North Carolina RHTP Compliance Prerequisites

The April 2, 2026 deadline is for Hub Lead applications — organizations proposing to serve as the fiduciary and programmatic lead for one of NC's six regional hubs. If your organization is not a Hub Lead applicant, your compliance preparation work happens now so you are ready when Hub Leads begin selecting network partners, expected June–August 2026.

For Hub Lead applicants: the RFA requires SAM.gov registration as a hard prerequisite. Beyond that, the fiduciary responsibility for a $39.25 million award means reviewers will be assessing your financial management systems, audit history, and organizational capacity to float costs before reimbursement. NCDHHS will scrutinize: audited financial statements (most recent two fiscal years), prior grant management experience at comparable scale, and documented cash reserves or credit capacity. These are not stated in the RFA as pass/fail criteria — they are the substance of competitive review.

For network partner preparation: if you expect to join a Hub network rather than lead one, prepare the same compliance infrastructure now. Hub Leads will conduct their own sub-award processes for network partners, and they will apply similar vetting criteria. Organizations that arrive at those conversations with active SAM.gov registration, documented cost allocation methodology, and clean audit history will secure network partnerships; those that don't will be passed over in favor of organizations that are ready.

For tribal applicants: there is no separate tribal set-aside in NC ROOTS. The Eastern Band of Cherokee Indians and NC's state-recognized tribes participate through the general hub structure. Tribal organizations are explicitly eligible, but competition is in the same pool as FQHCs, CAHs, and large health systems. Contact NCDHHS Office of Rural Health directly regarding how tribal governance documentation (tribal resolutions, 638 contract structure) should be incorporated into hub applications.