PHYSICIANS COMPARABILITY ALLOWANCE PLAN

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP90G01353R001500150009-5
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 14
• Document Creation Date: December 27, 2016
• Document Release Date: October 24, 2012
• Sequence Number: 9
• Publication Date: June 7, 1988
• Content Type: MEMO

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THE FOLLOWING DOCUMENTS
ARE ATTACHED:
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CRETARIAT
ROUTING SLIP
ACTION
INFO
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EXDIR
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STAT
Ex tary
29 Jun '88
Date
3637 (10-81)
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EXECUTIVE OFFICE OF THE PRESIDENT
OFFICE OF MANAGEMENT AND BUDGET
WASHINGTON, D.C. 20503
JUN 2 7 1988
Mr. James H. Taylor
Executive Director
Central Intelligence Agency
Washington, D. C. 20505
This letter advises you that the Central Intelligence
Agency's Physicians Comparability Allowance (PCA) plan
submitted on 9 June 1988 is consistent with the require-
ments and policy on comparability based on data presented
and proposed policy actions included in the PCA plan. The
plan will operate through September 30, 1989. Given the
continuing changes in physician supply, reimbursement
policies, demographics, and related health status
indicators, an updated assessment of PCA requirements for
FY 90, reflecting the latest available data, will assist in
clarifying CIA's physician retention priorities.
In revising CIA's plan for FY 90, PCA bonus-levels
should reflect program and physician labor market changes
since.the previous plan. To ensure time for careful review
of the PCA plan submission before conclusion of the FY 88/89
operating period, please submit the updated PCA plan and all
?supporting documentation at least 30 days before the date on
which the revised plan is scheduled to become effective.
Sincerely,
Robert E. Howard
Deputy Associate Director
National Security
cc: Barry Clendenin
3111 Dorotinsky
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 STAT
FOR
I-79M 610 uEOITI
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ROUTING AND RECORD SHEET
SUBJECT: (Optional)
Physicians Campar ak)ility Allowance Plan
FROM: EXTENSION NO.
Daniel A. Child CC>MPT 88-804
Comptroller oATE
7 June 1988
TO: (Officer designation, room number, and DATE
building) OFFICER'S COMMENTS (Number each comment to show from whom
REC21vED FORWARDED INITIALS to whom. Draw a line across column after each comment.)
Executive Registry
.~$
2.
Ze-utive Director
.9 JUN
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Comptroller
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 COMPT 88-804
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Daniel A.L ilds, Jr.
FROM: Daniel A. Childs, Jr.
Comptroller
SUBJECT: Physicians Comparability Allowance Plan
1. I recommend that you sign the attached memorandum to the Director of
OMB. The memorandum forwards for OMB approval the Agency's plan for
implementation of the Physicians Comparability Allowance Extension Act of 1987
(Public Law 100-140) which authorizes bonuses to General Schedule physicians
of $10,000 to $20,000 (depending on length of service and categorized
duties). The Office of Medical Services considers this allowance essential to
2. Until the attached plan is approved by OMB, we do not have the
authority to offer these allowances to new physicians entering on duty with
the Agency, and currently employed physicians are limited to the previous
authority for such allowances of $7,000 to $14,000.
25X1
25X1
3. Please return the signed memorandum a
nd plan for forwarding to OMB.
attract qualified physicians for employment.
Attachments:
As stated
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COMPT 88-804
Central Intelligence Agency
The Honorable James C. Miller III
Director
Office.of Management a-..3 Budget
Washington, D. C. 20503
10 JUN ION
In accordance with OMB Circular M-88-11 dated 25 January 1988, enclosed is
CIA's plan for the implementation of the Physicians Comparability Allowance
and a summary of retention and recruitment data for Agency physicians. This
revised plan supersedes our 25 March 1988 submission.
Over the past several years, we have faced continuing problems recruiting
and retaining qualified physicians because of the highly specialized nature of
the work at CIA as well as the broader problem of the noncompetitive Federal
Government salary structure. More important, CIA requires extremely strict
qualifications, including a Top Secret security clearance and the willingness
to undertake sensitive duties and assignments both here and abroad
Between 1984 and 1988, separations of Agency physicians averaged three per
year--more than 10 percent of our staff of physicians--and vacancies averaged
five per year. Despite the increased availability of graduates from medical
schools, our pool of qualified applicants has not grown appreciably. We often
review 500 to 600 applicants to recruit two or three physicians and, even
after initial selection, a high percentage of applicants fail the rigorous
security and medical screening process. Others decline our employment offers
because of the time required to complete the processing. For those physicians
who do accept employment, the Physicians Comparability Allowance has been a
decisive element in the applicant's decision. Almost all of our applicants
stated that they would not have accepted employment with the Agency without
the comparability allowance.
