[Material transmitted]{.underline}:

Instruction 595-1, Physicians' Comparability Allowance

[Material superseded]{.underline}:

Instruction 595-1, Physicians' Comparability Allowance (all), dated
November 1, 1999

[Background]{.underline}

This transmits the new Physicians' Comparability Allowance (PCA) plan
that has been approved by the U. S. Office of Management and Budget.
This plan is revised to incorporate changes made by Public Law 106-571.
While no major policy changes have been made, the entire instruction has
been reorganized to simplify it, make it more user friendly and
eliminate redundancy and unnecessary historical information.

[Filing Instructions]{.underline}

Remove superseded material and file new material.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 White\
> Principal Deputy Assistant Secretary\
> for Administration and Management

INSTRUCTION 595-1*\
*

DISTRIBUTION: MS (PERS): HRFC-001

**Subject:** **PHYSICIANS' COMPARABILITY ALLOWANCE**

595-1-00 Purpose and Legal Authorities\
595-1-10 Coverage and Exclusions\
595-1-20 Definitions\
595-1-30 Roles and Responsibilities\
595-1-40 Policy\
595-1-50 Annual Review Requirements and Reporting Procedures

Exhibit A: Tables for Computing PCA Allowance\
Exhibit B: Appointment and Pay Authorities for Which PCA May Be Paid\
Exhibit C: Appointment/Pay Authorities for Which PCA May Not Be Paid\
Exhibit D: Creditable Service as a Government Physician\
Exhibit E: Service That is Not Creditable Service as a Government
Physician\
Exhibit F: Categories and Subcategories of Work\
Exhibit G: Format for Documenting Recruitment and Retention Problems\
Exhibit H: Service Agreement

Exhibit I: Privacy Act Notification Statement

Exhibit J: Approval of PCA Agreement

**595-1-00 PURPOSE AND LEGAL AUTHORITIES**

This instruction provides policy and guidance for implementing the
Physicians' Comparability Allowance Program (PCA) within the Department
of Health and Human Services (HITS), under authority of Title 5, U. S.
Code, section 5948 and Title *5,* Code of Federal Regulations, part 595.

**595-1-10 COVERAGE AND EXCLUSIONS**

A.  [Coverage]{.underline}. This plan covers eligible physicians
    assigned to all Operating Divisions (OPDIVs) of the Department of
    Health and Human Services (HHS).

    1.  *Positions* eligible for coverage. To be eligible for PCA, the
        position must:

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a.  Be classified in the Medical Officer, GS-0602 occupational series;
    and

b.  Be filled under one of the appointment/pay authorities specified in
    Exhibit B.

    1.  *Individuals* eligible for coverage. To be eligible for PCA, a
        physician must:

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    a.  Be serving under a permanent appointment or a temporary
        appointment of at least one year's duration; and

    b.  Must be employed on a full-time basis or a part-time work
        schedule of at least 40 hours per pay period. 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
        agreement.

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B.  [Exclusions]{.underline}.

    1.  *Positions* excluded from coverage include:

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a.  Positions which do not require the services of physicians who fully
    meet the U. S. Office of Personnel Management qualification
    standards for Medical Officer, GS-0602;

b.  Positions classified as interdisciplinary;

c.  Resident or intern positions; and

d.  Positions established under any appointment/pay authority identified
    in Exhibit C.

    1.  *Individuals* not eligible for coverage include:

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    a.  Physicians in the Executive Schedule (pay plan EX);

    b.  Reemployed annuitants;

    c.  Employees fulfilling scholarship obligations;

    d.  Members of the PHS Commissioned Corps;

    e.  Employees receiving Physicians' Special Pay under Title
        38, U. S. Code; and

    f.  Physician members of the Senior Biomedical Research Service.

**595-1-20 DEFINITIONS**

A.  [Board certification]{.underline}. The certification conferred upon
    a physician who has one or more current specialty or subspecialty
    certificates from the American Board of Medical Specialties or the
    Advisory Board for Osteopathic Specialists.

B.  [Demonstrated recruitment and retention problem]{.underline}. A
    recruitment and retention problem that can be measured objectively
    and shown to impact adversely upon the agency's ability to
    accomplish its mission.

C.  [Loan repayment oblige]{.underline}. A physician who is receiving
    loan repayment assistance under *5* U.S.C. 5379.

D.  [Mission-specific factor]{.underline}. A job-related factor that may
    be used to provide up to \$10,000 additional allowance as authorized
    by Public Law 105-266. These factors are targeted to address the
    most critical agency needs, and must be explicitly linked to OPDIV
    missions and programs.

E.  [Scholarship service obligation]{.underline}. A defined period of
    paid service a physician must satisfy to repay an academic
    scholarship under a specified government program. An example is the
    National Health Services Corps Scholarship Program, authorized by
    the Health Professions Educational Assistance Act of 1976 (P.L.
    94-484).

F.  [Uniformed Services]{.underline}. The U. S. Army, Navy, Air Force,
    Marine Corps, Coast Guard, the\
    Commissioned Corps of the National Oceanic and Atmospheric
    Administration, and the\
    Commissioned Corps of the U. S. Public Health Service (see 37 U.S.C.
    subsection 101).

**595-1-30 ROLES AND RESPONSIBILITIES**

A.  OPDIV heads have the authority to establish programs for the payment
    of PCA to physicians within their organizations OPDIVs must develop
    a plan for administering PCA before making PCA payments. The
    Assistant Secretary for Administration and Management performs this
    function for the Office of the Secretary.

B.  The Deputy Assistant Secretary for Human Resources is responsible
    for establishing and disseminating Department PCA policies and
    guidance, and for coordinating the collection, analysis, and
    dissemination of information to OPDIVs and interested organizations
    outside the Department.

