Attachment 10 - Survey Methodology and Selection Specifications

Community and Migrant Health Centers and
Homeless and Public Housing
Patient Surveys
Survey Methodology and Selection Specifications

Table of Contents
1. Introduction............................................................................................................................................... 1
2. Target Population...................................................................................................................................... 2
3. Grantee Sample Selection ......................................................................................................................... 3
3.1

Sampling Frame Construction ...................................................................................................... 3

3.2

Stratification Variables ................................................................................................................. 3

3.3

Select Stratified PPS Sample of Grantees..................................................................................... 3

4. Site Sample Selection ............................................................................................................................... 5
4.1

Determination of Eligible Sites within Participating Grantees ..................................................... 5

4.2

Evaluate Distances between Eligible Sites ................................................................................... 5

4.3

Select Sites .................................................................................................................................... 6

5. Patient Sample Selection........................................................................................................................... 8
5.1

Patient Sample Allocation............................................................................................................. 8

5.2

Patient Sample Selection Procedure ............................................................................................. 9

6. Hypothetical Examples of Grantee, Site, and Patient Selection........................................................... 13

i

1. Introduction
The Bureau of Primary Health Care (BPHC) Patient Surveys, sponsored by the Health Resources and
Services Administration (HRSA), aim to collect data on the patients who use health centers funded under
Section 330 of the Public Health Service Act. Results from the Patient Surveys will guide and support
BPHC in its mission of improving the health of the Nation’s underserved communities and vulnerable
populations by assuring access to comprehensive, culturally competent, quality primary health care
service. The Patient Surveys will collect data from the clients of health centers funded through four
BPHC grant programs: the Community Health Center Program (CHC), the Migrant Health Center
Program (MHC), the Health Care for the Homeless Program (HCH), and the Public Housing Primary
Care Program (PHPC).
To this end, the BPHC funded two contracts:
•

•

The Community and Migrant Health Center Patient Surveys (C/MHC) contract will collect and
analyze data from clients of the CHC and MHC programs. Respectively, these two programs
serve low-income and migrant/seasonal agricultural workers.
The Homeless and Public Housing Health Centers Patient Surveys (H/PH) contract will collect
and analyze data from clients of the HCH and PHPC. Respectively, these two programs serve
homeless individuals and residents of public housing.

Because some of the Section 330-funded health centers receive grants through more than one of the
aforementioned grant programs, extensive coordination between the two contracts will create efficiencies
that will allow for larger sample sizes and ensure consistency between the two studies. Therefore, the
sample design for the C/MHC and H/PH studies reflects the decision by BPHC to coordinate these two
studies using a harmonized sampling and data collection approach.
In Deliverable 5, we presented a three-stage PPS sample design for the Patient Survey and discussed
the plan of sample selection at each stage in order to select the patient samples for four funding programs.
Our target is to recruit 115 unique grantees and complete 4,522 patient interviews for the Patient Survey
(2,210 for C/MHC and 2,312 for H/PH). In this report, RTI International1 will further clarify our plans by
providing more details on methodology and selection specification at each stage of selection.

1

RTI International is a trade name of Research Triangle Institute.

1

2. Target Population
The target population for the Patient Surveys is defined as persons receiving face-to-face services
from a CHC, MHC, HCH, or PHPC grantee, and as persons receiving these services from a clinical staff
member who exercises independent judgment in the provision of services.2 Clients of grantees located
within the 50 United States and the District of Columbia are included; clients of grantees within U.S.
territories and possessions are excluded.
Only persons who received services through one of these grantees at least once in the year prior to the
current visit were considered eligible for the survey. This eligibility criterion was used because many of
the questions in the Survey ask about services received in the past year; individuals without previous
visits would not have been able to answer these questions and, therefore, were not considered eligible.
This eligibility criterion was also implemented in the BPHC’s previous Community Health Center Survey
(2002) and Healthcare for Homeless Survey (2003).

2

To meet the criterion for “independent judgment,” the provider must be acting on his/her own when serving the
patient and not assisting another provider.

