Form 1 LOI

Attachment: Required Content for Letter of Intent to Apply

Prospective applicants must submit a Letter of Intent that includes the following information. (For multi-state applications, only one letter of intent should be submitted. This letter should be submitted by the state or SDE that will act as the applicant on behalf of all states involved in the proposed project.):

• Descriptive title of proposed project.

• Indication of whether a State Plan already exists or will be developed during the life of this cooperative agreement.

• Will the application submitted be for more than one state/territory? If so, which states/territories will be included?

• Name, address, and telephone number of the primary Point of Contact.

• Names of other key personnel.

• Participating stakeholders.

• Does the applicant for this program intend to apply to be a Regional Center as well?

• Number and title of this funding opportunity.

• The total amount of expenditures to develop HIE capacity based on funded activities in the following domains:

• Legal and policy HIE capacity: Types of activities include but are not limited to expenses incurred to create: data use agreements, business associate agreements, vendor contracts, privacy policies and procedures, governance documents, employee policies and procedures, and legal opinions.

• Governance capacity: Types of activities include but are not limited to expenses incurred to: convene health care stakeholders, create plans for statewide coverage of HIE services; provide oversight and accountability of health information exchange activities.

• Business and Technical Operations capacity: Types of activities include but are not limited to expenses incurred to: develop and operate the technical services needed for health information exchange on a national, state and regional level, support activities including procurement, functionality development, project management, help desk, systems maintenance, change control, program evaluation, reporting and other related activities, legal and policy documents that support HIE enabled meaningful use criteria to be established by the Secretary through the rulemaking process.

• Technical infrastructure capacity: Types of activities include but are not limited to expenses incurred to: developed the architecture, hardware, software, applications, network configurations and other technological aspects that physically enable health information exchange in a secure and appropriate manner that also meets overarching goals for a high performance health care system.

• Finance capacity: Types of activities include but are not limited to expenses incurred to: develop and manage finance policies procedure and controls, sustainability plans, pricing strategies, market research, public and private financing strategies, financial reporting, business planning, and audits.

• A brief description of your state’s progress in each of the areas above, as well as, a brief description of the state’s intentions to leverage existing regional efforts to advance health information exchange.

• Explanation of how the proposed project will be in the public interest.

A letter of intent is not binding, and does not enter into the review of a subsequent application, the information that it contains allows ONC staff members to estimate the potential review workload and plan the review.

The letter of intent should be no longer than 5 pages and can be sent by the date listed in the Important Dates table above (Opportunity Overview).

The letter of intent shall be sent to at the following address:

David Blumenthal MD, MPP

National Coordinator for Health Information Technology

Department of Health and Human Services

200 Independence Avenue, S.W.
Washington, DC 20201

Tel: (202) 690-7151

StateHIEgrants@hhs.gov