C.  Physicians receiving PCA are responsible for notifying the servicing
    personnel office when circumstances occur that may affect the terms
    and conditions of their service agreements.

**595-1-40 POLICY**

A.  [Basis for PCA]{.underline}.

    1.  PCA is authorized only to address demonstrated recruitment and
        retention problems. Objective measures of these problems should
        be quantifiable and may include such indicators as: vacancy
        rates, average length of time to fill positions, turnover rates,
        cost of turnover, and cost of contracting because of inability
        to staff positions. These measures must be part of a written
        recruitment and retention analysis when establishing new PCA
        payment classes. Recruitment and retention problems must be
        fully documented, following the guidelines in Exhibit G. Total
        PCA amounts payable to a position may be reduced when it is
        determined that total compensation exceeds the maximum needed to
        address existing recruitment or retention problems. For the
        purpose of this instruction, recruitment and retention problems
        are considered to exist if all of the following conditions are
        documented:

        a.  A history of long-lasting vacancies;

        b.  High turnover rates in physician positions;

        c.  Applicants lack superior qualifications required for the
            position; and

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

B.  [Payment of PCA]{.underline}

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1.  Physicians' comparability allowances must be based on the minimum
    amount required to prevent recruitment and retention problems. This
    amount should be based on\
    considerations such as relative earnings, responsibilities,
    workload, working conditions, and benefits for comparable physician
    positions within and outside the Federal\
    government. The factors used for this purpose are: Category and
    subcategory of work, length of service, board certification, grade
    of the physician, length of contract, and\
    mission-specific factors.

    a.  [Categories and Subcategories of Work]{.underline}. The
        categories and subcategories of work are listed below. OPDIV
        heads may authorize additional subcategories as needed to cover
        unique work situations. Detailed descriptions are in Exhibit F.

+-----------------------------------+-----------------------------------+
| **Category**                      | **Subcategory**                   |
+-----------------------------------+-----------------------------------+
| I. Clinical                       | a\. Shortage specialty            |
|                                   |                                   |
|                                   | b\. Locale                        |
|                                   |                                   |
|                                   | c\. Duties                        |
+-----------------------------------+-----------------------------------+
| II\. Research                     | a.  Research                      |
|                                   |                                   |
|                                   | b.  Research in specific health   |
|                                   |     problems related to food,     |
|                                   |     drugs, and devices            |
|                                   |                                   |
|                                   | c.  Epidemiology and occupational |
|                                   |     research                      |
+-----------------------------------+-----------------------------------+
| III\. Occupational Health         | a.  Shortage Specialty            |
|                                   |                                   |
|                                   | b.  Locale                        |
+-----------------------------------+-----------------------------------+
| IV\. Disability Evaluation and    | a.  Disability Evaluation         |
| Administration of Health and      |                                   |
| Medical Programs                  | b.  Administration                |
+-----------------------------------+-----------------------------------+

1.  [Length of Service as a Government Physician]{.underline}. The
    employee's length of service as a government physician is used to
    determine the amount he or she earns under this factor as shown in
    Exhibit A. Physicians having 24 or fewer months may be paid no more
    than \$14,000 in PCA annually; those with more than 24 months may be
    paid no more than \$30,000 annually. Periods of leave without pay,
    absence without leave, suspension, or other non-paid absences do not
    count toward the length of service as a government physician.
    Exhibit D summarizes appointment and pay authorities that are
    qualifying for determining the length of service as a Government
    physician.

2.  The use of board certification, grade and length of service
    agreement in determining PCA amounts are summarized in Exhibit A.

3.  Mission-Specific Factors are criteria structured to alleviate severe
    retention problems and to enable OPDIVs to target additional
    payments 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 include:

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a.  The prevention and alleviation of illness, disease, and the most
    intractable threats to the nation's health;

b.  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 approaches to public health problems. To be considered
> for mission-specific pay, a physician must meet these criteria *and*
> must sign at least a two-year service agreement.

C.  [Determining Amount of PCA.]{.underline}

    1.  PCA is a position-based pay authority. Once positions have been
        approved for payment 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. Payments are
        paid each pay period only for the hours the employee is in a pay
        status. No PCA will be paid for any pay period in which the
        number of hours in a pay status falls below 40.

    2.  Exhibit A reflects the maximum amounts that may be paid for
        various combinations of factors. OPDIV heads may further specify
        payment amounts for newly established subcategories which do not
        exceed existing maximums.

    3.  PCA may not be withheld from a physician .for reasons of
        performance, misconduct, or other reasons unrelated to the
        position. Other personnel actions (e.g., performance-based
        action) should be used to address these matters. However, this
        does not preclude the use of exemplary performance as a factor
        in awarding mission-specific pay as provided in Exhibit A.

D.  [Relationship of PCA to Basic Pay]{.underline}. PCA is not basic pay
    for purposes of premium pay, payment for accumulated and accrued
    leave, severance pay, compensation for work injuries, or life
    insurance. It *is* basic pay for retirement purposes, including
    participation in the Thrift Savings Plan, subject to the limitations
    in Public Law 106-57 1.

E.  [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. The OPDIV head must determine when additional
    compensation is required to meet critical mission requirements.

F.  [Payment of PCA to Retired Members of the Uniformed
    Services.]{.underline}

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1.  PCA will not be paid to retired members of the uniformed services
    except when retirement was under one of the following conditions:

    a.  After completion of 30 years of service;

    b.  Upon reaching age 64;

    c.  Under disability retirement;

    d.  After completing at least 20 but fewer than 30 years of service
        and with a break in\
        service of at least one calendar year from the date of
        separation; or

    e.  When the retired member is the only qualified candidate for the
        position, or is eminently qualified (written justification must
        be attached to the service agreement).