2

3. Grantee Sample Selection
This section discusses the methodology for selecting grantees. This process includes sampling frame
construction, stratification, and PPS selection of grantee samples.

3.1

Sampling Frame Construction

Grantee sample selection will begin with the construction of a sampling frame using the updated
BPHC Uniform Data System (UDS). In this report, we used 2006 Uniform Data System (UDS). The 2006
UDS grantee-level data have 1,002 grantees. A total of 961 grantees are eligible for the Patient Survey by
excluding 6 grantees that received CHC funding but only operated School-Based Health Centers; 28
grantees that are from Puerto Rico, the Virgin Islands, and the Pacific Basin U.S.
territories/possessions/affiliated States; and 7 grantees receiving MHC funding but that served clients
through a voucher program. Grantee characteristics such as funding program, region, urban/rural location
and number of sites will be used as explicit and implicit stratification variables (see Deliverable 5 Statistical Design Plan).
A sampling frame file in SAS will be created, and the SAS data file will include at least the following
key variables: unique grantee identification, stratification variable (see next section for details), region,
urban/rural location, number of sites, and number of patients.

3.2

Stratification Variables

As discussed in Deliverable 5 - Statistical Design Plan, a random unstratified sample would yield a
very small patient sample size for the PHPC and MHC funding programs, which would result in very
limited statistical power to compare survey outcomes between funding programs. Our design goals
include decreasing the grantee and patient sample size from the CHC funding program, increasing the
grantee and patient sample size for MHC and PHPC funding programs and completing a total of 4,522
interviews (2,210 for C/MHC and 2,312 for H/PH). We will create four strata according to the funding
programs that a grantee receives. Exhibit 1 shows the details of the stratification of grantee by funding
programs.
Exhibit 1. Definition of Stratification
Strata

Grantee Funding Type*

Stratum 1: Grantees with CHC Funding Only

Number of
Grantees

C
P; CP; PH; CMP; CPH;
CMPH

651

Stratum 3: Remaining Grantees with MHC Funding

M; CM; CMH

123

Stratum 4: All Remaining Grantees Not Included in
Stratum 1-3

H; CH

150

Stratum 2: All Grantees with PHPC Funding

Total

37

961

NOTE: C = Community Health Center Program; H = Healthcare for Homeless Program; M = Migrant Health Center
Program; P = Public Housing Primary Care Program.

3.3

Select Stratified PPS Sample of Grantees

We will achieve our design goals by applying a stratified PPS sampling method of selecting grantees.
One scenario of a stratified disproportionate sampling was proposed in Deliverable 5 - Statistical Design
Plan. The grantee sample allocation for each stratum is summarized in Exhibit 2.

3

Exhibit 2. Grantee Sample Allocation of a Stratified Disproportionate
Sampling
Total Number
of Grantees

Selected
Grantees

Sampling Rate

Stratum 1: Grantees with CHC Funding Only

651

40

6.14%

Stratum 2: All Grantees with PHPC Funding

37

37

100.00%

Stratum 3: Remaining Grantees with MHC Funding

123

25

20.32%

Stratum 4: All remaining Grantees Not Included in
Stratum 1-3

150

13

8.67%

Total

961

115

11.97%

Strata

NOTE: C = Community Health Center Program; M = Migrant Health Center Program; P = Public Housing
Primary Care Program.

With the specified sample allocation for each stratum shown in Exhibit 2, we will then select
grantees using the PPS sampling selection using PROC SURVEYSELECT in SAS for Strata 1, 3, and 4.
We will use the sequential random selection option and sort the frame by region, urban/rural location, and
number of sites to serve as implicit stratification within each stratum, as discussed in Deliverable 5 Statistical Design Plan. The number of patients of a grantee is served as the size measure in the PPS
sequential sampling selection. A random number seed will be used and retained to ensure that the sample
is repeatable and verifiable. The selected grantee sample will be output to a SAS dataset, and analyses
will be conducted to ensure the selected grantees are a representative sample in terms of key grantee
characteristics, such as funding type, region, urban/rural location, and categorized number of sites. All
RTI International Standard Operating Procedures and Technical Operating Procedures regarding sample
selection will be followed.
To account for selected grantees’ refusal to participate, in Strata 1, 3 and 4 we will select 15% more
grantees for each stratum. The additional 15% will be held in reserve to replace grantees refusing to
participate in the study.

