Attachment #4 - IHIN Cost Proposal.xlsx
XLSX spreadsheet 39 KB Posted
- Solicitation number
- RFP-185-2515-2026
- Issued by
- Polk County, Des Moines City, Iowa
About this file
This document is a Cost Proposal Template for the Iowa Health Information Network (HIE) Request for Proposal (RFP-185-2515-2026), issued by Iowa Health and Human Services (HHS). The comprehensive cost proposal template covers a 10-year contract period and requires respondents to detail implementation, maintenance and operations (M&O), and transition out costs for a Health Information Exchange infrastructure and associated applications. The template is structured to capture costs across 15 distinct task areas, including core HIE functionality, various HIE applications such as patient record exchange, bed availability dashboard, electronic lab reporting, syndromic surveillance, and bidirectional data sharing using FHIR standards.
The cost proposal template is designed with empty cost fields that respondents must populate, with specific instructions to enter costs only in yellow-shaded areas. The document outlines cost categories including implementation costs, annual M&O costs for eight years, and transition out costs, with the expectation that respondents will provide firm fixed pricing. The rate card section requires respondents to list project roles, staff titles, and corresponding hourly professional services rates for each contract year. The template emphasizes that all costs must include hardware, software, licensing, staffing, and other associated expenses required to meet the specified deliverables, with the understanding that the Agency will not pay maintenance, support, hardware, hosting, and license costs during the implementation phase.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment #2 - Subcontractor Disclosure Form.docx | DOCX document | |
| RFP-185-2515-2026 Health Information Network (Health Information Exchange).pdf | ||
| 1305844-event.pdf | ||
| Attachment #5 - Sample Contract.docx | DOCX document | |
| Attachment #1 - Respondent Information Form.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Table of Contents
| RFP-185-2515-2026: Iowa Health Information Network (Health Information Exchange) | |
| Cost Proposal | |
| Respondent: | Enter Respondent Name in This Cell - Linked to other worksheets |
General Cost Proposal Guidelines: 1. This Microsoft Excel Cost Proposal Template contains multiple worksheets designed to provide an understanding of the costing models used by the Respondent.
2. Use of this Cost Proposal Form is essential to the Agency for proposal evaluation, and it is essential that the Respondent use this form in preparing firm fixed fee pricing in response to this RFP.
3. This Cost Proposal Form must be completed in its entirety and be provided as part of the Proposal, and it is the responsibility of the Respondent to ensure worksheet calculations are correct.
4. Please supply requested information in only the yellow-shaded areas throughout the worksheets.
5. The RFP document provides details on how costs will be evaluated.
| Worksheet Title/Hyperlink | Description |
| Total Cost Summary | The Total Cost Summary worksheet includes the Implementation, M&O, and Transition Out costs for a 10-year total cost of ownership. |
| Implementation Costs | The Implementation Costs worksheet details the costs associated with the efforts and deliverables for the implementation project. |
| M&O Costs | The M&O Costs worksheet details the one-time and ongoing Maintenance, Support, Hardware, Hosting, and License costs for the system. |
| Transition Out | The Transition Out worksheet details the costs for the Vendor to transition M&O services to the Agency or a new Vendor. |
| Rate Card | The Rate Card worksheet is a list of all the roles utilized by the Respondent on the Project and for ongoing professional services with rates for the first 10 years of the contract. |
&9&A &9&P &9Print Date &D
Total Cost Summary
| RFP-185-2515-2026: Iowa Health Information Network (Health Information Exchange) | |
| Cost Proposal | |
| Respondent: | Enter Respondent Name in This Cell - Linked to other worksheets |
| RETURN TO TABLE OF CONTENTS | |
| Instructions | |
| 1. The Total System Implementation Cost Summary table is linked to the Implementation Costs worksheet. |