2.  Exceptions to the above criteria may be granted on a case-by-case
    basis by the OPDIV head or designee. Written justification must be
    attached explaining why the services of the individual are required,
    the probable consequences if PCA is not authorized, and attempts
    made to recruit other candidates for the position.

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G.  [Employee Service Agreements]{.underline}. Service agreements of at
    least one and not more than four years are required for physicians
    who receive PCA. Service agreements will normally be in one-year
    increments. An exception may be made to allow agreements to coincide
    with a planned retirement or other separation; in these cases the
    agreement must be for a minimum of one year. A model agreement is at
    Exhibit H OPDIVs may adapt the model to document PCA authorizations.
    The following provisions govern the approval of service agreements:

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1.  Acceptance of the agreement does not alter the conditions or terms
    of employment, and the agreement does not limit management's right
    to take corrective or disciplinary actions as otherwise appropriate.

2.  Entitlement to the allowance must be based solely on the position to
    which the physician is assigned.

3.  A service agreement may be renegotiated at any time it is mutually
    agreeable to both the physician and management. A new period of
    obligated service is incurred each time an agreement is
    renegotiated; the duration of the new agreement will not be less
    than the time remaining under the old agreement, and in any case
    cannot be less than one year.

4.  Service agreements must be renegotiated when the physician moves
    from one position to another as outlined in paragraph L, Position
    Changes, below.

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

6.  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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H.  [Failure to Complete a Service Period.]{.underline}

    1.  Physicians who, voluntarily or because of misconduct, fail to
        complete at least one full year of service (26 pay periods) in a
        position entitling them to receive PCA will refund the entire
        amount of the allowance received.

    2.  Physicians who voluntarily leave their positions or are
        terminated because of misconduct after one year of service in a
        multi-year contract must refund the portion of the allowance
        received for the 26 weeks of service immediately preceding
        separation.

    3.  The OPDIV head may waive repayment if the individual's failure
        to complete the period of service is because of circumstances
        beyond the employee's control.

    4.  Requests for waivers of overpayment may be initiated in writing
        by the physician concerned or a management official. Requests
        will outline the circumstances leading to the termination of the
        service agreement and must be forwarded through management
        channels to the OPDIV head.

I.  [Automatic Waiver of Repayment.]{.underline}

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1.  A physician who retires under a disability retirement is not
    obligated to repay any portion of PCA received prior to retirement.

2.  Physicians in organizations undergoing a reduction-in-force (RIF)
    may terminate their PCA agreements without penalty of repayment
    under either of the following conditions:\
    the physician receives a general notice of RIF and it is known that
    all medical officer positions in the same competitive area are being
    abolished; or the physician receives a specific RIF notice which
    results in his or her separation from Federal service prior to
    completion of the service period.

3.  Physicians receiving PCA who are reassigned or moved to non-PCA
    positions may retain the portion of the allowance already received.

4.  Physicians who, as a result of RIF procedures, are assigned to-
    another PCA covered position that is lower in grade or in a lower
    PCA payment class may continue to receive the allowance to which
    they were entitled prior to reassignment. The original agreement
    will remain in effect, and the allowance amount continued through
    the original period, of the agreement. Upon expiration of that
    agreement, any new agreement must reflect the approved allowance for
    the PCA payment class of the new position.

5.  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.

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J.  [Effective Dates]{.underline}. A service agreement will become
    effective on the first day of the first pay period following
    approval unless another future date is specified in the agreement.
    All agreements shall be made effective on the first day .of a pay
    period unless the employee enters on duty other than the first day
    of the pay period. In such cases the agreement may be made effective
    on the EOD date.

K.  [Administrative Errors]{.underline}.

    1.  If a physician occupies a position in an approved payment class
        but because of administrative error was not offered PCA, the
        error will be corrected. The effective date of the service
        agreement will be the date the agreement would have been
        effective had the error not occurred. The personnel officer will
        prepare and sign a statement outlining the nature of the error;
        this statement will be made a part of the service agreement
        record.

    2.  If because of administrative error, a physician received a PCA
        amount less than the amount that should have been offered, the
        agreement must be terminated and a new service agreement with
        the correct amount executed. The effective date and termination
        date of the new agreement will be the same as the dates on the
        erroneous agreement. If a physician's PCA amount is greater than
        the amount to which he or she is entitled under this
        instruction, the agreement must be terminated and a new
        agreement with the correct amount executed. The effective date
        and the termination date of the new agreement will be the same
        as the dates on the erroneous agreement. The physician will be
        required to refund the overpayment; however he or she may
        request waiver of this requirement under 5 U.S.C. 5584*.*

L.  [Position Changes]{.underline}

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1.  When a physician receiving PCA moves by reassignment, promotion, or
    other personnel action from one PCA-covered position to another
    covered position within HHS, the original service agreement must be
    terminated and a new agreement established. The physician may retain
    the portion of PCA received before the position change was effected.

2.  When a physician receiving PCA moves from a PCA-covered position to
    a non-covered position within HHS, the service agreement must be
    terminated. The physician may retain that portion of the PCA already
    received.

3.  When a physician receiving PCA transfers to a. position in another
    Federal agency outside of HHS, the service agreement must be
    terminated. The physician is responsible for repayment of PCA as
    described in paragraph 595-1-40-H.

4.  When a physician is detailed from a PCA-covered position to another
    covered position, PCA payments may continue. If detailed to a
    non-covered position, the PCA will be suspended for the duration of
    the detail.

    a.  If detailed to unclassified duties, PCA may be continued only if
        those duties fully meet the criteria in this instruction. OPDIVs
        must examine these duties on a case-by-case basis to determine
        whether the criteria are met.

5.  When a physician 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. The physician may no longer receive the portion of the
    allowance granted for board certification, but may retain any
    portion properly paid under the original agreement.

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

    1.  There is no legal authority to pay PCA 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. A physician who
        goes on an IPA assignment 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 may receive an
        allowance if 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.