4

4. Site Sample Selection
As discussed in Deliverable 5 - Statistical Design Plan, more than half of the grantees have three or
more sites. In general, grantees with more sites tend to have larger numbers of patients. Furthermore, the
grantees are selected with the PPS method at the first stage of selection, which means that grantees with
large numbers of patients have a higher probability of being selected in the sample. As a result, we expect
that a fair number of the recruited grantees will have more than three sites. We will only allow at most
three sites for each funding program within a grantee to be in the studies; therefore, for those grantees
with more than three sites, we will select three from their larger total. This section discusses the
methodology and specifications for selecting a site from a participating grantee.

4.1

Determination of Eligible Sites within Participating Grantees

Once a grantee is recruited and agrees to conduct the study in its sites, our recruiters will work with
the grantee administration to collect and verify the number of sites and the funding support that each site
receives. The sites that do not receive support from at least one of the four specific funding programs will
be excluded from the study.
As discussed in Deliverable 5 – Statistical Design Plan, some grantees have school-based sites,
which are funded under the CHC program. Due to the complexity of recruiting a school-based sites and
the required extra effort of getting permissions from a school and parents/guardians to interview the
patients, recruiting stand-alone, school-based sites is not feasible within the current survey schedule and
budget. Therefore, such sites will be excluded from the Patient Survey. Although these sites are excluded,
along with any grantees that have only school-based sites, we will not necessarily be excluding all
patients who receive school-based health services; some children who receive medical care at a schoolbased health center site may receive some of their care at a non-school-based Community Health Center
site near their residence.
Sites operated by the grantee and subcontractor sites are considered eligible if they meet the following
criteria:
•
•
•
•

The site should participate in at least one of the four specific funding programs and must have
been operating under the grantee for at least 1 year.
The site is not a temporary clinic.
The site is not a school-based health center.
The site is not a specialized clinic, excepting clinics providing OB/GYN services.

After the eligible sites are determined, our field staff will complete a Grantee Information Sheet
(Exhibit 3) to gather the following information from each participating grantee. Field staff must ensure
that the collected information is accurate and updated because the information is very critical to the
Patient Survey. Our sampling staff will use the information to select the health centers from the
participating grantee. For each funding type(s) that the grantee receives, the following information will be
collected:
•
•
•

4.2

number of eligible sites serving each client type (i.e., migrants, homeless, public-housing, and
low-income)
address and contact information for each eligible site
number of patients served in each eligible site, overall and by type of client (CHC, MHC, HCH
and PHPC)

Evaluate Distances between Eligible Sites

As discussed in Deliverable 5 – Statistical Design Plan, our sampling staff will evaluate the
distances between all of the eligible sites and the grantee’s headquarter for a specific funding program of
a participating grantee.

5

4.3

Select Sites

If there are three or fewer sites for a specific funding program, and all of the sites are within a 100mile radius of the grantee’s headquarters, all of the sites will be selected. When there are sites for one
funding program, if one health center site is far from the other two sites that are nearer to each other, the
two sites that are close to each other will be selected. However, if all three sites are far from each other,
we will select only one health center site, the site with the largest patient volume. Similarly, when two
sites for a specific funded program are far from each other, the one with the largest number of patients
will be selected.
Sampling sites for a specific funding program in grantees with more than three sites is addressed
below.
For grantees with more than three sites for a specific funding program, we will evaluate the distances
between all sites and the grantee’s headquarters as discussed in Section 4.2. We will only focus on the
sites that are within a 100-mile radius of the grantee’s headquarter and use a PPS sampling method
similar to the one described in Section 3.3 to select three sites. The number of patients for the sites of a
specific funding program will serve as the size measure in the PPS sampling. The PPS selection is
independent for each funding program in the grantees with multiple funded programs.
We will select three sites using the PPS sample using PROC SURVEYSELECT in SAS. Some
grantees may have sites operating in both urban and rural areas. For those grantees, we will balance the
selected site sample in terms of urban/rural location. We will sort the sites by urban/rural location before
PPS selection if necessary. A random number seed will be used and retained to ensure that the sample is
repeatable and verifiable. The selected site sample will be output to a SAS dataset, and analyses will be
conducted to ensure that the selected health center sites are a representative sample. All RTI Standard
Operating Procedures and Technical Operating Procedures regarding sample selection will be followed.

