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April
24, 1997
BULLETIN NO. 97-05
TO THE HEADS OF EXECUTIVE
DEPARTMENTS AND ESTABLISHMENTS
SUBJECT: Physicians
Comparability Allowance Data Reporting Requirements
1. Purpose. This
Bulletin, which includes Attachments A through C, provides detailed
instructions on agency data reporting requirements regarding operation
of the Physicians Comparability Allowance (PCA) program. The Bulletin
is issued pursuant to the 1996 edition of OMB Circular A-11, section
13.2(b)(12).
Collection of the data
by OMB is required to monitor government-wide PCA usage, physician
employment, and physician compensation. The data will be used to
evaluate the effect of the PCA on Federal physician recruitment
and retention and to issue the 1997 Presidential Report on the Physicians'
Comparability Allowance in accordance with the Federal Physicians
Comparability Allowance Act of 1978 Extension (P.L. 103-114).
2. Background.
On October 26, 1993, the President signed P.L. 103-114, reauthorizing
the Federal Physicians Comparability Allowance until September
30, 1997. This Act extends authority to pay annual bonuses for
Federal physicians serving in areas or specialties with documented
recruitment and retention problems.
Office of Personnel
Management (OPM) regulations implementing PCA require OMB approval
of agency plans to pay bonuses. OPM regulations implementing the
PCA are published in 5 CFR 595.
OMB is collecting data
on PCA program operation and Federal physician recruitment and retention
to ensure consistent government-wide implementation and to evaluate
the effectiveness of the PCA program.
3. Due Date.
Agencies must submit the requested data by May 19, 1997.
4. Termination
Date. This Bulletin will terminate as soon as the requested
data have been submitted.
Franklin D. Raines
Director
Attachments
ATTACHMENT
A
Agencies with currently
approved PCA Plans
Department of Defense
Department of Energy
Department of Health and Human Services
Department of Labor
Department of State
Department of Transportation
Social Security Administration
United States Soldiers' and Airmen's Home
Agencies that have
employed or now employ physicians eligible for PCA
Agency for International
Development
Central Intelligence Agency
Department of Agriculture
Department of the Interior
Department of Justice
Department of Treasury
Department of Veterans Affairs
Environmental Protection Agency
Library of Congress
National Aeronautics and Space Administration
Tennessee Valley Authority
NOTE:
Agencies not listed that employ physicians eligible for PCA are
also covered by this Bulletin.
ATTACHMENT
B
Physicians
Comparability Allowance (PCA) Report and Worksheets
Authority.
5 U.S.C. 5948 authorizes
payment of physicians comparability allowance to eligible individuals
paid as physicians under the following pay systems: General Schedule;
administratively determined pay for certain specially qualified
scientific or professional personnel; Tennessee Valley Authority
Act; Foreign Service Act; CIA Act; section 121 of title 2 of the
Canal Zone Code; or section 2 of the Act of May 29, 1959, relating
to the National Security Agency.
P.L. 100-140, the Federal
Physicians Comparability Allowance Amendments of 1987, amended 5
U.S.C. 5948 to provide a maximum PCA of $14,000 per year for physicians
with less than 24 months' Federal service, and $20,000 per year
for physicians with 24 or more months' Federal service. P.L. 100-140
also allows physician service in the Department of Veterans Affairs
and the Public Health Service Commissioned Corps to be creditable
towards 24 months Federal civilian service when calculating maximum
PCA allowance eligibility. P.L. 103-114 reauthorized PCA until September
30, 1997.
Executive Order No.
12109 delegates authority granted the President under 5 U.S.C. 5948
to the Directors of the Office of Personnel Management and the Office
of Management and Budget.
5 CFR 595 sets additional
requirements for agency implementation of 5 U.S.C. 5948, including
agency reporting requirements.
OMB Circular A-11,
13.2(b)(12), requires agencies to reflect approved plans to pay
bonuses in annual budget estimates in accordance with P.L. 100-140
and P.L. 103-114.
Coverage. This
Bulletin covers all agencies that employ physicians eligible for
PCA. This includes both agencies with currently approved PCA plans
that are eligible to pay PCA bonuses, whether or not they actually
do pay the bonuses, and agencies without approved plans that employ
physicians eligible for PCA. Attachment A lists those agencies that
currently have an approved PCA plan, as well as agencies that do
not currently have an approved plan but are known to have employed
physicians eligible for PCA. Agencies not listed that employ physicians
eligible for PCA are still covered by this Bulletin.
Submission Requirements.