**595-1-50 ANNUAL REVIEW REQUIREMENTS AND REPORTING PROCEDURES**

Each OPDIV must review all approved positions and categories annually to
determine if recruitment and retention problems continue to exist, lithe
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 discontinued. Existing PCA agreements for discontinued
positions will remain in effect until scheduled expiration dates.

**Exhibit A:**

**[TABLES FOR COMPUTING PCA ALLOWANCE]{.underline}**

**[Categories and subcategories of work]{.underline}\
**

**TABLE la -**- **For physicians with 24 months or less service**

+------------------------------+------+------+------+------+---------+
| **Category**                 | *    | *    | *    | *    | **GS-1  |
|                              | *GS- | *GS- | *GS- | *GS- | 5/SES** |
|                              | 11** | 12** | 13** | 14** |         |
+------------------------------+------+------+------+------+---------+
| I. Clinical                  | Up   | Up   | Up   | Up   | Up to:  |
|                              | to:  | to:  | to:  | to:  |         |
+------------------------------+------+------+------+------+---------+
| > a\. Shortage Specialty     | \$   | \$   | \$   | \$   | \$3500  |
|                              | 1500 | 2000 | 2500 | 3000 |         |
+------------------------------+------+------+------+------+---------+
| > b\. Locale                 | \$   | \$   | \$   | \$   | \$3500  |
|                              | 1500 | 2000 | 2500 | 3000 |         |
+------------------------------+------+------+------+------+---------+
| > c\. Duties                 | \    | \    | \$   | \$   | \$5000  |
|                              | -\-- | -\-- | 2000 | 3500 |         |
+------------------------------+------+------+------+------+---------+
| II\. Research                | Up   | Up   | Up   | Up   | Up to:  |
|                              | to:  | to:  | to:  | to:  |         |
+------------------------------+------+------+------+------+---------+
| > a\. All subcategories      | \$   | \$   | \$   | \$   | \$8000  |
|                              | 2000 | 3000 | 5000 | 6000 |         |
+------------------------------+------+------+------+------+---------+
| III\. Occupational Health    | Up   | Up   | Up   | Up   | Up to:  |
|                              | to:  | to:  | to:  | to:  |         |
+------------------------------+------+------+------+------+---------+
| > a\. Shortage Specialty     | \$   | \$   | \$   | \$   | \$3500  |
|                              | 1500 | 2000 | 2500 | 3000 |         |
+------------------------------+------+------+------+------+---------+
| > b\. Locale                 | \$   | \$   | \$   | \$   | \$3000  |
|                              | 1000 | 1500 | 2000 | 2500 |         |
+------------------------------+------+------+------+------+---------+
| IV\. Disability Evaluation   |      |      | Up   | Up   | Up to:  |
| and Administration           |      |      | to:  | to:  |         |
+------------------------------+------+------+------+------+---------+
| > a\. Disability Evaluation  |      |      | \$   | \$   | \$4000  |
|                              |      |      | 2000 | 3000 |         |
+------------------------------+------+------+------+------+---------+
| > b\. Administration         |      |      | \$   | \$   | \       |
|                              |      |      | 8000 | 9000 | $10,000 |
+------------------------------+------+------+------+------+---------+

The maximum PCA for Categories I, II, and IV-b is \$10,000 for one-year
agreements and \$14,000 for multi-year agreements.

The maximum PCA for Categories III and IV-a is \$5000 for one-year
agreements and \$7000 for multi-year agreements.

Amounts shown are the *maximum* allowable; individual allowances may be
fixed at any level up to that amount.

**TABLE 1b -- For physicians with more than 24 months of service**

+------------------------------+------+------+------+------+---------+
| **Category**                 | *    | *    | *    | *    | **GS-1  |
|                              | *GS- | *GS- | *GS- | *GS- | 5/SES** |
|                              | 11** | 12** | 13** | 14** |         |
+------------------------------+------+------+------+------+---------+
| I. Clinical                  | Up   | Up   | Up   | Up   | Up to:  |
|                              | to:  | to:  | to:  | to:  |         |
+------------------------------+------+------+------+------+---------+
| > a\. Shortage Specialty     | \$   | \$   | \$   | \$   | \$7000  |
|                              | 3000 | 4000 | 5000 | 6000 |         |
+------------------------------+------+------+------+------+---------+
| > b\. Locale                 | \$   | \$   | \$   | \$10 | \       |
|                              | 5000 | 6000 | 8000 | ,000 | $11,000 |
+------------------------------+------+------+------+------+---------+
| > c\. Duties                 | \    | \    | \$   | \$   | \       |
|                              | -\-- | -\-- | 3000 | 6000 | $10,000 |
+------------------------------+------+------+------+------+---------+
| II\. Research                | Up   | Up   | Up   | Up   | Up to:  |
|                              | to:  | to:  | to:  | to:  |         |
+------------------------------+------+------+------+------+---------+
| > a\. All subcategories      | \$   | \$   | \$   | \$12 | \       |
|                              | 3000 | 4000 | 6000 | ,000 | $16,000 |
+------------------------------+------+------+------+------+---------+
| III\. Occupational Health    | Up   | Up   | Up   | Up   | Up to:  |
|                              | to:  | to:  | to:  | to:  |         |
+------------------------------+------+------+------+------+---------+
| > a\. Shortage Specialty     | \$   | \$   | \$   | \$   | \$3500  |
|                              | 1500 | 2000 | 2500 | 3000 |         |
+------------------------------+------+------+------+------+---------+
| > b\. Locale                 | \$   | \$   | \$   | \$   | \$3500  |
|                              | 1500 | 2000 | 2500 | 3000 |         |
+------------------------------+------+------+------+------+---------+
| IV\. Disability Evaluation   |      |      | Up   | Up   | Up to:  |
| and Administration           |      |      | to:  | to:  |         |
+------------------------------+------+------+------+------+---------+
| > a\. Disability Evaluation  |      |      | \$   | \$   | \$6000  |
|                              |      |      | 2000 | 4000 |         |
+------------------------------+------+------+------+------+---------+
| > b\. Administration         |      |      | \$   | \$12 | \       |
|                              |      |      | 8000 | ,000 | $16,000 |
+------------------------------+------+------+------+------+---------+

The maximum PCA for Categories I, II, and IV-b is \$24,000 for one year
agreements and \$30,000 for multi-year agreements.

