United States Public Health Service Commissioned Corps (USPHSCC) officers who serve at least 180 consecutive days at a site that is considered isolated, remote, insular, or in which service constitutes hardship duty qualify for the Isolated/Hardship (ISOHAR) Award. It is possible for officers to earn the award for duty at the same site, provided their subsequent deployments there are due to a Permanent Change of Station (PCS) order, the 180-consecutive day minimum is met on each tour, and that there’s at least one PCS between tours.
Several methods are used to determine if a duty site is in an Isolated/Hardship location. The most common is the U.S. Department of Health and Human Service’s Personnel Policy Memorandum (PPM) 06-006, Isolated Hardship Sites. Last updated in 2006, the list was created by evaluating duty sites based on six factors: physical location, geographic location (within CONUS or OCONUS), housing availability, availability of health care and medical treatment for the USPHSCC officer and any dependents; living conditions; and the site’s designation as an area suffering from a shortage of health-care professionals.
But just because a duty site is not included in that list doesn’t mean it doesn’t qualify for credit toward the ISOHAR. The USPHSCC employs the U.S. State Department’s “post differential” designation for determining if a foreign-duty post qualifies for ISOHAR, to wit, if the conditions of the environment differ substantially from conditions of environment in the CONUS and thus required additional compensation as a means of recruitment and retention.
USPHSCC officers who have been permanently assigned to a vessel that’s classified as “Unusually Arduous Sea Duty” (away from home port for a minimum of 180 days) also receive ISOHAR credit. Lastly, the Director of the Division of Commissioned Corps Personnel and Readiness is empowered to evaluate sites on a case-by-case to determine if they meet the ISOHAR standard.