2. The Total M&O Cost Summary table is linked to the M&O Costs worksheet.
3. The Total Transition Out Cost Summary table is linked to the Transition Out worksheet.
4. Verify that totals match since the Agency is not responsible for reconciling conflicting information.
| Total System Implementation Cost Summary | |
| Project Tasks | Cost |
| Project Initiation Effort, Project Staffing, Project Management, and Transition Planning (ST-01 to ST-10, PM-01 to PM-06, TRAN-01 to TRAN-03) | $0.00 |
| Task 1: HIE Core Functionality-Core Infrastructure (HIE-01 through HIE-10) (Deliverable HIED-01) | $0.00 |
| Task 2: HIE Core Functionality-Core Data Feeds (HIE-11 through HIE-16) (Deliverable HIED-02) | $0.00 |
| Task 3: HIE Core Functionality-Core Data Quality (HIE-17 through HIE-18) (Deliverable HIED-03) | $0.00 |
| Task 4: HIE Core Functionality-Core Data Security (HIE-19 through HIE-25) (Deliverable HIED-04) | $0.00 |
| Task 5: HIE Core Functionality-Core Data Governance (HIE-26 through HIE-27) (Deliverable HIED-05) | $0.00 |
| Task 6: HIE Application - Longitudinal Patient Record Exchange (APP-01 through APP-04) (Deliverable APPD-01) | $0.00 |
| Task 7: HIE Application - Bed Availability Dashboard (APP-05 through APP-09) (Deliverable APPD-02) | $0.00 |
| Task 8: HIE Application - Electronic Lab Reporting and Electronic Case Reporting (APP-10) (Deliverable APPD-03) | $0.00 |
| Task 9: HIE Application - Syndromic Surveillance (APP-11 through APP-16) (Deliverables APPD-04 and APPD-05) | $0.00 |
| Task 10: HIE Application - Public Health Registry Reporting (APP-17 through APP-18) (Deliverable APPD-06) | $0.00 |
| Task 11: HIE Application - Admission, Discharge, and Transfer (ADT) Notification (APP-19 through APP-20) (Deliverable APPD-07) | $0.00 |
| Task 12: HIE Application - Direct Secure Messaging (APP-21 through APP-22) (Deliverable APPD-08) | $0.00 |
| Task 13: HIE Application - Expanded Provider Types and Data Feeds for Healthcare Purposes (APP-23) (Deliverable APPD-09) | $0.00 |
| Task 14: HIE Application - Expanded Provider Types and Data Feeds for Social Care Purposes and Closed Loop Referrals (APP-24 through APP-29) (Deliverable APPD-10) | $0.00 |
| Task 15: HIE Application- Bidirectional data sharing using FHIR standards capability (APP-30 through APP-32) (Deliverable APPD-11) | $0.00 |
| $0.00 | |
| Total Implementation Cost | $0.00 |
| Total M&O Cost Summary | |||||||||
| Cost Category | Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 | Total All Years |
| Annual M&O Costs | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Total Transition Out Cost Summary | |
| Cost Category | Cost |
| Total Transition Out Deliverable and Effort Costs | $0.00 |
| *Total 8-Year Cost: | $0.00 |
| *Total cost is the sum of Implementation, M&O, and Transition Out Costs |
&9Attachment&K000000 D&K01+000: Cost Proposal Template
&9&A &9&P &9&D
Implementation Costs
| RFP-185-2515-2026: Iowa Health Information Network (Health Information Exchange) | |
| Cost Proposal | |
| Respondent: | Enter Respondent Name in This Cell - Linked to other worksheets |
| RETURN TO TABLE OF CONTENTS | |
| Instructions | |
| 1. All costs and estimated hours for each effort and deliverable must be added. This should include all costs required to meet the deliverables in these sections, including operational costs and customizations, hardware, software, licensing, staffing, etc. Costs must be firm fixed costs, and the hours are estimates only for resource preparation. Updates to deliverables must be included in the total cost of the deliverable. Please add as many rows as needed. |
2. Please include descriptions and comments.
3. The efforts and deliverables should match the Respondent's proposed project schedule and implementation plan, and any other deliverables defined in the RFP should be included in the costs in the applicable Task.
| Project Initiation Effort, Project Staffing, Project Management, and Transition Planning (ST-01 to ST-10, PM-01 to PM-06, TRAN-01 to TRAN-03) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Project Management Plan | $0.00 | - 0 | |
| Annual Report | $0.00 | - 0 | |
| Transition Plan and Operational Readiness Document | $0.00 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 |
| Task 1: HIE Core Functionality-Core Infrastructure (HIE-01 through HIE-10) (Deliverable HIED-01) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Architectural Diagram + Documentation | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 |
| Task 2: HIE Core Functionality-Core Data Feeds (HIE-11 through HIE-16) (Deliverable HIED-02) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Documentation as Required | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 |
| Task 3: HIE Core Functionality-Core Data Quality (HIE-17 through HIE-18) (Deliverable HIED-03) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Data Quality Plan | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 |
| Task 4: HIE Core Functionality-Core Data Security (HIE-19 through HIE-25) (Deliverable HIED-04) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Security and IR/DR Plan | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 |
| Task 5: HIE Core Functionality-Core Data Governance (HIE-26 through HIE-27) (Deliverable HIED-05) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Draft Agreements | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 |
| Task 6: HIE Application - Longitudinal Patient Record Exchange (APP-01 through APP-04) (Deliverable APPD-01) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Documentation as Required | $0.00 | - 0 | |
| Demonstration as Required | |||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 |
| Task 7: HIE Application - Bed Availability Dashboard (APP-05 through APP-09) (Deliverable APPD-02) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Documentation as Required | $0.00 | - 0 | |