The maximum PCA for Categories III and IV-a is \$12,000 for one-year
agreements and \$15,000 for multi-year agreements.

Amounts shown are the maximum allowable; individual allowances may be
fixed at any level up to that amount.

**Exhibit A: (continued)**

**Table 2 - Board Certification and Multi-year Agreements**

  -------------------- ----------- ----------- ----------- ----------- ---------------
  **Factor**           **GS-11**   **GS-12**   **GS-13**   **GS-14**   **GS-15/SES**

  **Board                                      \$3000      \$3000      \$3000
  Certification**                                                      

  **2 yr contract**    \$2000      \$2000      \$4000      \$4000      \$4000

  **3 yr contract**    \$2000      \$2000      \$5000      \$5000      \$5000

  **4 yr contract**    \$2000      \$2000      \$6000      \$6000      \$6000
  -------------------- ----------- ----------- ----------- ----------- ---------------

NOTE: The amounts shown in table 2 are mandatory, fixed amounts for
physicians meeting the board certification and length of agreement
criteria.

**Table 3** - **Mission-Specific Factors**

Physicians who meet the criteria for mission-specific pay may be awarded
an additional PCA amount based on grade mid length-of-service as a
government physician. The following matrix reflects the maximum amount
payable for the criteria indicated. A physician must sign a multi-year
agreement to be eligible for a mission-specific allowance.

  ----------------- ----------------- ----------------- -----------------
  **Length of                                           
  Service**                                             

  **Grade**         **2-5 years**     **5-8 years**     **More than 8
                                                        years**

  **GS-13**         Up to \$1000      Up to \$3000      Up to \$5000

  **GS-14**         Up to \$2000      Up to \$5000      Up to \$8000

  **GS-15/SES**     Up to \$4000      Up to \$7000      Up to \$10,000
  ----------------- ----------------- ----------------- -----------------

NOTE 1. Amounts shown in the table are the *maximum* amounts payable for
the grade and years of service shown. These amounts are not mandatory;
OPDIVs may authorize lesser amounts within the limits stated, or may
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 no longer
essential to retention of an adequate physician staff. In no case may
the PCA exceed the statutory maximum of \$30,000.

NOTE 2. In ***unusual*** circumstances, a physician may be authorized a
mission-specific allowance higher than those shown in Table 3, up to a
maximum of \$10,000, to acknowledge special circumstances outlined
below. Reasons for the exception must be filly documented, and must show
how retention will be hampered if not approved, in no case may the PCA
exceed the statutory maximum of \$30,000; for physicians with [two years
service or less, it cannot exceed \$14,000.]{.underline} 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, unless the OPDIV has fewer than 25
physicians receiving PCA; in that case, no more than 4 physicians may be
placed in this category. Under this exception mechanism, up to \$5000
may be authorized 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;

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

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

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

**Exhibit B:**

**[APPOINTMENT AND PAY AUTHORITIES FOR WHICH]{.underline}** PCA MAY BE
PAID

  --------------------------------------------------- -------------------
  **Pay Authority**                                   **Legal Authority**

  General Schedule (GS), including former members of  5 U.S.C. 5332
  the Performance Management Recognition System (GM)  

  Senior Executive Service (SES), including both      5 U.S.C. Chapter
  career and non-career                               53, subchapter VIII

  Senior level positions (SL and ST)                  5 U.S.C. 5376

  Former members of the Commissioned Corps of the U.  Pay authorities
  S. Public Health Service^4^                         cited in U.S.C.
                                                      5948

  Former members of the uniformed services (other     5 U.S.C. 5948
  than PHS Commissioned Corps)                        

  Appointed PHS Service Fellows                       42 U.S.C. 209(f)
                                                      and (g)

  210(g) Appointments                                 42 U.S.C. 210(g)

  NIH Special Expert Appointments                     42 U.S.C.
                                                      282(d)(1)\
                                                      42 U.S. C.
                                                      285a-2(b(5)\
                                                      42 U.S.C.
                                                      285b-3(b)(l)

  AHRQ Special Experts                                42 U.S.C. 925(f)

  SAMHSA Special Experts                              42 U.S.C. 290aa(g)

  Appointed Intergovernmental Personnel Act           Pay authorities
  participants                                        cited in 5 U.S.C.
                                                      5948

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

  Critical positions                                  5 U.S.C. 5377

  Special Occupational Pay Systems                    Subchapter IX of
                                                      chapter 53, 5
                                                      U.S.C.
  --------------------------------------------------- -------------------

^4^ Limitations apply to the payment of PCA to retired members of the
Commissioned Corps and other uniformed services (see HHS 595-l-40F)

**Exhibit C:\
\
[APPOINTMENT/PAY AUTHORITIES FOR WHICH PCA MAY NOT BE
PAID]{.underline}**

  ---------------------------------------------------- ------------------
  **Appointment/Pay Authority**                        **Legal Citation**

  PHS physicians receiving Physicians Special Pay      5 U.S.C. 5371
  under delegated Title 38 authority\                  
  NOTE: This does not preclude physicians receiving    
  other forms of pay under Title 38 (e.g., premium     
  pay, special rates) from receiving PCA.              