6

Exhibit 3. Grantee Information Sheet

7

Grantee Name:
Grantee Address:
Funding Type Received:
Number of Eligible Heath Center Sites Receiving Support at Least One of the Four Funding Programs:
Eligible
Total #
Number of Patients Served Under Each
Health
Street
City
State
Zip
of Patients
Funding Program
Center
Address
Served
Migrant Public Housing Homeless Low Income
Site
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
.
.
99
100

5. Patient Sample Selection
In Section 3 and Section 4 of this report, we discussed the selection of grantees and the selection of
sites from selected grantees. In this section, we present the methodology and specifications for selecting
patients from participating sites.

5.1

Patient Sample Allocation

Following the sampling selection scenario presented in Exhibit 2, we will recruit a total of 115
unique grantees. Because we will select an independent sample from each funding program in which each
sampled grantee participates, this practice is equivalent to collecting a patient sample from 208 grantees if
the patient samples had only been selected from a total of 115 unique grantees, with each grantee only
representing one funding program. To meet the targeted number of interviews for each patient population,
the targeted number of interviews per grantee varies by patient population. In grantees participating in the
MHC funding program, a total of 35 interviews will be completed with patients who are migrant workers.
In grantees participating in the HCH funding program, a total of 48 interviews with homeless patients will
be completed. In grantees participating in the PHPC funding program, a total of 18 patients who live in
public housing will be interviewed. Finally, in grantees participating in the CHC funding program, a total
of 11 interviews will be completed with patients who are not migrant workers, homeless, or living in
public housing (see Exhibit 4). This specific sampling scenario achieves the design objective of
recruiting 115 grantees and selecting enough patients to complete 4,522 total patient interviews, with
2,210 for C/MHC and 2,312 for H/PH.
Exhibit 4. Yield of the Grantee Funding Type and Patients of a Stratified
Disproportionate Sampling

Funding Type

Expected Number of
Grantees

Number of Patients per
Grantee

Expected Number of
Completed Interviews
for each Funding Type

C

106

11

1,166

H

34

48

1,632

M

31

35

1,085

P

37

18

666

Total

208

4,549

NOTE: C = Community Health Center Program; H = Healthcare for Homeless Program; M = Migrant
Health Center Program; P = Public Housing Primary Care Program.

For C/MHC, we get roughly the same number of interviews for CHC and MHC programs. However,
the goal of roughly the same interviews for HCH and PHPC is difficult to achieve for H/PH. In the 2006
UDS, there were 701,623 patients from HCH program, and only 129,280 patients from PHPC. The PHPC
population is much smaller than HCH population. We are concerned about the amount of time an

interviewer may need to spend in the sites in order to come into contact with eligible PHPC
patients. Therefore, we have reduced the production goal for the PHPC population. We expect 48
patient interviews will be completed from each participating HCH grantee and 18 patient interviews will
be completed for each participating PHPC grantee. The reduced goal of 18 completed interviews per
PHPC grantee may still be too aggressive. We will check the patient volume for each selected site that
served PHPC patients and will consult with BPHC Project Officer when/if it becomes problematic.
When we select the real sample, to meet the targeted complete interviews of 4,522 (2,210 for
C/MHC, 2,312 for H/PH), we will need to adjust the sampling rates at grantee selection for each stratum
described previously and the number of interviews per grantee for a specific funding program as well.
If more than one site is selected for a funding program in a particular grantee, the number of
completed interviews will be divided equally among those sites. For example, in a grantee where three
8

sites are selected as part of the HCH program, patients will be selected to complete 16 interviews from
each site.
The number of interviews for a site varies from 3 to 91, as discussed in Deliverable 5 – Statistical
Design Plan. We provide three hypothetic examples to show the allocation of patient interview to each
site in Section 6.

