First Choice Services, Inc.

First Choice Services, Inc., a tax-exempt nonprofit organization headquartered in Charleston, West Virginia, operates as a federal grant recipient delivering behavioral health crisis services, health insurance navigation, and mental health support programs to state and federal agencies across West Virginia and Pennsylvania. The organization receives direct federal grants (27% of recent awards) and operates predominantly as a sub-recipient under state-administered federal grants (73% of recent awards), with no federal prime contracts in its portfolio.

First Choice's funding footprint centers on the Department of Health and Human Services. The organization holds three direct federal grants from HHS Substance Abuse and Mental Health Services Administration (SAMHSA Center for Mental Health Services) under the 988 and Behavioral Health Crisis Services Programs (CFDA 93.00R) and related crisis intervention initiatives, plus a cooperative agreement from HHS Centers for Medicare and Medicaid Services for health insurance navigation services. The largest direct award is a five-year, $2.5 million annual cooperative agreement from CMS (Aug 27, 2024 through Aug 26, 2029) to provide health insurance navigation services statewide in West Virginia and Iowa, leveraging 30 federally trained and certified navigators to serve racial and ethnic minorities, rural communities, LGBTQ+ individuals, unhoused populations, American Indian individuals, and other priority populations including Medicaid-eligible but unenrolled consumers. A $250,000 SAMHSA grant awarded September 30, 2026, funds a three-year follow-up support program for individuals contacting the 988 Suicide and Crisis Lifeline in West Virginia, serving 2,500 callers annually with systematic follow-up within 24 hours, suicide and overdose risk assessment through 12 months, and staff training on veteran-specific needs and emerging acuity trends. An earlier $1 million SAMHSA project grant (Sept 30, 2023 through Sept 29, 2026) supported crisis case management and coordination across West Virginia's crisis continuum of care, serving 9,000 individuals annually.

First Choice also serves as a sub-recipient on 22 federal grants flowing through state entities. The West Virginia Department of Health and Human Resources and the Pennsylvania Department of Drug and Alcohol Programs are the primary pass-through grantees, funding First Choice to deliver children's mental health programs and 24/7 treatment referral and crisis intervention hotline services in both states. Sub-award flow includes six sub-grants from West Virginia DHHR for children's mental health programs (most recent December 2025) and at least four sub-grants from Pennsylvania for crisis hotline operations (most recent April 2026). Workforce West Virginia also passed through a reentry employment opportunities grant (Sept 1, 2024). Combined obligated dollars across all awards total $37 million, with activity increasing from one award in 2022 to six in 2025, though the three awards recorded in 2026 suggest a more recent modulation in award velocity. The organization serves six distinct federal customer agencies through its grant work, concentrated heavily in HHS as the primary funder of behavioral health and navigation services in Appalachia and the Upper Midwest.