  Members of the Commissioned Corps of the U. S.       37 U.S.C.
  Public Health Service                                

  IPA participants detailed to HHS                     No appointment

  Guest workers                                        Not paid

  Reemployed annuitants                                5 U.S.C. 3323

  Executive Level officials (Pay Plan EX)              Subchapter U,
                                                       Chapter 53, Title
                                                       5, U.S.C.

  Internship or residency training positions           Various

  PHS visiting fellows                                 Not Federal
                                                       employees

  Other positions specifically excluded by law or      5 U.S.C. 5948; 5
  regulation                                           CFR 595
  ---------------------------------------------------- ------------------

**Exhibit D:**

**[CREDITABLE SERVICE AS A GOVERNMENT PHYSICIAN]{.underline}**

  ----------------------------------------- -----------------------------
  **Appointment/Pay Authority**             **Legal Authority**

  General Schedule (GS), including former   5 U.S.C. 5332
  members of the Performance Management     
  Recognition System\                       
  (GM)                                      

  Senior Executive Service (SES), including 5 U.S.C. Chapter 53,
  both career and non-career                subchapter VIII

  Senior Level positions (SL and ST)        5 U.S.C. 5376

  Physicians receiving Physicians Special   5 U.S.C. 5371
  Pay under Title 38 authorities            

  Service as a medical officer in the       38 U.S.C. 7306 or predecessor
  Department of Veterans Affairs, Veterans  authority
  Health Administration                     

  Service as a medical officer in the       37 U.S.C.
  Commissioned Corps of the U. S. Public    
  Health Service                            

  Appointed PHS Service Fellows             42 U.S.C. 209(f)\
                                            42U.S.C.209(g)

  210(g) appointments                       42U.S.C.210(g)

  NIH Special Expert Appointments           42 U.S.C. 282(d)(1)\
                                            42 O.k. 285a-2(b)(5)\
                                            42 U.S.C. 285h-3(b)(1)

  AHRQ Special Experts                      42 U.S.C. 925(f)

  SAMHSA Special Experts                    42 U.S.C. 290aa(g)

  Former medical officers in the Central    50 U.S.C. 403j (Section 10 of
  Intelligence Agency                       the Central Intelligence
                                            Agency Act of 1949)

  Former medical officers of the Panama     Section 1202 of the Panama
  Canal Commission                          Canal Act of 1979

  Former medical officers of the National   50 U.S.C. 402 note (Section 2
  Security Agency                           of P.L. 86-36, as amended)

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

  Intergovernmental Personnel Act           5 U.S.C. 5948
  participants appointed to positions in    
  HHS                                       
  ----------------------------------------- -----------------------------

**Exhibit E:\
**

**[SERVICE THAT IS *NOT* CREDITABLE AS SERVICE AS A GOVERNMENT
PHYSICIAN]{.underline}**

  ------------------------------------------------ ----------------------
  **Appointment/Pay Authority**                    **Legal Authority**

  Service in the uniformed services (other than    37 U.S.C.
  the PHS Commissioned Corps)                      

  Executive Level positions (EX)                   5 U.S.C. Chapter 53,
                                                   subchapter II

  PHS visiting fellows                             Not Federal employees

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

**Exhibit F:**

[**CATEGORIES AND SUBCATEGORIES OF WORK**\
]{.underline}

The categories and subcategories of work established in this Department
for which physicians may receive PCA are defined as follows:

A.  [Category I -- Clinical]{.underline}. Clinical positions primarily
    involve 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.\
    \
    The following subcategories will be used to determine 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.

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

    3.  [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, e.g., service chiefs who have
        these responsibilities. Allowances may also be granted for
        hazardous duty situations and maximum security settings.

B.  [Category II -- Research]{.underline}. Research includes positions
    that involve research and investigative assignments in one of the
    following subcategories:

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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}

    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.

3.  [Epidemiology and Occupational Research.]{.underline} This category
    includes 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.

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```
C.  [Category III -- Occupational Health]{.underline} This category
    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).

D.  [Category IV - Disability Evaluation and Administration of Health
    and Medical Programs]{.underline} This category includes two
    subcategories:

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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
    illustrated 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. Through department heads, the chief manages
        the physicians on the staff of the facility and evaluates the
        staff and the quality of medical care given by the staff.
        Depending on the size of the installation or program and its
        associated workload, a chief of professional services may
        require one to 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 day-to-day decisions. The planning, policy,
        and decisions made by the physician program director have a
        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 agencies
        and to local, state, Federal, private, or international
        organizations. The advice and consultation are based on 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 on
        medical considerations relating to patient care, community
        health programs, health planning, health system design, and
        health profession staff 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 organizational level. 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.

