
    retention will be hampered if not approved. In **no case** may the
    [total]{.underline} PCA exceed the statutory maximum of \$30,000;
    for physicians with two years service or less, it cannot exceed
    \$14,000.

> Up to \$5,000 may be authorized under this exception for a physician
> who meets *one* of the following criteria; up to \$10,000 may be
> authorized for a physician who meets *more than one:*

-   Work that has materially and measurably improved the health outcomes
    of the target population;

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-   Work that has substantially improved policy development or made a
    significant scientific or regulatory advancement;

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```
-   Achieving substantial, documented efficiencies in the design or
    implementation of projects to maximize health care quality and
    better serve beneficiary needs;

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```
-   Exemplary performance in the mission-specific areas noted in item 1,
    as evidenced by two or more consecutive years of "outstanding"
    ratings or equivalent evidence of exceptional performance.

> **APPOINTMENT & PAY AUTHORITIES FOR WHICH PCA MAY BE PAID**

+-----------------------------------+-----------------------------------+
| **Description of Appointment/Pay  | **Legal Citation**                |
| Authority**                       |                                   |
+-----------------------------------+-----------------------------------+
| General Schedule (GS) including   | Section 5332 of Title 5 U.S.C.,   |
| former members of the Performance | relating to the General Schedule  |
| Management Recognition System     | (GS)                              |
| (PMRS) who are designated as GM   |                                   |
+-----------------------------------+-----------------------------------+
| Senior Executive Service (SES)    | Subchapter VIII of chapter 53 of  |
|                                   | Title 5 U.S.C., relating to the   |
|                                   | Senior Executive Service (SES,    |
|                                   | pay plan ES), (including both     |
|                                   | career and noncareer)             |
+-----------------------------------+-----------------------------------+
| Senior level positions including  | Section 5376 of Title 5 U.S.C.,   |
| 3104s (SL/ST)                     | relating to senior-level          |
|                                   | positions                         |
+-----------------------------------+-----------------------------------+
| Former members of the             | GS or other covered pay           |
| Commissioned Corps of the Public  | authorities cited in law (Title 5 |
| Health Service                    | U.S.C. § 5948)                    |
+-----------------------------------+-----------------------------------+
| Former members of the uniformed   | GS or other covered pay           |
| services other than the           | authorities cited in law (Title 5 |
| Commissioned Corps of the Public  | U.S.C. § 5948)                    |
| Health Service                    |                                   |
+-----------------------------------+-----------------------------------+
| Appointed PHS Service Fellows     | 42 U.S.C. 209(f)                  |
|                                   |                                   |
|                                   | 42 U.S.C. 209(g)                  |
+-----------------------------------+-----------------------------------+
| 210(g) Appointments               | 42 U.S.C. 210(g)                  |
+-----------------------------------+-----------------------------------+
| NIH Appointments                  | 42 U.S.C. 282(d)(1)               |
|                                   |                                   |
|                                   | 42 U.S.C. 285a-2(b)(5)            |
|                                   |                                   |
|                                   | 42 U.S.C. 285b-3(b)(1)            |
+-----------------------------------+-----------------------------------+
| AHCPR Special Experts             | 42 U.S.C. 925(f)                  |
+-----------------------------------+-----------------------------------+
| SAMHSA Special Experts            | 42 U.S.C. 290aa(g)                |
+-----------------------------------+-----------------------------------+
| Intergovernmental Personnel Act   | GS or other covered pay           |
| (IPA) participants                | authorities cited in law (Title 5 |
| [appointed]{.underline} to HHS    | U.S.C. § 5948)                    |
+-----------------------------------+-----------------------------------+
| IHS employees detailed out of HHS | P.L. 93-638 contracts             |
| to perform work for tribal        |                                   |
| organizations                     |                                   |
+-----------------------------------+-----------------------------------+
| Critical Positions                | Section 5377 of Title 5 U.S.C.,   |
|                                   | relating to critical positions    |
+-----------------------------------+-----------------------------------+
| Special Occupational Pay Systems  | Subchapter IX of chapter 53 of    |
|                                   | Title 5 U.S.C., relating to       |
|                                   | special occupational pay systems  |
+-----------------------------------+-----------------------------------+

^1^ Certain limitations apply on the payment of PCA to former members of
the Commissioned Corps and other uniformed services (see 595-1-40-H)

