3. Implementation Reviewer Cost Form Final.xlsx

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Implementation Reviewer for Child Welfare Psychotropic Med
Solicitation number
RFP - 10A - 202512157
Issued by
Maine

About this file

This is a Cost Proposal Form submitted to the State of Maine Department of Health and Human Services for RFP #202512157, which seeks an Implementation Reviewer to evaluate the Department's compliance with a Settlement Agreement regarding psychotropic medication administration to children and youth in foster care. The contractor will be responsible for gathering, analyzing, and reporting on statewide practices concerning psychotropic medication oversight, with deliverables including a sampling and data analysis plan, data collection within 60 calendar days of each reporting period, and draft reports within four months of each reporting period's close. The initial performance period runs from April 1, 2026, to March 31, 2028, with three optional renewal periods available, potentially extending the contract term to five years. The proposal submission deadline is December 30, 2025, at 4:00 p.m. local time via the Vendor Self Service System, with a questions deadline of December 12, 2025, at 4:00 p.m. local time. The proposal evaluation uses a 100-point scale comprising 30 points for Organization Qualifications and Experience, 40 points for Proposed Services, and 30 points for Cost Proposal.

The cost must be presented as a fixed amount for a maximum total of 90 completed case reviews per review period, with the first reporting period including twelve months of data following the start date and subsequent reporting periods covering six-month intervals. Bidders must complete the budget form by itemizing all proposed salary positions with hourly rates and total hours, subcontractor or consultant costs, travel expenses (not to exceed current State rates as referenced on Maine's Office of State Comptroller travel website), and supply costs. Travel reimbursement must comply with State rates and requires justification for all related expenses including mileage, lodging, airfare, and incidentals. A detailed budget for any contract renewals must be provided at least 120 calendar days prior to the renewal period, and the contractor must be free of conflicts of interest with specified entities while maintaining HIPAA compliance and MaineIT Policies & Standards.

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Text version

Cost Form

State of Maine
Department of Health and Human Services
COST PROPOSAL FORM
RFP# 202512157
Implementation Reviewer for Child Welfare

Psychotropic Medication Performance Criteria

Agency Name:
Contact Person:
Bidders must complete the budget form by entering data in the white spaces. Bidders should take caution when adding additional lines ensuring existing formulas calculate correctly. This cost must be presented as a fixed amount for a maximum total of ninety (90) completed cases per review period. The first reporting period shall include twelve (12) months of data following the start date of the initial period of performance. Subsequent reporting periods include data for the next six (6) month period.
Review Period
1Salaries
(list all positions proposed for this RFP and the rate for each)Hourly RatexTotal # of Hours=Amount
x=$0.00
x=$0.00
x=$0.00
x=$0.00
2Total Salary$0.00
3Subcontractor(s)/Consultant(s)Amount
4Total Subcontractor Cost$0.00
5Other
6Travel - Justification
Provide all related travel costs (i.e. mileage, lodging, airfare, incidentals, etc.)

Travel reimbursement may not exceed the current State rates.

https://www.maine.gov/osc/travel Amount

7 Supplies - Justification

Total Other$0.00
8Total Cost for Completing Ninety (90) Cases per Review Period$0.00

File details come from the government source that posted it. Updated .