> **\
> **

**Exhibit G:**

[**FORMAT FOR DOCUMENTING RECRUITMENT AND RETENTION PROBLEMS**\
]{.underline}

+-----------------------------------+-----------------------------------+
| **Date:**                         | **Organization:**                 |
+-----------------------------------+-----------------------------------+
| **Location:**                     | **Grade Level(s):**               |
+-----------------------------------+-----------------------------------+
| **Check one category and          |                                   |
| appropriate subcategories as      |                                   |
| applicable:**                     |                                   |
+-----------------------------------+-----------------------------------+
| **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 following questions 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.  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*   |                                   |
|     subcategory is to be used in  |                                   |
|     determining the PCA payment   |                                   |
|     amount, describe the current  |                                   |
|     staffing situation in the     |                                   |
|     specialty. List any factors   |                                   |
|     which affect the ability to   |                                   |
|     recruit and retain physicians |                                   |
|     in the specialty. When        |                                   |
|     possible, include relevant    |                                   |
|     turnover data as well as      |                                   |
|     current private sector        |                                   |
|     salaries. Also indicate       |                                   |
|     whether the specialty or      |                                   |
|     geographic area has been      |                                   |
|     designated as a shortage area |                                   |
|     for health professionals by   |                                   |
|     the Department or other       |                                   |
|     Federal entity.               |                                   |
+-----------------------------------+-----------------------------------+
| 4.  If the *Locale* subcategory   |                                   |
|     is to be used in 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 beyond the norm.     |                                   |
+-----------------------------------+-----------------------------------+
| 5.  If the *Duties* subcategory   |                                   |
|     is to be used in, 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           |                                   |
|     recruitment and retention.    |                                   |
+-----------------------------------+-----------------------------------+
| 6.  Provide the following         |                                   |
|     documentation for the         |                                   |
|     position/subcategory          |                                   |
|     described above:              |                                   |
|                                   |                                   |
| > a\. [Number of current          |                                   |
| > physician                       |                                   |
| > positions]{.underline}:         |                                   |
| >                                 |                                   |
| > Filled: [     ]{.underline}     |                                   |
| >                                 |                                   |
| > Vacant: [     ]{.underline}     |                                   |
| >                                 |                                   |
| > Average length of time          |                                   |
| > position(s) have been vacant:   |                                   |
| > [     ]{.underline}             |                                   |
| >                                 |                                   |
| > b\. Number of positions filled  |                                   |
| > during the past 12 months by:   |                                   |
| >                                 |                                   |
| > Scholarship-obligated           |                                   |
| > physicians: [     ]{.underline} |                                   |
| >                                 |                                   |
| > Individuals in loan repayment   |                                   |
| > programs: [     ]{.underline}   |                                   |
| >                                 |                                   |
| > Other means:                    |                                   |
| > [     ]{.underline}             |                                   |
+-----------------------------------+-----------------------------------+
| 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? [     ]{.underline} |                                   |
+-----------------------------------+-----------------------------------+
| 11. What is the average number of |                                   |
|     qualified physicians referred |                                   |
|     for each position actually    |                                   |
|     filled? [     ]{.underline}\  |                                   |
|     a. Of those interviewed per   |                                   |
|     position, how many are found  |                                   |
|     unacceptable?                 |                                   |
|     [     ]{.underline}\          |                                   |
|     b. List reasons for finding   |                                   |
|     interviewed physicians        |                                   |
|     unacceptable:                 |                                   |
+-----------------------------------+-----------------------------------+
| 12. What is the average number of |                                   |
|     qualified physicians who      |                                   |
|     reject valid employment       |                                   |
|     offers for each position      |                                   |
|     filled? [     ]{.underline}   |                                   |
|     List reasons given for        |                                   |
|     rejecting offers:             |                                   |
+-----------------------------------+-----------------------------------+
| 13. How many physicians in the    |                                   |
|     position/category have        |                                   |
|     resigned during the past 12   |                                   |
|     months? [     ]{.underline}   |                                   |
|                                   |                                   |
| List reasons given for            |                                   |
| resignation:                      |                                   |
+-----------------------------------+-----------------------------------+
| 14. Describe your efforts to      |                                   |
|     enhance retention of          |                                   |
|     physicians in this            |                                   |
|     position/category.            |                                   |
+-----------------------------------+-----------------------------------+
| 15. Include any additional        |                                   |
|     information you feel may be   |                                   |
|     helpful in describing your    |                                   |
|     overall recruitment and       |                                   |
|     retention problems.           |                                   |
+-----------------------------------+-----------------------------------+

**Exhibit H:**

**[SERVICE AGREEMENT]{.underline}**

**Name: [     ]{.underline} Agency: [     ]{.underline}**

In consideration of payment of a Physicians' Comparability Allowance
under 5 U.S.C. 5948, 5 CFR 595, and policies of the Department of Health
and Human Services, I hereby agree:

1.  To serve as a medical officer in
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ for a period of
    \_\_\_\_ years, for an allowance in the amount of
    \$\_\_\_\_\_\_\_\_\_\_\_\_ per year.

2.  That acceptance of this agreement does not alter the conditions or
    terms of my employment; accordingly, this agreement will not
    preclude nor limit the agency's right to take corrective or
    disciplinary actions as may be appropriate.

3.  \(a\) 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 full amount of the
    allowance I have received unless it is determined that my failure to
    complete the agreed period of service is due to circumstances beyond
    my control;

> \(b\) In the event I voluntarily or because of misconduct fail to
> complete any service beyond the first year of a multi-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
> it is determined that my failure to complete the agreed period of
> service is due to circumstances beyond my control.

4.  That any amount which I am obligated to refund under paragraph 3
    above will be a debt due to the United States, which I agree to pay
    in full as directed by the Department of Health and Human Services.

5.  That the effective date of this agreement and payments pursuant to
    it will be \_\_\_\_\_\_\_\_\_\_\_\_\_.

6.  That my entitlement to the allowance under this agreement will
    terminate when any of the following occurs:

    a.  Separation from employment with the Department of Health and
        Human Services;

    b.  Assignment to a position excluded from PCA coverage or not
        approved for PCA;

    c.  Completion of the agreed period of service or enactment of
        superseding law;

    d.  Change of my tour of duty to less than half-time.

7.  *(Applicable only to individuals who have served in a health
    professional shortage area and have signed a contract with the
    Federal government to service in such an area in return for the
    government paying all or part of a student loan.)*

    a.  That the amount equivalent to any load repaid under a Federally
        supported loan repayment program will reduce the allowance for
        which I would otherwise be eligible under the applicable
        regulations;

    b.  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;

    c.  I (am) (am not) participating in a Federally supported loan
        repayment program. The amount that has been or will be repaid by
        this loan repayment agreement is \$\_\_\_\_\_\_\_\_\_\_\_ for
        the period \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_to
        \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

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

  ----------------------------------- -----------------------------------
  First specialty:                    Date of Certification:      

  Second specialty:                   Date of Certification:      
  ----------------------------------- -----------------------------------

I agree to the terms of this contact.