In order to meet our goal of hiring and retaining a highly qualified staff
of physicians, we must continue to offer. the Physicians Comparability .
Allowance to all our physicians. We ask that you approve CIA's implementation
plan for the program.
"E ec Ve!Director
James H. Ta-y-loff
Enclosures:
As stated 25X1
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? stLK b i
Summary of Recruitment and Retention of Agency Physicians
The following table shows the number of physician recruitments, separations,
and position vacancies from FY 1984 to FY 1988. The increase in the vacancy
rate results both from separations and an increase in the number of authorized
positions.
FISCAL YEAR
RECRUITMENTS
SEPARATIONS
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Section 1: Statement of statutory and regulatory authority for Physicians
Comparability Allowance.
The Federal Physicians Comparability Allowance Act of 1978 (Public Law
95-603) and the Physicians Comparability Allowance Extension Act of 1987
(Public Law 100-140) authorize federal agencies to pay under certain
conditions bonuses to General Schedule physicians. F_~
The Central Intelligence Agency submitted its initial implementation plan
for.the Physicians Comparability Allowance (PCA) program on 3 August 1979.
Amended plans were submitted on 31 August 1979, 4 December 1980, 30 September
1981, and 11 June 1984. Internal regulations for the administration of the
program are based on the approved implementation plans.
Section 2: Statement of Agency employees eligible for the Physicians
Comparability Allowance, including the occupational series number
and pay system.
All.physicians employed by the Agency who are assigned to physician
positions (occupational series designation 0602.00 to 0602.99) are eligible to
receive the Physicians Comparability Allowance provided they satisfy the
criteria for the allowance. Agency physicians are paid on the GSM schedule, a
special pay schedule patterned after the schedule for physicians authorized by
the Office of Personnel Management, or the Senior Intelligence Service I SIS
schedule. There are currently 29 physicians receiving the allowance. i ~
Section 3: Statement of the purpose and necessary conditions for use of the
Physicians Comparability Allowance.
The Physicians Comparability Allowance is authorized only to solve severe
and well-documented problems in recruiting and retaining physicians. Agency
physician positions qualify for this allowance if all of the following
conditions exist:
-- Positions remain vacant for extended periods of time.
-- Positions requiring well-qualified physicians experience high turnover
rates.
-- Applicants often do not have all of the qualifications for the
position..
-- Existing vacancies cannot be filled with well-qualified candidates
without using the PCA. F-1
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Section 4: Determination of Individual Allowances.
The CIA employs a small staff of physicians. These employees require
special qualifications--including United States citizenship; Top Secret
security clearance; Doctor of Medicine degree from a medical school approved
by the American Medical Association; license to practice medicine in any of
the 50 states; eligibility for certification as a diplomate of or qualified
for the Boards in internal medicine, family practice, psychiatry, pediatrics,
or occupational health; and willingness to undertake sensitive duties and
assignments in the United States and abroad, including temporary and permanent
reassignments to remote areas of the world. These special qualifications
present significant recruitment and retention problem for all physician
positions. We require these qualifications of all of our physicians, all of
whom perform the same clinical activities. Thus the y implements the-PCA
equally for all full-time physicians whom we employ. Agenc
b. Categories of Work
All of the physicians employed by the Agency are qualified and required to
perform Category I (clinical) duties.. Because recruitment and retention is so
difficult, Agency management concluded that our few physicians must all be
clinical practioners. There are a limited number of our physicians assigned
Category II C (one) and Category IV B (four) positions, however, these
physicians are also required to carry out Category I duties. Because we have
such a-small number of physicians and must provide direct patient care in
response to worldwide requirements, all physicians must be qualified to
perform duties assigned in any category, frequently on short notice and for
extended or frequent temporary duty assignments. Inside the Agency, part-time
contract physicians, medical technicians, and nurses perform almost all of the
occupational health (Category III) activities.
c. Allowance Eligibility
Eligibility for the Physicians Comparability Allowance will be based on
the following:
-- CIA's Director of Medical Services will certify that a position
requires a physician.
