Background: Creating policy, systems, and environment changes (PSEs) is an evidence-based health promotion strategy supported by public health research. However, issues in facilitating understanding of PSEs have caused challenges with implementation. PSEs are crucial in West Virginia (WV) where only 50% of residents have access to physical activity opportunities, 12% are food insecure, and 10.2% have limited access to health care due to cost. In this case study, the WV health agency used micro-funding to encourage community-based organizations and health care systems to implement PSEs. This study reports the number of PSEs implemented and the extent grantees accurately identified their activities as PSEs. Methods: The study sample is 61 grantees that received micro-funding. Resources and technical assistance (TA) processes were created to increase the capacity of grantees to implement and report PSEs. In one year, grantees were provided self-guided resources, and, in another year, grantees were provided self-guided resources and tailored TA. In their end-of-year evaluation reports, grantees were asked to identify their activities as P, S, or E. Study investigators independently coded reported activities and resolved discrepancies though consensus. Comparisons between the two years were made to determine the extent to which grantees accurately described their PSEs. Additionally, responses from 11 grantees who received funding in both years were analyzed to determine capacity to identify PSEs. Results: Eighty-two percent of the activities implemented were identified as PSEs by the study investigators; the average cost per PSE was $941. Grantees receiving self-guided resources and tailored TA correctly classified activities as PSEs more frequently than those receiving only self-guided resources. Roughly half of the 11 repeat grantees increased the percentage of correctly identified PSEs. Conclusions: Micro-funding can be a cost-effective way to increase the PSE implementation. To build capacity for reporting, a combination of self-guided and tailored TA provides better results.