OpenTHC is very simple for deployment into a government environment.
Typical deployments are done on redundant systems, for high availability.
OpenTHC can also be hosted in your favourite cloud, or virtual-private-server service provider such as Amazon, Azure, GCS, Linode, Digital Ocean, etc.
This deployment is a fairly simple process, more technical details are provided in the CRE codebase.
Customization of the system can be performed by either agency staff, their preferred technology service provider or OpenTHC community members.
Much of the customizaiton is done through simple Middleware and number of existing, and example libraries are provided.
Not much maintenance is required, software wise. As rules change, Middleware would need to be updated. Updates to OpenTHC core components and libraries would need to be performed on a periodic basis.