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Incentive Rates for Indian Health Service Nurses

Public Health Service
Indian Health Service
Rockville, Maryland 20857

Refer to: OCPS


Effective Date:  06/14/18



    The purpose of this Circular is to establish the Indian Health Service (IHS) policy and procedure on paying a nurse candidate or employee up to 50 percent in a recruitment, relocation, or retention (3Rs) incentive on a case-by-case basis.


    The Office of Personnel Management (OPM) in a memorandum dated December 1, 2017, has given the Department of Health and Human Services (HHS) the authority to waive the 25 percent limit, as set forth by regulation in 5 C.F.R. 575, for 3Rs incentives for IHS General Schedule nurses (0610 occupational series) employed by the IHS. This waiver provides for incentive levels at the 26-50 percent range for a nurse at any grade level, in any specialty, and at any location – provided full compliance with law, regulation, and HHS Instruction 575-1.


    The OPM rarely grants this authority and IHS incentives over 25 percent will be scrutinized. Some of the requirements relating to 3Rs incentives over 25 percent highlighted in the HHS approval memorandum include the following:

    1. Documenting in writing each determination to pay an incentive to an individual employee as required by 5 C.F.R. 575.108, 575.208, 575.308;
    2. Limiting service agreements for 26-50 percent incentives to a maximum of a two-year service period;
    3. Requiring all recipients, including employees proposed for a retention incentive, to sign a service agreement;
    4. Paying a retention incentive only after an appropriate official has substantiated that the employee is likely to leave federal service if the incentive is not provided;
    5. Adhering to processing and reporting requirements in the Guide to Processing Personnel Actions (to include correct authority codes);
    6. Advising individual recipients on, and adhering to, the aggregate limitation on pay under 5 U.S.C. 5307; and
    7. Following applicable repayment requirements when an employee fails to fulfill the service period of a service agreement.
    1. Immediate supervisor of the position completes the applicable IHS 3Rs forms with complete responses for all text boxes (forms can be obtained through your Area Human Resources Office);
    2. The supervisor, through the Area specific routing protocols, submits a memorandum addressing the unique and critical reasons this high incentive amount is necessary and how the particular incentive rate was determined; and attaches any applicable supporting documentation on the local labor market, vacancy rates, turnover rates, job offers, etc.;
    3. While intermediate approvals may be obtained based on Area protocol, the Area Director will be the final Area level approving authority. The Approving Official on the form will be the IHS Chief Medical Officer (CMO) and the Human Resources Officer will be the Director, Office of Human Resources (OHR) at Headquarters (HQ) so these lines should be left blank;
    4. Once approved by the Area Director the request package is forwarded to HQ OHR, attention, the Compensation Policy Officer;
    5. The Compensation Policy Officer reviews for completeness and adherence to law, regulation and policy; and
    6. The package is then routed to the OHR Director, Deputy Director for Management Operations, and the CMO for their review and/or final approvals.

    Also note that when recruiting for a specific hard-to-fill nurse position, you may include a statement that this higher incentive rate is possible in your Job Opportunity Announcement. However, if the statement is not included, you may still offer a recruitment or relocation incentive up to 50 percent as it is not a regulatory requirement to state on the public notice.

  5. EFFECTIVE DATE.   This Circular becomes effective on the date of signature.

/Michael D. Weahkee/
RADM Michael D. Weahkee, MBA, MHSA
Assistant Surgeon General, U.S. Public Health Service
Acting Director
Indian Health Service

Distribution:  IHS-wide
Date:  06/14/18