West Virginia RHTP Compliance Prerequisites

No sub-grant solicitation has been published yet. West Virginia's RHTP implementation is advancing through a legislative appropriation (Senate Bill 570) rather than direct agency action, and the West Virginia Department of Health has not released a solicitation, framework, or sub-grantee eligibility document as of March 2026. Use this window to build compliance infrastructure — West Virginia's seven-program framework is more defined than most Phase 0 states, and solicitations could follow SB 570 passage quickly.

West Virginia is administering RHTP through the West Virginia Department of Health — the agency created in 2024 when the former DHHR (Department of Health and Human Resources) was reorganized into separate entities. The relevant agency is the WV Department of Health, not DHHR or the Department of Human Services. Applicants should verify agency identity before directing correspondence.

The sub-grant mechanism will operate under a grant structure (not a contract/procurement), meaning 2 CFR 200 Uniform Guidance applies in full to sub-grantees once solicitations are published. West Virginia does not use a WEBS-style procurement portal for health grants.

The payment mechanism (advance vs. reimbursement) has not been published. West Virginia's existing federal program administration has historically favored reimbursement, which creates cash flow burden for organizations with thin reserves — particularly relevant for WV's financially stressed CAHs and small behavioral health providers. Organizations should assess cash flow capacity before submitting.

West Virginia's unique feature is the legislative appropriation vehicle (SB 570) rather than pure agency action. This means implementation pace may depend on the WV legislative session calendar and Governor Morrisey's signature. As of March 2026, the session is still active and SB 570 has cleared House Finance Committee. Final passage is anticipated but not confirmed. No technical assistance for compliance preparation has been announced. Monitor the WV Department of Health website for implementation announcements following SB 570 passage.

SAM.gov registration with an active Unique Entity Identifier (UEI) is a federal baseline requirement for all organizations receiving federal grant funds, including state-administered pass-through awards under 2 CFR 200. No West Virginia-specific RFA has been published to confirm the explicit requirement, but it should be treated as a hard prerequisite. Verify your organization's SAM.gov registration is active at sam.gov. Annual renewal is required — registrations expire after 12 months; a lapsed registration disqualifies an applicant at submission. Initial registration or renewal takes 7–10 business days. West Virginia CAHs and FQHCs that receive Medicare/Medicaid reimbursement and existing federal grants typically have active SAM.gov registrations already. Behavioral health organizations and smaller rural providers that have not previously received federal grants should begin the SAM.gov registration process now.

Under 2 CFR 200 Uniform Guidance, sub-grantees must maintain a written cost allocation methodology that demonstrates how shared costs are assigned to federal awards. West Virginia's CAHs (21) and FQHC organizations have existing cost allocation frameworks tied to Medicare cost reports and Section 330 requirements. However, the seven-program framework may require organizations to allocate costs across multiple RHTP-funded activities — confirming that your methodology can handle multiple concurrent federal awards from the same pass-through entity is a compliance preparation task for this window. CCBHCs and behavioral health providers applying under programs like Health To Prosperity Pipeline or Personal Health Accelerator should verify their cost allocation methodology covers federal pass-through grants if they primarily operate under state-only or Medicaid fee-for-service funding. The de minimis indirect cost rate (10% under 2 CFR 200.414(f)) is available to organizations without a negotiated rate.

Organizations expending $1,000,000 or more in federal funds in a fiscal year are required to obtain a single audit under 2 CFR 200 Subpart F (threshold updated under 2024 Uniform Guidance revision from $750,000). West Virginia's CAHs and FQHC organizations almost universally exceed the $1M federal expenditure threshold and already undergo single audits. Audit health is particularly material in WV: the state's rural hospitals have documented financial stress, and some have had audit findings related to liquidity or internal controls. A history of clean audits — no material findings, no repeat findings — will be an important competitive signal when RFAs are published.

No state-specific compliance prerequisites for West Virginia RHTP have been published as of March 2026. SB 570 has not yet received final passage, and the WV Department of Health has not released a solicitation. When solicitations are published, monitor for: state procurement registration through the wvOASIS system, insurance minimums, match or cost-share requirements, organizational age requirements, audited financial statements (prepare 2–3 years; WV DOH may require more for CAHs given financial stability concerns), and whether the seven programs have separate solicitations or a single unified RFA with program tracks.

West Virginia reorganized DHHR in 2024 into separate agencies. The "West Virginia Department of Health" (not the Department of Human Services, not DHHR) is the entity designated in SB 570 to receive the RHTP appropriation. Applicants should direct all RHTP inquiries to the Department of Health specifically. West Virginia has no federally recognized tribal nations. No tribal set-aside or dedicated tribal track applies.