NC ROOTS Hub Lead RFA (RFA# 2026-NCROOTS)
North Carolina
Eligible Entity Types
Funding
Tribal Provisions
The RFA does not explicitly name tribal organizations as eligible Hub Lead applicants. Eligibility is stated as "public and private entities" with a UEI issued by SAM.gov, at least 3 years of NC presence, and sufficient fiduciary capacity — language that includes tribal governments and tribal health programs. EBCI (the only federally recognized tribe in NC) may apply as Hub Lead for Region 1 or participate as a network partner. There is no separate tribal set-aside or government-to-government track in NC ROOTS. Contact NCDHHS Office of Rural Health (dhhs-ncroots.rfa@dhhs.nc.gov) with questions about how tribal governance documentation should be presented.
Application Guide
The NC ROOTS Hub Lead RFA is a competition for six organizations to serve as the programmatic and fiduciary lead for one of NC's Medicaid Standard Plan regions. Each selected Hub Lead receives approximately $39.25 million for the initial 17-month contract period (June 2026 – October 2027) and is responsible for building a regional network of providers to implement all six NCRHTP initiatives.
This is not a direct sub-grantee application. If your organization is not applying to be a Hub Lead, there is no direct application to NCDHHS — your entry point will be joining a Hub network after Hub Leads are selected, expected June–August 2026.
The RFA states three eligibility requirements: (1) a Unique Entity Identifier (UEI) issued by SAM.gov; (2) at least three years of physical presence in and experience delivering programs in North Carolina; (3) sufficient capital and fiduciary capacity to cover program costs before reimbursement. The grant operates on a reimbursement basis — Hub Leads pay upfront and invoice NCDHHS.
For large FQHCs: organizations like Greene County Health Care, Roanoke Chowan Community Health Center, and Blue Ridge Health are strong Hub Lead candidates. Section 330 grant management experience translates directly. Confirm your SAM.gov registration is current and your cost allocation methodology is documented.
For health systems: ECU Health, UNC Health, Novant, and Atrium affiliates may apply for their respective regions. NCDHHS reviewers will assess how Hub Lead applicants plan to structure network partner selection — perceived bias toward system-affiliated facilities is a risk to the application.
For EBCI and tribal organizations: eligibility is confirmed under the "public and private entities" language. The RFA does not enumerate specific eligible entity types. If applying as Hub Lead, your 638 contract management infrastructure demonstrates fiduciary capacity. If participating as a network partner, engage with the Region 1 Hub Lead organization once selected.
For organizations not pursuing a Hub Lead role: prepare now — SAM.gov registration, documented cost allocation methodology, and prior federal award documentation — so you are ready when Hub Leads solicit network partners.
Notice of Intent to Apply was due March 6, 2026. Hub Lead awards announced May–June 2026 (estimated). Network partner solicitation by Hub Leads expected June–August 2026.