**AUTHORITIES FOR WHICH PCA [MAY NOT]{.underline} BE PAID**

+-----------------------------------+-----------------------------------+
| Description of Appointment/Pay    | Legal Citation                    |
| Authority                         |                                   |
+-----------------------------------+-----------------------------------+
| PHS physicians receiving          | Section 5371 of Title 5 U.S.C.,   |
| Physicians Special Pay (PSP)      | relating to Health Care           |
| under the Title 38 authorities    | Positions.                        |
| delegated by the U.S. Office of   |                                   |
| Personnel Management to the       |                                   |
| Department of Health and Human    |                                   |
| Services.                         |                                   |
|                                   |                                   |
| Note: physicians who are in       |                                   |
| positions for which other forms   |                                   |
| of pay under title 38 authority   |                                   |
| have been approved (e.g., premium |                                   |
| pay, special rates), but not PSP, |                                   |
| may be eligible to receive PCA.   |                                   |
+-----------------------------------+-----------------------------------+
| Current members of the            | 37 U.S.C                          |
| Commissioned Corps of the Public  |                                   |
| Health Service                    |                                   |
+-----------------------------------+-----------------------------------+
| IPA participants detailed to HHS  | No appointment                    |
+-----------------------------------+-----------------------------------+
| HHS employees detailed out of HHS | GS or other covered pay           |
| under an IPA                      | authorities cited in law (Title 5 |
|                                   | U.S.C. § 5948)                    |
+-----------------------------------+-----------------------------------+
| Guest worker                      | Not paid                          |
+-----------------------------------+-----------------------------------+
| Reemployed Annuitants             | 5 U.S.C. §3323                    |
+-----------------------------------+-----------------------------------+
| Executive Level (Pay Plan EX)     | Subchapter II of Chapter 53 of    |
|                                   | Title 5 U.S.C., relating to       |
|                                   | Executive Schedule (EX) positions |
+-----------------------------------+-----------------------------------+
| Internship or residency training  | Various authorities               |
| positions                         |                                   |
+-----------------------------------+-----------------------------------+
| PHS visiting fellows              | Not Federal employees             |
+-----------------------------------+-----------------------------------+
| Other positions that are          | 5 U S.C. § 5948; 5 CFR 595        |
| specifically excluded by law or   |                                   |
| regulation                        |                                   |
+-----------------------------------+-----------------------------------+

**CREDITABLE SERVICE AS A GOVERNMENT PHYSICIAN**

+-----------------------------------+-----------------------------------+
| Description of Appointment/Pay    | Legal Citation                    |
| Authority                         |                                   |
+-----------------------------------+-----------------------------------+
| General Schedule (GS) including   | Section 5332 of Title 5 U.S.C.,   |
| former members of the Performance | relating to the General Schedule  |
| Management Recognition System     | (GS)                              |
| (PMRS) who are designated as GM   |                                   |
+-----------------------------------+-----------------------------------+
| Senior Executive Service (SES)    | Subchapter VIII of chapter 53 of  |
|                                   | Title 5 U.S.C., relating to the   |
|                                   | Senior Executive Service (SES,    |
|                                   | pay plan ES), (including both     |
|                                   | career and noncareer)             |
+-----------------------------------+-----------------------------------+
| Senior level positions including  | Section 5376 of Title 5 U.S.C.,   |
| 3104s (SL/ST)                     | relating to senior-level          |
|                                   | positions                         |
+-----------------------------------+-----------------------------------+
| HHS physicians receiving          | Section 5371 of Title 5 U.S.C.    |
| Physicians Special Pay (PSP)      | relating to Health Care Positions |
| under the title 38 authorities    |                                   |
| delegated by the U.S. Office of   |                                   |
| Personnel Management to the       |                                   |
| Department of Health and Human    |                                   |
| Services                          |                                   |
+-----------------------------------+-----------------------------------+
| Former medical officers in the    | Section 7306 of Title 38 U.S.C.,  |
| Veterans Administration           | or former authority, relating to  |
|                                   | physicians within the Department  |
|                                   | of Veterans Affairs, Veterans     |
|                                   | Health Administration.            |
+-----------------------------------+-----------------------------------+
| Service as a member of the        | 37 U.S.C.                         |
| Commissioned Corps of the Public  |                                   |
| Health Service                    |                                   |
+-----------------------------------+-----------------------------------+
| Appointed PHS Service Fellows     | 42 U.S.C. 209(f)                  |
|                                   |                                   |
|                                   | 42 U.S.C. 209(g)                  |
+-----------------------------------+-----------------------------------+
| 210(g) Appointments               | 42 U.S.C. 210(g)                  |
+-----------------------------------+-----------------------------------+
| NIH Appointments                  | 42 U.S.C. 282(d)(1)               |
|                                   |                                   |
|                                   | 42 U.S.C. 285a-2(b)(5)            |
|                                   |                                   |
|                                   | 42 U.S.C. 285b-3(b)(1)            |
+-----------------------------------+-----------------------------------+
| AHCPR Special Experts             | 42 U.S.C. 925(f)                  |
+-----------------------------------+-----------------------------------+
| SAMHSA Special Experts            | 42 U.S.C. 290aa(g)                |
+-----------------------------------+-----------------------------------+
| Former employees of the Central   | Section 10 of the Central         |
| Intelligence Agency               | Intelligence Agency Act of 1949   |
|                                   | (50 U.S.C. § 403j), relating to   |
|                                   | the Central Intelligence Agency   |
+-----------------------------------+-----------------------------------+