(1) Each agency should review and update the 1996 PCA reporting
worksheet submitted by that agency. (Copies of the 1996 data have
been given to the appropriate OMB staff. Agencies should contact
their OMB examiners if they need a copy of the 1996 data.)
Please verify that
all FY 1993 - FY 1996 figures in the worksheet are correct and add
a new column providing FY 1997 estimates. See below for instructions
on how to calculate figures.
(2) Review the attached
copies of the 1996 Presidential Report on the PCA (Attachment C).
Verify and update the text for your agency that appears in the section
entitled "Summary of Agency PCA Reports," pp. 5 to 10.
Submit the revisions
to the PCA Report and PCA worksheet to the OMB examiner responsible
for that agency.
Information Contact:
Inquiries should be addressed to Marc Garufi, telephone (202) 395-4926.
Instructions
for Preparing Worksheet
General guidance
The data requested
should be supplied for all Federal physicians eligible for
PCA, and as a subset, all Federal physicians actually receiving
PCA. Eligibility for PCA is defined in 5 U.S.C. 5948 and 5 CFR 595.
Data for the budget
year should be the estimates included in budget formulation where
applicable (e.g., average PCA per physician, average compensation,
etc.) or the agency's best estimate (e.g., number of accessions
anticipated). Agency estimates may simply be the average of the
previous fiscal years. All dollars should be on an obligational
basis, and all employment numbers should be on a full-time equivalent
(FTE) basis unless otherwise noted.
Several sections of
the worksheet request data by physician category. Some agencies
may not employ physicians in all categories, but complete data should
be provided for those physician categories applicable to the agency.
Definitions-General
Government Physician.
5 U.S.C. 5948(g)(1) defines Government physician as any individual
paid as a physician under the following pay systems: General Schedule;
administratively determined pay for certain specially qualified
scientific or professional personnel; Tennessee Valley Authority
Act; Foreign Service Act; CIA Act; section 121 of title 2 of the
Canal Zone Code; or section 2 of the Act of May 29, 1959, relating
to the National Security Agency.
Creditable Federal
Service. For purposes of PCA bonus calculations under 5 U.S.C.
5948, as amended by P.L. 100-140, creditable federal service includes
service as a Government physician in any of the personnel systems
established under authorities listed immediately above, as well
as service as a physician in the Department of Veterans Affairs
and the Public Health Service Commissioned Corps.
Definitions-Physician
Categories
Category I-Clinical
Positions: 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.
Category II-Research
Positions: Physician positions primarily involving research
and investigative assignments.
Category III-Occupational
Health: 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 screening, or fitness-for-duty examinations.
Category IV-Disability
Evaluation and Administration of Health and Medical Programs:
Subcategory
IV A: Physician positions primarily involving disability
evaluation.
Subcategory
IV B: Physician positions primarily involving the administration
of health and medical programs, including but not limited
to a chief of professional services, senior medical officer,
or physician program director position.
Description Worksheets
to Be Submitted to OMB
(1) Total Number
Employed: The total number of agency physicians eligible
for PCA (includes all eligible physicians, whether or not they actually
received PCA bonuses) should be supplied for the fiscal years 1993,
1994, 1995, 1996, and 1997 in Part 1. The total number of agency
physicians actually receiving or expected to receive PCA should
be supplied for the fiscal years 1993, 1994, 1995, 1996, and 1997
in Part II. The same data should be provided by category for each
of the fiscal years.
(2) Number of Physicians
Signing One-Year and Two-Year PCA: Under the PCA program, physicians
may elect to sign a one-year or two-year PCA service agreement.
For those physicians actually receiving or expected to receive
PCA (Part II), the number of physicians signing one-year and two-year
agreements should be supplied for each fiscal year.
(3) Average Compensation
per Physician: Average annual compensation per physician should
exclude the PCA bonus, but include base pay and all other
bonuses and awards. The average compensation for agency physicians
eligible for PCA should be supplied for the fiscal years
1990, 1991, 1992, 1993, and 1994 in Part I. The average compensation
for agency physicians actually receiving or expected to receive
PCA should be supplied for the fiscal years 1993, 1994, 1995, 1996,
and 1997 in Part II. The same data should also be provided by
category for each fiscal year.
(4) Average PCA
Amount per Physician, by Category: The average annual PCA bonus
paid per physician for all categories, as well as for each individual
category of physician, should be supplied for each fiscal year in
Part II.
(5) Average PCA
Amount per Physician, by Length of Service Agreement: The average
annual PCA bonus paid per physician should be supplied for physicians
with a one-year service agreement and two-year service agreement
and for each fiscal year in Part II.