-- All physicians will have satisfied all criteria for employment with
the Central Intelligence Agency.
-- Each physician will execute a continued service agreement (copy
attached) that defines the terms and conditions for payment-and for
repayment of the comparability allowance. Any waiver of repayment
will require approval of the Agency's Deputy Director for
Administration.
SECRET
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- Physicians who have served less than 24 months as a US Government
physician will receive under the terms of a continued service
agreement $14,000 per year.
-- Physicians who have served 24 months or more as a US Government
physician will receive under the terms of a continued service
agreement $20,000 per year.
- The Deputy Director for Administration will be responsible fo
administering the Physicians Comparability Allowance Program.
d. Limitations on Eligibility
For physicians. signing a two-year agreement, the maximum allowances
payable are: $14,000 per annum for physicians with less than 24 months
creditable Federal service (as defined in P.L. 100-1.40); and, $20,000 per
annum for physicians with 24 months or more creditable Federal service (as
defined in P.L. 100-140).
For.physicians signing a one-year agreement these maximum allowances are
reduced to $10,000 and $15,000, respectively.
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SUBJECT: Physicians Comparability Allowance Plan
James C. Miller III, Director, 0MB
Executive Director
Executive Registry
DDA
D/OP
D/OMS
DDA Registry
Compt Subject
Compt, DCompt
C/AG
Reading File
O/COMPT/C/AG) I (COMPT 88-804) (6Jun88)
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CIA-RDP90GO1353R001500150009-5 SECRETARIAT
ROUTING SLIP
ACTION
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DCI
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DDCI
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EXDIR
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D/ICS
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DDI
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DDA
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DDO
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DDS&T
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Chm/NIC
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GC
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IG
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D/PERS
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D/Ex Staff
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Remarks
STAT
xecutive Secretary
10 Feb 88
Date
3637 (10-81)
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EXECUTIVE OFFICE OF THE PRESIDENT
OFFICE OF MANAGEMENT AND BUDGET
WASHINGTON, D.C. 20503
January 25, 1988
IExerut;iP: ,
88-0429X
MEMORANDUM FOR HEADS OF EXECUTIVE D TMENTS AND AGENCIES
FROM: Joseph R. Wright, J
SUBJECT: Agency Plans To
On October 28, 1987, the President signed P.L. 100-140, the
Physicians Comparability Allowance Extension Act of 1987. The Act
extends agency authority to pay bonuses for General Schedule (GS)
physicians serving in areas or specialties with documented
recruitment and retention problems- increases the maximum annual
bonus from $7,000 to $14,000 for physicians with less than 24
months Federal service and from $10,000 to $20,000 for physicians
with 24 months or more Federal service; and, allows prior service
credit for purposes of determining bonus levels for former
Veterans Administration and Public Health Service Commissioned
Corps physicians entering the GS system. The'Administration
sought this legislation to selectively address specific physician
recruitment problems in keeping with its goal of improving
government services.
Regulations issued by the Office of Personnel Management
implementing the original Federal Physicians Comparability
Allowance Act of 1978 require agencies who wish to pay bonuses to
submit a plan to the office of management and Budget for review
and approval. On September 30, 1987, Office of Management and
Budget approval of all previously-approved plans expired. While
bonus payments can be continued under existing agreements through
September 30, 1989, departments and agencies wishing to enter
into new agreements or to renew existing agreements must submit
new or updated plans for implementing the Act within 60 days
after the date of this memorandum.
In developing. your plans, you may wish to limit bonuses to levels
which reflect a balance between agency requirements within
current appropriations levels and the well-documented growing
surplus of physicians.
L.-a Y7- r,
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Higher bonus levels should be targeted at specific shortage areas
and specialties. Of the four categories specified in OPM's
regulations, higher bonus levels should be limited to Category I
direct patient care, Category II clinical research, and Category
IV (B) medical program administrative positions. Any increase in
Category IV (B) physician position bonuses over current levels
should.be awarded, in addition to the current statutory and OPM
regulatory requirements (e.g. position requires a physician;
documented recruitment and retention problems; etc.), on a merit
basis similar to the annual Senior Executive Service awards.
All agency plans should adhere to these guidelines unless they
can provide justification of compelling need, including
sufficient supporting documentation, to warrant an exception.
You should refer to the Act, its extension, and to forthcoming
OPM revised regulations in preparing your plans, which are to be
submitted to the OMB examiner responsible for your department or
agency.
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