+-----------------------+----------------------+----------------------+
| **Print Name:**       | **Signature:**       | **Date:**            |
|                       |                      |                      |
| [     ]{.underline}   | [     ]{.underline}  | [     ]{.underline}  |
+-----------------------+----------------------+----------------------+

**Exhibit I:**

**DEPARTMENT OF HEALTH AND HUMAN SERVICES**\
**Privacy Act Notification Statement**

To accompany service agreement under the 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 93-579.

**Purpose and Uses\
**

The principal purpose for collecting the information requested on this
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 the Treasury for
payroll action, and the Department of Labor for workers compensation
clams. 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 from
them, may be used within DHHS for study purposes, such as projection of
staffing needs and/or creation of non-identifiable statistical data for
reports to other Federal agencies and Congress.

**Information Regarding Disclosure of Your Social Security 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 necessary because of the large number of
present and former employees and applicants who have identical names and
birth dates, and whose identities can be distinguished only 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 may
also 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 information 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 the payroll office would be unable to process the
necessary actions.

**Exhibit J:**

**[APPROVAL OF PCA AGREEMENT]{.underline}**

+-----------------------+-----------+-----------------+----------------+
| **1.** **Name:**      |           | **              |                |
| [     ]{.underline}   |           | Organization:** |                |
|                       |           | [               |                |
|                       |           |   ]{.underline} |                |
+-----------------------+-----------+-----------------+----------------+
| **Title, series,      |           | **Location:**   |                |
| grade and position    |           | [               |                |
| number:**             |           |   ]{.underline} |                |
| [     ]{.underline}   |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| **2. Type of          |           | **3. Tour of    |                |
| Appointment:**        |           | Duty:**         |                |
|                       |           |                 |                |
| Permanent             |           | Full Time       |                |
|                       |           |                 |                |
| Term                  |           | Part Time       |                |
|                       |           |                 |                |
| Temporary NTE         |           | Regularly       |                |
| [     ]{.underline}   |           | scheduled hours |                |
|                       |           | per pay period: |                |
|                       |           | [               |                |
|                       |           |   ]{.underline} |                |
+-----------------------+-----------+-----------------+----------------+
| **4. Does the         |           |                 |                |
| assignment require    |           |                 |                |
| board                 |           |                 |                |
| certification?**      |           |                 |                |
| **Yes** **No          |           |                 |                |
| Specialty:**          |           |                 |                |
| [     ]{.underline}   |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| **5.** It has been    |           |                 |                |
| determined that       |           |                 |                |
| recruitment and       |           |                 |                |
| retention problems    |           |                 |                |
| exist for this        |           |                 |                |
| position, and it has  |           |                 |                |
| been approved for PCA |           |                 |                |
| coverage under        |           |                 |                |
| Category              |           |                 |                |
| [     ]{.underline}   |           |                 |                |
| SubCategory           |           |                 |                |
| [     ]{.underline}   |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| **6.** Employee has   |           |                 |                |
| served as a           |           |                 |                |
| Government physician  |           |                 |                |
| for: 24 months or     |           |                 |                |
| less More than 24     |           |                 |                |
| months                |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| **7.** The amount to  |           |                 |                |
| be paid under this    |           |                 |                |
| agreement is          |           |                 |                |
| \$[     ]{.underline} |           |                 |                |
| per year for          |           |                 |                |
| [     ]{.underline}   |           |                 |                |
| year(s) based on      |           |                 |                |
| [     ]{.underline}   |           |                 |                |
| hours per pay period; |           |                 |                |
| this amount is        |           |                 |                |
| determined as         |           |                 |                |
| follows:              |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| Allowance for         |           |                 |                |
| category and          |           |                 |                |
| subcategory           |           |                 |                |
| (specify): \$         |           |                 |                |
| [     ]{.underline}   |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| Allowance for board   |           |                 |                |
| certification: \$     |           |                 |                |
| [     ]{.underline}   |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| Allowance for         |           |                 |                |
| multi-year agreement: |           |                 |                |
| \$                    |           |                 |                |
| [     ]{.underline}   |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| Allowance for         |           |                 |                |
| mission-specific      |           |                 |                |
| factors: \$           |           |                 |                |
| [     ]{.underline}   |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| Total: \$             |           | Total Payable   |                |
| [     ]{.underline}   |           | PCA: \$         |                |
|                       |           | [               |                |
|                       |           |   ]{.underline} |                |
+-----------------------+-----------+-----------------+----------------+
| 8\. This agreement is |           |                 |                |
| effective on          |           |                 |                |
| [     ]{.underline}   |           |                 |                |
| and expires on        |           |                 |                |
| [     ]{.underline}.  |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| I certify that this   |           |                 |                |
| position requires a   |           |                 |                |
| physician and approve |           |                 |                |
| this agreement:       |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| **Authorizing         | **Au      |                 | **Date:**      |
| Official (Print):**   | thorizing |                 |                |
|                       | Official  |                 |                |
| **     **             | (Signa    |                 |                |
|                       | ture):**\ |                 |                |
|                       |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| I certify that this   |           |                 |                |
| position is one that  |           |                 |                |
| has been approved for |           |                 |                |
| PCA payment and that  |           |                 |                |
| the information above |           |                 |                |
| is accurate:          |           |                 |                |
+-----------------------+-----------+-----------------+----------------+
| **Personnel           | **        |                 | **Date:**      |
| Officer/Designee      | Personnel |                 |                |
| (Print):**            | Officer   |                 |                |
|                       | /Designee |                 |                |
| **     **             | (Signa    |                 |                |
|                       | ture):**\ |                 |                |
|                       |           |                 |                |
+-----------------------+-----------+-----------------+----------------+