5.2

Patient Sample Selection Procedure

C/MHC and H/PH patients will be selected for the study using onsite recruitment procedures
designed to address Health Insurance Portability and Accountability Act (HIPAA) privacy concerns. No
field interviewer (FI) will be allowed to approach any of the health center’s patients or to obtain any
identifying information about a patient unless the selected patient initiates such contact with an FI.
The procedures for patient selection are as follows.
1. Patient Registration: As each patient enters the site during the sample selection period, the
receptionist will register him/her to receive health services and record a tally mark on the Patient
Arrival and Selection Tracking Form (as shown in Exhibit 5). The receptionist will determine
whether a patient is eligible for the Patient Survey (i.e., had received services at least once in the
past year from one of the four funding programs).
2. Patient Selection: The receptionist will select patients as they enter and register according to the
detailed sample selection protocols to ensure the selection of a random sample of patients. The
receptionist will select the first eligible patient registered after the FI informs the receptionist that
he/she is ready for the next interview. If the patient is eligible, the receptionist will read a brief
recruitment script to the patient (or to his/her parent or guardian, for selected children) and give
him/her a packet of information on the Patient Survey. The receptionist will record the number of
patients selected in the Patient Arrival and Selection Tracking Form as shown in Exhibit 5. The
Patient Arrival and Selection Tracking Form will be used in the nonresponse adjustment in
calculating analysis weights.
3. Patient/Interviewer Contact: If the selected patient is interested in participating in the Patient
Survey or has questions, he/she will approach the FI, who will be waiting in a designated area in
the site. The FI will take the participant to a designated, private location at the site to begin the
screening, informed consent, and interview processes. Migrant workers and homeless individuals
will be encouraged to begin the interview process immediately because we anticipate it would be
difficult for them to arrange to meet at a later time and date. CHC and PHPC patients will also be
encouraged to begin the interview process immediately, but we anticipate that some may find it
more convenient to schedule an appointment with the interviewer for a later time and date. The FI
will ask the participant some initial screening questions to confirm the patient’s eligibility for the
study. There are eight screening questions, including whether the patient received service in the
last 12 months; whether they qualify for services under the MHC, HCH, PH, or CHC programs;
patient age; a parent or guardian with you for young patients; etc.(see Exhibit 6). If the patient is
eligible, the FI will continue the data collection interview using the appropriate questionnaire
designed for the population type to which the patient belongs. When the interview is complete,
the patient will receive a $25 incentive.
4. Disposition of Patient Logs: At the end of each day, the FI will collect the Patient Arrival and
Selection Tracking Form from the receptionist. Collected forms will be shipped to RTI’s
sampling department on a weekly basis. RTI statisticians will use the information to calculate
analysis weights. The number of completed patient interviews for each funding program will be
monitored to ensure that the sample size targets are being met for each site.

9

Exhibit 5. Patient Arrival and Selection Tracking Form
Grantee:
Health Center Site:
Funding Program:
Start Time:
Today’s Date:

End Time:

RECORD A TALLY MARK FOR EACH PATIENT WHO PRESENTS FOR SERVICES AND
ANOTHER FOR EACH PATIENT WHO IS SELECTED AND REFERRED TO THE
INTERVIEWER.
Tallies

Total

Patients Registered For Services
Today
Patients Referred to Interviewer
Today

10

Exhibit 6. Patient Screening Form

Bureau of Primary Health Care Patient Surveys
S1.

Have (you/child’s name) received services from a health care professional such as a doctor, nurse, drug
counselor, or mental health counselor at [NAME OF HEALTH CARE CENTER] in the last 12 months?
YES.................................... 1
NO...................................... 2 (TERMINATE INTERVIEW)
REFUSED.......................... 7 (TERMINATE INTERVIEW)
DON’T KNOW.................. 9 (TERMINATE INTERVIEW)

S2.