**CREDITABLE SERVICE AS A GOVERNEMT PHYSICIAN**

**(CONTINUED)**

  ----------------------------------- -----------------------------------
  Description of Appointment/Pay      Legal Citation
  Authority                           

  Former employees of the Panama      Section 1202 of the Panama Canal
  Canal Commission                    Act of 1979, relating to the Panama
                                      Canal Commission

  Former employees of the National    Section 2 of the Act of May 29,
  Security Agency                     1959 (Public Law 86-36, as amended,
                                      50 U.S.C. 402 note), relating to
                                      the National Security Agency

  IHS employees detailed out of HHS   P.L. 93-638 contracts
  to perform work for tribal          
  organizations                       

  Intergovernmental Personnel Act     GS or other covered pay authorities
  (IPA) participants appointed to HHS cited in law (Title 5 U.S.C. §
                                      5948)
  ----------------------------------- -----------------------------------

**PREVIOUS SERVICE THAT IS NOT CREDITABLE FOR**

**DETERMINING MAXIMUM PAYABLE PCA**

  ----------------------------------- -----------------------------------
  Description of Appointment/Pay      Legal Citation
  Authority                           

  Former members of the uniformed     37 U.S.C.
  services other than the             
  Commissioned Corps of the Public    
  Health Service                      

  Executive Level (Pay Plan EX)       Subchapter II of Chapter 53 of
                                      Title 5 U.S.C., relating to
                                      Executive Schedule (EX) positions

  PHS visiting fellows                Not Federal employees

  Other positions that are not        5 U.S.C. § 5948; 5 CFR 595
  specifically covered by law or      
  regulation                          
  ----------------------------------- -----------------------------------

Sample PCA Agreement

Operating Divisions may use locally developed forms to document and
approve the payment of PCA to authorized physicians. This exhibit
includes a model form, together with a Privacy Act statement, that may
be adapted as appropriate. OPDIVs may also continue to use existing PHS
Form 6106 for one and two-year service agreements until current supplies
are exhausted.

NAME(Print or Type) Agency:

**AGREEMENT**

To Receive An Allowance Under the

Federal Physicians Comparability Allowance Program

(5 U.S.C. 5948)

In consideration of payments of the allowance for which I qualify under
the Federal Physicians Comparability Allowance (PCA) Program (5 U.S.C.
5948) as implemented by the Regulations of the Office Personnel
Management (5 CFR Part 595), and the policies of the Department of
Health and Human Services, I hereby agree:

1\. To serve in \_\_\_\_\_\_\_\_\_, HHS for one two three years in a
position(s) designated as Category
\_\_\_\_\_\_Subcategory\_\_\_\_\_\_\_\_.

^(agency)^

2\. That the amount of allowance payable to me shall be determined by
the appropriate official as prescribed by the HHS\
plan for payment of such allowances. The allowance payable under this
agreement is \$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ per year for
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_year(s).

3\. That if I elect to enter into a multi-year contract, the approving
official may limit this agreement to one year if it has been determined
that the category or subcategory to which I am assigned will not have
recruitment or retention problems after the one year period.

4\. That acceptance of this agreement does not alter the conditions or
terms of my employment.

