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 1994, 1995, 1996, 1997, and 1998 in Part 1. The total number
of agency physicians actually receiving or expected to receive
PCA should be supplied for the fiscal years 1994, 1995, 1996,
1997, and 1998 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
1994. 1995, 1996, 1997, and 1998 in Part I. The average compensation
for agency physicians actually receiving or expected to
receive PCA should be supplied for the fiscal years 1994, 1995,
1996, 1997, and 1998 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, 1996,
would have one-year creditable Federal service for purposes of
PCA for fiscal year 1998).
(8) Number of Accessions:
The total number of accessions for all physicians (Part 1) 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.
UNITED
STATES
OFFICE OF PERSONNEL MANAGEMENT'
WASHINGTON. D.C. 20415
JULY
18, 1997
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 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 and the duration of
the agreements, the size of the allowances provided, and the degree
to which recruitment and retention problems are alleviated by
the allowance.
The report also recommends
a simple 3-year reauthorization of the PCA authority to September
30, 2000. Under the current PCA authority (5 U.S.C. 5948), no
PCA service agreement may be entered into later than September
30, 1997.
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 nature and
extent of recruiting and retention problems justifying the use
of the allowance by each agency;
- number of physicians
with whom agreements were entered into by each agency;
- size of the allowances
and duration of the agreements;
- and the degree
to which the allowance alleviates recruiting and retention problems.
To prepare this report,
the Office of Management and Budget (OMB) asked all agencies with
PCA eligible physicians to provide data on:
- number of physicians
they employ, type of work they do (clinical research, occupational
health or disability evaluation), how many are eligible for
the allowance and how many actually receive it;
- average compensation
(excluding PCA) of physicians receiving and not receiving the
allowance, size of the average PCA, and size of allowances provided
to eligible physicians by category of work and length of PCA
agreement;
- average number
of years of continuous service per physician, number of accessions
and separations the agency experienced, number of unfilled physician
positions and average length of time positions were vacant;
- descriptions of
the physicians' work, and recruiting and retention problems
justifying payment of PCA.
Using these data,
the report describes the use of PCA by Federal agencies. It also
addresses the Federal physician recruiting and retention situation,
and the effectiveness of PCA in improving the situation.
Reauthorization
of PCA
Under 5 U.S.C. 5948,
the current PCA authority extends to September 30, 1997. Based
on information presented in this and previous reports to Congress,
PCA has been effective in assisting Federal agencies to address
recruitment and retention problems for physicians. Consistent
with these findings, the Administration supports a simple, 3-year
reauthorization of PCA to September 30, 2000. The simple reauthorization
will allow OMB and the Office of Personnel Management (OPM) to
continue to monitor the impact of PCA on the recruitment and retention
of Federal physicians.
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. PCA was originally authorized by P.L. 95-603
in 1978 (5 U. S. C. 5 94 8) 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 1evels.
PCA is authorized
only to solve severe, documented physician 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 f:illed with well-qualified
candidates without PCA. Some agencies use alternative programs
to improve recruitment and retention of physicians such as the
physician special pay authority under title 38, United States
Code, that are not covered by this report.
Summary of
PCA Usage Throughout the Federal Government
Table 1. Number and
Compensation of Federal Physicians Receiving PCA
|
Federal
Physicians Receiving the Physicians Comparability Allowance
Fiscal Years 1993 to 1997
|
| |
FY
1993 (Actual) |
FY
1994 (Actual) |
FY
1995 (Actual) |
FY
1996 (Actual) |
FY
1997 (Est) |
| Physicians
Eligible |
2,952 |
2,975 |
2.916 |
2,402 |
2,580 |
| Physicians
Receiving |
1,896 |
1,890 |
2,014 |
1,841 |
1,793 |
| % of
Eligible Receiving |
64% |
64% |
69% |
77% |
69% |
| Average
Compensation (PCA excluded) |
$77,777 |
$83,283
|
$86.188
|
$88,761 |
$90,141 |
| Average
PCA |
$14,698 |
$14,124 |
$14,541 |
$15,765 |
$15,373 |
Source:
OMB data collection from Federal agencies using PCA. Data for
FY 1997 are estimated. Some agencies did not provide all of the
requested data.
As of FY 1996, the
last year for which we have complete data, 1,841 physicians in
Federal employment received PCA, out of 2,402 who were eligible.
The average allowance paid was $15,765. The largest users of PCA
were the Department of Health and Human Services (HHS), which
gave bonuses to 1,019 physicians and the Department of Defense,
which gave bonuses to 487 physicians.
The recruiting and
retention problems that justify the allowance vary greatly. Some
agencies require physicians with special expertise such as aeronautics
or agriculture. Other agencies require physicians to live and
work in remote areas. Still other agencies suffer difficulties
because local non-Federal competition for physicians has driven
salaries past the standard government pay scale.
The percentage of
physicians receiving PCA has risen from FY 1994 to FY
1996, but estimates for FY 1997 indicate a decline from FY 1996.
The average compensation (excluding PCA) for physicians has risen
consistently over the years, and estimates for FY 1997 indicate
this trend will continue. From FY 1994 to FY 1997, PCA has constituted
roughly 17% of the income of the physicians who receive the allowance.
Table 2. Data on Number
and Compensation of Federal Physicians by Length of Agreement
Physicians
Signing One-Year and Two-Year PCA Agreements
Fiscal Years 1993 to 1997 |
| |
FY
1993 (Actual) |
FY
1994 (Actual) |
FY
1995 (Actual) |
FY
1996 (Actual) |
FY
1997 (Est.) |
| Signing
One-Year Agreements |
Physicians |
187 |
175 |
275 |
221 |
243 |