Do any of the following apply to you?
HAVE YOU WORKED AS A FARMWORKER OR MIGRANT WORKER IN THE PAST 12
MONTHS?
YES.................................... 1 IF YOUR QUOTA IS ALREADY MET, THANK THE
RESONDENT FOR THEIR TIME. IF NOT, USE AN M
CASE ID
NO...................................... 2
IN THE PAST 12 MONTHS, HAVE YOU BEEN WITHOUT REGULAR HOUSING OR HOMELESS,
THAT IS NOT LIVING IN YOUR OWN HOUSE, APARTMENT, OR ROOM ON A REGULAR
BASIS?
YES.................................... 1 IF YOUR QUOTA IS ALREADY MET, THANK THE
RESONDENT FOR THEIR TIME. IF NOT, USE AN H
CASE ID
NO...................................... 2
ARE YOU CURRENTLY LIVING IN A PUBLIC HOUSING UNIT?
YES.................................... 1 IF YOUR QUOTA IS ALREADY MET, THANK THE
RESONDENT FOR THEIR TIME. IF NOT, USE A P CASE
ID
NO...................................... 2
NONE OF THE ABOVENONE ................................ 1 IF YOUR QUOTA IS ALREADY MET, THANK THE
RESONDENT FOR THEIR TIME. IF NOT, USE A C CASE
ID

S3.

What is your age?
•
•
•

S4.

____ YEARS
IF RESPONDENT IS 18 OR OLDER, THEN CONTINUE WITH INFORMED CONSENT.
IF PROXY RESPONDENT FOR CHILD AGE 12 OR YOUNGER, THEN CONTINUE WITH
INFORMED CONSENT.
IF RESPONDENT IS 13-17, THEN GO TO S3.
Is a parent or guardian with you?
YES........................................1 (FIND PARENT, AND PROCEED WITH PARENTAL
INFORMED CONSENT PROCEDURES)
NO..........................................2
REFUSED..............................7
DON’T KNOW......................9

11

S5.

Are you currently living with a parent or guardian?
YES........................................1 (DETERMINE HOW TO REACH PARENT, AND
PROCEED WITH PARENTAL INFORMED CONSENT
PROCEDURES)
NO..........................................2
REFUSED..............................7
DON’T KNOW......................9

S6.

When is the last time that you spent the night with a parent or guardian?
____ NIGHTS AGO. IF S5<7, THEN GO TO S6. OTHERWISE, GO TO S7.

S7.

Could I contact a parent or guardian to ask him/her to allow you to participate in this study?
YES........................................1 (DETERMINE HOW TO REACH PARENT, AND
PROCEED WITH PARENTAL INFORMED CONSENT
PROCEDURES)
NO..........................................2
REFUSED..............................7
DON’T KNOW......................9

S8.

ASK A SITE STAFF PERSON TO OBSERVE THE ADMINISTRATION OF INFORMED
CONSENT PROCEDURES, TO ACT AS AN ADVISOR TO THE YOUTH, AND TO SIGN THE
UNACCOMPANIED YOUTH INFORMED CONSENT FORM AS A WITNESS.

12

6. Hypothetical Examples of Grantee, Site,
and Patient Selection
Exhibit 7 illustrates the three stages of sample selection using five hypothetical grantees. As
described in Section 4 of this report, for each funding program in which a grantee participates, no more
than three associated sites will be selected. Grantee 1 provides a simple example. This grantee receives
funding only through the CHC program. Because this grantee has only two sites, both sites will be
selected into the site sample. Grantee 4 provides a more complex example. Grantee 4 participates in three
funding programs: CHC, MHC, and PHPC. The CHC program supports six sites; the MHC program
supports five sites, and the PHPC program supports one site. A random selection of the six
CHC-supported sites will result in three being selected. Similarly, a random selection of the five
MHC-supported sites will result in three selected. Because there is only one Public Health Primary Care
Program, it will be selected automatically.
Exhibit 7. Hypothetical Example of Grantee, Site, and Patient Selection
Hypothetical
Grantee
Grantee 1

Funding Program(s)
the Grantee
Received

Total Number of
Sites

Number of Selected
Site Sites

Total Patient
Interviews

C

2

2

11

2

2

11

Total
Grantee 2

C

5

3

11

M

2

2

35

7

5

46

Total
Grantee 3

H

1

1

48

P

2

2

18

3

3

56

Total
Grantee 4

C

6

3

11

M

5

3

35

P

1

1

18

Total
Grantee 5

Total

12

7

64

C

5

3

11

P

2

2

18

H

1

1

48

M

3

3

35

11

9

112

NOTE: C = Community Health Center Program; H = Healthcare for Homeless Program; M = Migrant
Health Center Program; P = Public Housing Primary Care Program.