5\. That my entitlement of this allowance is based solely on the
position to which I am assigned and is not associated with my
performance and/or

conduct. Accordingly, this agreement will not preclude nor limit the
agency's right to take corrective or disciplinary actions as\
may be appropriate.

6\. (a) That in the event I voluntarily or because of misconduct fail to
complete at least one year of service in a position which entitles me to
receive

the allowance, I will refund the amount of the allowance I have received
unless the approving official, in accordance with

prescribed regulations, determines that my failure to complete my agreed
period of service is due to circumstances which are beyond my

control.

\(b\) That in the event I voluntarily or because of misconduct fail to
complete the second year of a two-year agreement in a position which
entitles me

to receive the allowance, I will refund the amount of the allowance I
received \\under this agreement for the 26 weeks of service immediately

preceding the termination unless the approving official determines that
my failure to complete my agreed period of service is due to

circumstances which are beyond my control.

\(c\) It is further agreed that any amount which I am obligated to
refund under (a) or (b) of this paragraph will be a debt due to the
United States

which I hereby agree to pay in full as directed by the Department of
Health and Human Services.

7\. That the effective date of this agreement and payments pursuant to
this agreement will normally commence on the first day of the pay period
after

the following conditions are met:

\(a\) My position of record is approved as one of a category or
subcategory for which recruitment and

retention problems exist; and

\(b\) The agreement is signed and notarized.

In unusual circumstances, such payments will commence on a later date
specified by me or a date specified by the agency which is

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

8\. That my entitlement to the allowance under this agreement will
terminate when any of the following occur:

\(a\) Cessation of employment with the agency.

\(b\) Assignment to a position excluded from PCA coverage or not
approved for PCA.

\(c\) Completion of agreed period of service or enactment of superseding
law.

\(d\) Change of tour of duty to less than half-time.

\(e\) October 1, 2002 or any subsequent date established by law.

9\. (*This section is applicable only to individuals who have served in
a health professionals shortage area and have signed a contract with
the*

*Federal Government to serve in such an area in return for Government
paying all or part of a student loan.)*

That the amount equivalent to any loan repaid under a Federally
supported loan repayment program will reduce the allowance for which I
would

otherwise be eligible under applicable regulations and instructions.
That failure to report a repayment contract now in effect or which
becomes

effective during the period of this agreement will result in my
obligation to refund the allowance I have received. I am am not

participating in a Federally supported loan repayment program. The
amount that has or will be repaid by this loan repayment agreement is:

\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ for the period
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ to \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

10\. That the regulations and policies implementing 5 U.S.C. 5948 are
incorporated into and made a part of this agreement and I have read
these

these regulations and policies.

11\. I am board certified in the following medical specialty or
specialties:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

^(Specialty)\ (Date\ of\ Certification)^

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

^(Specialty)\ (Date\ of\ Certification)^

I AGREE TO THE TERMS OF THIS CONTRACT NOTARIZATION

Signature:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Print / Type Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Date: \_\_\_\_\_\_\_\_\_\_ Social Security Number:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

DEPARTMENT OF HEALTH AND HUMAN SERVICES

PUBLIC HEALTH SERVICE

Privacy Act Notification Statement to accompany Agreement to Receive an
Allowance Under Federal Physicians Comparability Allowance Program.

**General**

This information is provided pursuant to the Privacy Act of 1974 (P.L.
93-597).

**Authority for Collection of Information**

P.L. 95-603, Executive Order 9379.

**Purpose and Uses**

The principal purpose for collecting the information requested on the
above mentioned form is to establish the terms under which an individual
receives an allowance under the Federal Physicians Comparability
Allowance Program. The information collected will be used as a basis for
payroll actions. Accordingly, disclosure of identifying information,
including your Social Security Number (SSN), may be made to the Internal
Revenue Service for tax withholding purposes, the Department of Treasury
for payroll action, and to the Department of Labor for workman
compensation claims. This information may also be disclosed to the
Department of Justice for other lawful purposes including law
enforcement and in the event of litigation. In addition, these records,
or information therefrom, may be used within DHHS for study purposes,
such as projection of staffing needs, and/or creation of nonidentifiable
statistical data for reports to other Federal agencies and Congress.