(6) Average PCA
Amount per Physician, by Length of Federal Service: The average
annual PCA bonus paid per physician with (a) less than two years
creditable Federal service, and (b) two or more years creditable
Federal service, should be supplied for each fiscal year in Part
II.
(7) Average Number
Years Continuous Service: The average number of years of continuous
creditable Federal service as a physician for those eligible (Part
I) and actually receiving or expected to receive PCA (Part II) should
be supplied for each fiscal year. The average should be calculated
as of the end of the fiscal year in question (e.g. for an agency
with one eligible physician who began Federal service as a physician
under the General Schedule on October 1, 1995, would have one-year
creditable Federal service for purposes of PCA for fiscal year 1997).
(8) Number of Accessions:
The total number of accessions for all physicians (Part I) and for
those receiving PCA (Part II) should be supplied for each
fiscal year. The number of accessions by category for each fiscal
year should also be supplied.
(9) Number of Separations:
The total number of separations for all physicians (Part I) and
for those receiving PCA (Part II) should be supplied for
each fiscal year. The number of separations by category for each
fiscal year should also be supplied.
(10) Number of Unfilled
Full-Time Equivalent Physician Positions: The number should
be equivalent to the total number of physician positions for which
the agency has budgeted for the fiscal year in question less the
number of physicians on-board during the fiscal year. For ,example,
the agency may have budgeted for 12 full-time equivalent physician
positions for the prior fiscal year, but had only 9.5 physicians
on-board for the entire year (9 physicians on-board the entire year,
and one on-board for six-months of the year). The number of unfilled
full-time equivalent physician positions in this case is equal to
2.5.
The total number for
all physicians (Part I) and for those receiving PCA (Part
II) should be supplied for each fiscal year. The number by category
for each fiscal year should also be supplied.
(11) Average Length
of Time Physician Positions Remained Unfilled: The time should
be reported in months as of the end of the fiscal year (e.g., as
of the end of the prior fiscal year the average length of time vacant
physician positions remained unfilled might be 13 months, and for
the current fiscal year it may have declined to an average of 8
months). Only the time during which the agency was actively searching
for candidates should be counted. The total number for all physicians
(Part I) and for those receiving PCA (Part II) should be
supplied for each fiscal year. The number by category for each fiscal
year should also be supplied.
ATTACHMENT
C
UNITED
STATES
OFFICE OF PERSONNEL MANAGEMENT
WASHINGTON, D.C. 20415
AUG.
8, 1996
OFFICE OF THE DIRECTOR
Honorable Newt Gingrich
Speaker of the House
of Representatives
Washington, DC. 20515
Dear Mr. Speaker:
The purpose of this
letter is to transmit a report by the Office of Management and
Budget on Physicians Comparability Allowances (PCA's), as required
by section 5948 (j) of title 5, United States Code. The report
was prepared by the Office of Management and Budget using data
gathered from those agencies with approved plans.
The enclosed report
describes which agencies have entered into PCA agreements, the
recruiting and retention problems justifying their use, the number
of physicians entering into PCA agreements, the size of the allowances
provided and the duration of the agreements, and the degree to
which recruiting and retention problems are alleviated by the
allowance.
Sincerely,
/S/
James B. King
Director
Enclosure
UNITED
STATES
OFFICE OF PERSONNEL MANAGEMENT
WASHINGTON, D.C. 20415
AUG.
8, 1996
OFFICE OF THE DIRECTOR
Honorable Albert
Gore, Jr.
President of the Senate
Washington, DC. 20510
Dear Mr. President:
The purpose of this
letter is to transmit a report by the Office of Management and
Budget on Physicians Comparability Allowances (PCA's), as required
by section 5948 (j) of title 5, United States Code. The report
was prepared by the Office of Management and Budget using data
gathered from those agencies with approved plans.
The enclosed report
describes which agencies have entered into PCA agreements, the
recruiting and retention problems justifying their use, the number
of physicians entering into PCA agreements, the size of the allowances
provided and the duration of the agreements, and the degree to
which recruiting and retention problems are alleviated by the
allowance.
Sincerely,
/S/
James B. King
Director
Enclosure
Presidential
Report on the Physicians' Comparability Allowance
Introduction
Public Law 103-114
requires the President to report to Congress on the operation of
the Physicians' Comparability Allowance (PCA), including information
on:
- which agencies
use the allowance;
- the recruiting
and retention problems justifying these agencies' use;
- the number of
physicians receiving the allowance;
- the size and
duration of the agreements entered into;
- and the degree
to which the allowance alleviates recruiting and retention
problems.
