SAC Application Process
Reduce/increase patient volume
Provider shortage
Site closure
Contract or agreement changes
HRSA’s Health Center Program award recipients provide comprehensive primary health care services in nearly 1,400 service areas to more than 30 million patients annually. This document details how HRSA annually calculates patient targets for these service areas in the Patient Target Calculation Overview table and provides frequently asked questions and answers.
On this page:
Calculations
- What is the difference between a patient projection and a patient target?
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A patient projection is the number of new, unduplicated Health Center Program patients an applicant commits to serving, typically on Form 1A: General Information Worksheet (Service Area Competition (SAC) or New Access Point (NAP) applications) or the Patient Impact Form (supplemental funding applications). A patient target is the sum of patient projections from previously awarded applications.
(Updated: 3/17/2023)
- What should I do in response to my patient target notification EHBs email?
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Your notification email will tell you if your organization is scheduled to complete a BPR or a SAC for FY 2024.
FY 2024 BPR (approximately two-thirds of health centers)
If you will complete a BPR for FY 2024, no action is required. However, you may review your patient target and ask questions by contacting the Patient Target Team using the BPHC Contact Form.FY 2024 SAC (approximately one-third of health centers)
If you will complete a SAC for FY 2024, action is required. The Project Director (PD) and Authorizing Official (AO) should review the patient target calculation, consulting with the governing board or other staff, as appropriate, that develop, review, and approve Health Center Program applications to ensure:- Accuracy of the application projections used to calculate the patient target.
- Understanding of the measurement period and achievement date.
If the patient target and calculation are correct, follow the instructions to confirm the patient target in EHBs. If you have questions, contact the Patient Target team using the BPHC Contact Form.
(Updated: 3/17/2023)
- How does HRSA calculate patient targets?
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Each patient target includes a base value, plus patient projections from awarded Health Center Program applications for operational funding. See the Patient Target Calculation Overview table for details.
(Added: 4/8/2021)
- Patient Target Calculation Overview
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If the next SAC for your service area is the: FY 2024 SAC
(FY 2023 SAC 1-year awards)FY 2024 SAC
(FY 2021 SAC 3-year awards with extensions)FY 2024 SAC
(FY 2020 SAC
3-year awards with extension)FY 2025 SAC
(FY 2022 SAC
3-year awards)FY 2026 SAC
(FY 2023 SAC
3-year awards)Your Patient Target Base Value is the Patient Projection from the: - FY 2023 SAC/SAC-AA
- FY 2021 SAC/SAC-AA
- FY 2020 SAC/SAC-AA
- FY 2022 SAC/SAC-AA
- FY 2023 SAC/SAC-AA
Plus Patient Projections from the following (if applicable): - FY 2022/2023 SAC/SAC-AA supplement
- FY 2020/2021/ 2022 SAC/SAC-AA supplement
- FY 2019/2020/2021/2022/2023 SAC/SAC-AA supplement
- FY 2019 NAP satellite
- FY 2019 IBHS
- FY 2021/2022/2023 SAC/SAC-AA supplement
- FY 2022/2023 SAC/SAC-AA supplement
(Updated: 3/17/2023)
- How can I view the patient target in EHBs?
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Only the PD and AO associated with the Health Center Program (H80) grant in EHBs can view the patient target, including its calculation values (see the Patient Target Calculation Overview table). The PD and AO can access the patient target from a link in the patient target EHBs notification email or in the H80 grant folder through the Patient Target Management link under the “Others” heading.
(Added: 4/8/2021)
- How can I update my role to PD or AO in EHBs to allow me to confirm the health center’s patient target?
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You can update your role in EHBs by following the instructions at How to Update Your System Role in EHBs (PDF - 301 KB).
(Added: 3/17/2023)
Adjustments
- How can I adjust the patient target?
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There are two ways to adjust the patient target, as delineated in the graphic below. COVID-19 public health emergency impacts fall into the SAC application process category. Raise any questions or concerns related to either adjustment method to the Patient Target team using the BPHC Contact form.
Patient Target Adjustment Factors and Methods
EHBs Adjustment Process
Lower patient projection noted in application
Relinquished award
Successor in interest/merger/transfer
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(Updated: 3/17/2023)
- How can I lower the patient target through an adjustment request?