| Demonstration as Required | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 |
| Task 8: HIE Application - Electronic Lab Reporting and Electronic Case Reporting (APP-10) (Deliverable APPD-03) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Architecture Diagrams | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 |
| Task 9: HIE Application - Syndromic Surveillance (APP-11 through APP-16) (Deliverables APPD-04, APPD-05) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Documentation as Required | $0.00 | - 0 | |
| Demonstration as Required | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 |
| Task 10: HIE Application - Public Health Registry Reporting (APP-17 through APP-18) (Deliverables APPD-06) This should include all hardware, software, licensing, staff, etc. costs. to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Reports as Required | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 | |
| Task 11: HIE Application - Admission, Discharge, and Transfer (ADT) Notification (APP-10 through APP-20) (Deliverable APPD-07) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Documentation as Required | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 | |
| Task 12: HIE Application - Direct Secure Messaging (APP-21 through APP-22) (Deliverable APPD-08) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Demonstration as Required | $0.00 | - 0 | |
| Documentation as Required | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 | |
| Task 13: HIE Application - Expanded Provider Types and Data Feeds for Healthcare Purposes (APP-23) (Deliverable APPD-09) This should include all hardware, software, licensing, staff, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Documentation as Required | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task Total: | $0.00 | - 0 | |
| Task 14: HIE Application - Expanded Provider Types and Data Feeds for Social Care Purposes and Closed Loop Referrals (APP-24 through APP-29) (Deliverable APPD-10) This should include all hardware, software, licensing, 3rd party, staffing, etc. costs. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Documentation as Required | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| Task 15: HIE Application- Bidirectional data sharing using FHIR standards capability (APP-30 through APP-32) (Deliverable APPD-11) This should include all hardware, software, licensing,staffing, etc. costs to meet the deliverable. | |||
| Cost Component | Description/Comments | Cost | Estimated Hours |
| Action Plan | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| $0.00 | - 0 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 |
M&O Costs
| RFP-185-2515-2026: Iowa Health Information Network (Health Information Exchange) | |
| Cost Proposal | |
| Respondent: | Enter Respondent Name in This Cell - Linked to other worksheets |
| RETURN TO TABLE OF CONTENTS |
| Instructions |
| 1. In Table 1, please include one-time and recurring or ongoing costs of the system including separate Maintenance, Support, Hardware, Hosting, and License costs including any third party software. Add rows as needed. |
3. Respondents should start M&O costs according to their estimated project schedule based on their estimated system acceptance date. The Agency will not pay Maintenance, Support, Hardware, Hosting, and License Costs during implementation.
| Table1: Maintenance, Support, Hardware, Hosting, and License Costs | Initial Contract Term | Optional Renewal Years | ||||||||
| Item | Description/Comments | Cost - Year 1 | Cost - Year 2 | Cost - Year 3 | Cost - Year 4 | Cost - Year 5 | Cost - Year 6 | Cost - Year 7 | Cost - Year 8 | Total |
| $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| Add other efforts and deliverables specific to this service as needed | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| Total: | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Transition Out
| RFP-185-2515-2026: Iowa Health Information Network (Health Information Exchange) | |
| Cost Proposal | |
| Respondent: | Enter Respondent Name in This Cell - Linked to other worksheets |
| RETURN TO TABLE OF CONTENTS | |
| Instructions | |
| 1. All cost and estimated hours for each effort and deliverable must be included. Please add rows as needed. |
3. The efforts and deliverables should match the Respondent's technical proposal for these services.
| Transition Out Costs | |||
| Effort/Deliverable Name | Description/Comments | Cost | Estimated Hours |
| Operations Transition Plan | $0.00 | - 0 | |
| Operations Transition Results Report | $0.00 | - 0 | |
| Agency System Inventory | $0.00 | - 0 | |
| Transition Support | $0.00 | - 0 | |
| Add other efforts and deliverables specific to this service as needed | $0.00 | - 0 | |
| $0.00 | - 0 | ||
| Total: | $0.00 | - 0 |
Rate Card
| RFP-185-2515-2026: Iowa Health Information Network (Health Information Exchange) | |
| Cost Proposal | |
| Respondent: | Enter Respondent Name in This Cell - Linked to other worksheets |
| RETURN TO TABLE OF CONTENTS | |
| Instructions | |
| 1. Enter the Project Roles/Staff Titles utilized by the Respondent in the Technical Proposal. |
2. Add any additional roles, including subject matter experts needed for ongoing support and other Agency projects.
3. Please include a short description for each role.
4. Enter the Respondent's proposed rates for each role. The rates will be used for negotiating additional work outside the scope of M&O for the implemented system.
| Hourly Professional Services Rates | |||||||||
| Project Role/Staff Title | Short Description | Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Year 6 | Year 7 | Year 8 |
File details come from the government source that posted it. Updated .