**Information Regarding Disclosure of Your Social Security Account
Number**

Disclosure of the SSN is mandatory since it is the identifier used by
the Internal Revenue Service and taxes must be withheld from your
salary. The use of the SSN is made necessary because of the large number
of present and former employees and applicants who have identical names
and birth dates, and whose identities can only be distinguished by the
SSN. It is used primarily to identify an employee's personnel, leave,
and pay records and to relate one to the other. In this regard it is
also used to locate records in order to respond to lawful requests for
information from former employers, educational institutions, and
financial or other organizations. The information gathered through the
use of the number will be used only as necessary in personnel
administration processes carried out in accordance with established
regulations and published notices of systems of records. The SSN also
will be used for the selection of persons to be included in statistical
studies of personnel management matters.

**Effect of Non-disclosure**

Your submission of this agreement is voluntary; however, if the
agreement is submitted, omission of significant information requested
would preclude continued processing of the agreement for you to receive
an allowance because payroll would be unable to process the necessary
actions.

**EMPLOYMENT DATA, ALLOWANCE APPROVAL DATA, COMPUTATION OF ALLOWANCE AND
APPROVAL OF AGREEMENT**

(To be approved by the Authorized Management Official and Certified by
the Servicing Personnel Office)

1\. Name (Print or Type):
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Title, Series and Grade: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Position:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Organization (OPDIV, Center, Agency): \_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Location: \_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

2\. Type of Appointment 3. Official Tour of Duty:

Permanent: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Full
Time: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Term: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Part Time: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Temporary: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Regularly scheduled

Not to Exceed: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
hours per pay period: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

4\. Assignment requires board certification: Yes No

5\. The appropriate official has determined that this position is one in
which recruitment and retention problems exist

Notice of this determination was given in approval certificate
#\_\_\_\_\_\_\_\_\_ dated \_\_\_\_\_\_\_\_\_\_\_\_\_.

This position was approved for PCA coverage under Category
\_\_\_\_\_\_\_SubCategory \_\_\_\_\_\_\_\_\_.

6\. Physician has served as Government physician for: 24 months or less
more than 24 months.

(Experience as a Medical Officer in the PHS Commissioned Corps or in the
Veterans Administration paid under Chapter 73 of 38 U.S.C. is also
creditable.)

7\. Amount to be paid under this agreement is \$\_\_\_\_\_\_\_\_\_\_\_\_
per year for \_\_\_\_\_\_\_ year(s) based on \_\_\_\_\_\_\_ hours per

pay period.

This amount is determined as follows:

Approved allowance for category (for category I & II, show amount for
shortage

specialty, if approved) \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Allowance for duties and locale, if approved
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Approved allowance for mission-specific factors (P.L. 105-266)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Allowance for board certification, if approved
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Retention allowance (for multi-year contracts only)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

TOTAL \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

TOTAL AMOUNT PAYABLE \$

\* Note limitations of \$14,000 per annum for physicians who have served
as Government physicians for

24 months or less and \$30,000 for physicians with more than 24 months'
service as Government physicians

Also note limitation of \$10,000 for individuals with less than two
years' service who execute one-year

agreement and \$24,000 limitation for individuals with two or more
years' service signing one-year agreement

8\. This agreement is effective on \_\_\_\_\_\_\_\_\_\_\_\_\_\_ and
expires on \_\_\_\_\_\_\_\_\_\_\_\_\_\_.

(All contracts must begin on the first day of a pay period and end on
the last day of a pay period.)

I CERTIFY THAT THIS POSITION REQUIRES A PHYSICIAN AND APPROVE THIS
AGREEMENT:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

^(Authorized\ Management\ Official)\ (Date)^

I CERTIFY THAT THIS POSITION IS ONE THAT HAS BEEN APPROVED FOR

PCA PAYMENT AND THAT THE DATA IS ACCURATE:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

^(Personnel\ Official)\ (Date)^

5 CFR 595.106 requires that physicians who terminate their contracts
before the expiration date refund all or a portion of the allowance
received. Servicing Personnel Officers are responsible for initiating
actions to recover such refunds in accordance with procedures in HHS
Instruction 595-1, dated \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

Copy Distribution: 1. Original (white)\--OPF 2. Green\--Employee copy
(after approval) 3. Yellow\--Budget copy

4\. Pink\--DPM&C/OPM/OM/PHS 5. Gold\--Employee copy

[^1]: 5 USC 5948 prohibits any agreement from extending more than two
    years beyond expiration of the statutory authority for PCA. Under
    current law, this means no agreement can extend beyond September 30,
    2002.