To meet the targeted number of interviews for each patient population, the targeted number of
interviews per grantee varies by patient population. In grantees participating in the MHC funding
program, a total of 35 interviews will be completed with patients who are migrant workers. These 35
interviews will be divided between that grantee’s sampled sites that serve migrant workers. In grantees
participating in the HCH funding program, a total of 48 interviews with homeless patients will be
completed. These 48 interviews will be divided between that grantee’s sampled sites that serve homeless
clients. In grantees participating in the PHPC funding program, a total of 18 patients who live in public
housing will be interviewed. These 18 interviews will be divided between that grantee’s sampled sites that
serve public-housing residents. Finally, in grantees participating in the CHC funding program, a total of
11 interviews will be completed with patients who are not migrant workers, homeless, or living in public
housing. These 11 interviews will be divided between that grantee’s sampled sites that serve patients who
13

are not part of a special population. The total number of patient interviews for a participating grantee can
vary from 11 to 112, as shown in Exhibit 7.
Although Exhibit 7 demonstrates how we arrive at the production goal for each patient population for
each grantee, this exhibit does not illustrate that a particular site could be selected into data collection for
interviews with patients from one or more of the funding programs. Exhibit 8 demonstrates this nuance
and illustrates how we arrive at the production goal for each patient population in each site.
Exhibit 8. Number of Completed Patient Interviews at Health Center Sites in
Hypothetical Grantee 4
Site Sites in Hypothetical Grantee 4
Scenarios

I

II

III

Site Category

1

2

3

4

5

6

7

Health Center Sites Selected
Patients for CHC
Patients for MHC
Patients for PHPC

X
4

X
3
11

X
4

X

X

12

12

Total

4

14

22

12

12

Health Center Sites Selected
Patients for CHC
Patients for MHC
Patients for PHPC

X
3

X

X

X

X
4

X
4

11

12
18

12

Total

3

11

30

12

4

4

Health Center Sites Selected
Patients for CHC
Patients for MHC
Patients for PHPC

X
3
11

X
4
12
18

X
4
12

Total

14

34

16

18

NOTE: The highlighted boxes with an “X” are used to indicate sites that are selected in the Patient Survey
for the hypothetical scenario.

Exhibit 8 focuses on Hypothetical Grantee 4, which we were first introduced to in Exhibit 7. This
hypothetical Grantee 4 has a total of seven sites. Each site is supported by following funding programs:
•
•
•
•
•
•
•

Site 1: CHC
Site 2: CHC; MHC
Site 3: CHC; MHC; PHPC
Site 4: MHC
Site 5: CHC; MHC
Site 6: CHC; MHC
Site 7: CHC

Because Grantee 4 participates in the CHC, MHC, and PHPC funding programs, the total production
goal for this grantee is 64. However, there are various permutations of sites that could be selected for this
grantee. Exhibit 8 illustrates three different scenarios of site selection and demonstrates how this affects
the way the 64 interviews are distributed between the selected sites. The target number of patient
interviews for a selected site depends on three factors: the number of different funding programs from
which the grantee receives, the number of sites a grantee has for each specific funding program, and
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whether a site is selected to represent a single funding program or multiple funding programs. For
example, Site 3 has 22 patient interviews in Scenario I (4 from CHC patients and 18 from PHPC
patients), 30 patient interviews in Scenario II (12 from MHC patients and 18 from PHPC patents), and 34
patient interviews in Scenario III (4 from CHC patients, 12 from MHC patients, and 18 from PHPC
patients).

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