To prepare this report,
OMB asked all agencies with PCA-eligible physicians to provide data
on:
- the number of
physicians they employ, the type of work they do (clinical,
research, occupational health or disability evaluation), how
many of these are eligible for the bonus and how many actually
receive it;
- the average
compensation (excluding PCA bonuses) of physicians receiving
and not receiving the bonus, the size of the average PCA bonus,
and the size of bonuses provided physicians by category of
work and length of PCA agreement;
- the average
number of years of continuous service per physician, the number
of accessions and separations the agency experienced, the
number of unfilled physician positions and the average length
of time these positions were vacant;
- descriptions
of the work done by their physicians receiving PCA, and the
recruiting and retention problems justifying payment of PCA
bonuses.
Using these data, the
report describes the use of the PCA bonus by Federal agencies. It
also addresses the Federal physician recruiting and retention situation,
and the effectiveness of the bonus in improving the situation.
Background
The Physicians' Comparability
Allowance authorizes agencies documenting severe recruitment and
retention problems to pay annual bonuses to physicians, up to $14,000
per year for physicians with less than two years Federal service
and up to $20,000 for physicians with more than two years Federal
service. The PCA was originally authorized by P.L. 95-603 in 1978
(5 U.S.C. 5948) and has been reauthorized a number of times, including
1979, 1981, 1983, 1987, 1990 and 1993. Most of the reauthorizations
were simple extensions of the PCA authority. The 1987 reauthorization
doubled the maximum allowable bonuses to the current levels. The
current authority extends to September 30, 1997.
The PCA is authorized
only to solve severe, documented physician position recruitment
and retention problems. For the purpose of this allowance, severe
recruitment and retention problems are considered to exist if all
of the following conditions exist: long-lasting position vacancies;
high turnover rates in positions requiring well qualified physicians;
applicants do not have the superior qualifications necessary for
the position; and existing vacancies cannot be filled with well
qualified candidates without use of PCA.
Federal
Physicians Receiving the Physicians' Comparability Allowance
Fiscal Years 1992 to 1996 |
| |
FY
1992 (Actual) |
FY
1993 (Actual) |
FY
1994 (Actual) |
FY
1995 (Actual) |
FY
1996 (Est.) |
| Number
of Physicians Eligible |
2,977 |
2,942 |
2,987 |
2,913 |
2,936 |
| Number
Receiving PCA |
1,869 |
1,891 |
1,885 |
2,015 |
1,952 |
| % of
Eligible Receiving PCA |
63% |
64% |
63% |
69% |
66% |
| Average
Compensation (PCA Excluded) |
$73,655 |
$78,852 |
$84,604 |
$90,616 |
$91,396 |
| Average
PCA |
$14,495 |
$14,694 |
$14,103 |
$16,723 |
$17,334 |
Source:
OMB data collection from agencies. Data for FY 1996 = estimated.
Summary of PCA Usage
Throughout the Federal Government
As of FY 1995, the
last year for which we have complete data, 2,015 physicians in federal
employment received a PCA bonus, out of 2,913 eligible. The average
bonus paid was $16,723. The largest users of PCA were the Department
of Health and Human Services, which gave bonuses to 1,193 physicians
and the Department of Defense, which gave bonuses to 480 physicians.
The recruiting and
retention problems justifying these bonuses vary widely. Some agencies
have physician personnel difficulties because they require physicians
with special expertise such as aeronautics or agriculture. Other
agencies have difficulty because they require physicians to live
and work in remote areas. Still other agencies have difficulties
because local competition for physicians has driven salaries past
the standard government pay scale.
The number of physicians
receiving PCA has risen slightly from FY 1992 to FY 1995. Estimates
for FY 1996 show a slight decline from FY 1995. Their average compensation
(excluding PCA) has risen and estimates for FY 1996 show this rise
continuing.
From FY 1992 (actual)
to FY 1996 (estimates) PCA has constituted a fairly constant 16%
of the income of those who receive it. The one exception is FY 1994,
in which PCA constituted 14% of receiving physicians' compensation
|
Physicians
Signing One Year and Two Year Agreements
|
| |
|
FY
1992 (Actual) |
FY
1993 (Actual) |
FY
1994 (Actual) |
FY
1995 (Actual) |
FY
1996 (Est.) |
| Signing
One-Year Agreements |
Number
|
132 |
187 |
175 |
330 |
342 |
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