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To request an adjustment to the patient target, consult with the Patient Target Team using the BPHC Contact Form. If it is determined that your patient target can be adjusted, the PD should click the Request Update button (accessible in the H80 grant folder through the Patient Target Management link under the “Others” heading in EHBs) to enter information and send it to the AO for review. The AO must then submit the request to HRSA. Requests for an adjustment must be supported with information available in funded H80 applications. Approval is not guaranteed.
(Added: 4/6/2022)
- How can I lower the patient target through SAC?
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You can lower the patient target up to 25 percent through the SAC application process by making a patient projection that is at least 75 percent of the patient target in the Service Area Announcement Table (SAAT).
If the SAC application patient projection is lower than 95 percent of the patient target, reduce the federal request for funding according to the table below.
Patient Projection Compared to Patient Target (%) Maximum Funding Request 95-100% of Patient Target No funding reduction 90-94.9% of Patient Target 0.5% funding reduction 85-89.9% of Patient Target 1% funding reduction 80-84.9% of Patient Target 1.5% funding reduction 75-79.9% of Patient Target 2% funding reduction Less than 75% of Patient Target Ineligible application (Added: 4/8/2021)
- What should I consider when making an application patient projection?
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Relevant factors to consider when making a patient projection within an application may include:
- Patient, clinical, and financial data.
- Service area and target population needs.
- Local and state trends (e.g., reimbursement changes, population shifts).
- The current patient target (do not duplicate projected new patients across applications).
- The achievement date (ensure a realistic and achievable projection in the calendar year referenced in each NOFO).
Primary Care Associations (PCAs) may serve as a useful resource in developing patient projections. Additional information regarding the impact of patient projections on patient targets will typically be included in the Notice of Award (NoA) for funded applications.
(Added: 4/8/2021)
- I am an existing health center and have submitted a Change in Scope (CIS) request to add a new site. Will the new patient projections for this site be added to the patient target?
- Patients projected in the CIS request to add a site is not a source that is used for the patient target calculation. Assuming the site is added to scope prior to release of the SAC, the new site will be included on Form 5B: Service Sites in the SAC competing continuation application that will be submitted by the health center. The health center should include the patient projection for the new site in the SAC application patient projection. If the SAC application is successfully funded, these patients will eventually be included in the patient target calculation. The SAC application patient projection is the base value for calculating the patient target.
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(Added: 3/17/2023)
Achievement
- What is the measurement period for assessing patient target achievement?
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The measurement period for achievement is the calendar year following the SAC period of performance start date. The achievement date is December 31 of that year. HRSA uses the Uniform Data System (UDS) report (number of patients served) to measure progress and patient target achievement. For example, for health centers awarded a 3-year period of performance through the FY 2024 SAC, the measurement period is calendar year 2025 and the achievement date is December 31, 2025.
(Updated: 3/17/2023)
- How does HRSA quantify achievement of the patient target?
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HRSA has not quantified achievement of the patient target. The SAC application patient projection minimum of 75 percent is specific to SAC application eligibility and is not related to patient target achievement.
(Added: 4/8/2021)
- What happens if my health center does not achieve the patient target by the required date?
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HRSA will monitor progress toward achieving the patient target during the period of performance. We recognize the significant impacts of the COVID-19 public health emergency on health center operations and do not anticipate adjusting funding prior to any FY 2024 SAC announcements based on past performance relative to patient targets.
(Updated: 3/17/2023)
- How does HRSA use the patient target?
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HRSA uses the patient target to:
- Ensure awareness of the patient commitment for each service area.
- Support fair competition and continued provision of comprehensive primary health care services within funded service areas.
- Assess health center progress toward serving the number of patients for which funding was awarded.
(Updated: 4/6/2022)
- How will patient targets fit into the new Advancing Health Center Excellence framework?
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HRSA is exploring ways to align patient targets more holistically with health center performance.
(Updated: 4/6/2022)
Acronyms
- IBHS – Integrated Behavioral Health Services (HRSA-19-100)
- NAP – New Access Points (HRSA-19-080)
- SAC – Service Area Competition
- SAC-AA – Service Area Competition-Additional Areas
Date Last Reviewed: