94
AFFORDABLE HEALTHCARE PROJECT (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP MODE) PROJECT INFORMATION MEMORANDUM GOVERNMENT OF ODISHA REPUBLIC OF INDIA HEALTH & FAMILY WELFARE DEPARTMENT

(DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

  • Upload
    others

  • View
    9

  • Download
    0

Embed Size (px)

Citation preview

Page 1: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

AFFORDABLE HEALTHCARE PROJECT

(DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE

PARTNERSHIP MODE)

PROJECT INFORMATION MEMORANDUMGOVERNMENT OF ODISHA

REPUBLIC OF INDIA

HEALTH amp FAMILY WELFARE DEPARTMENT

DISCLAIMER

This document is not an agreement and is neither an offer by the Government of Odisha (ldquoGoOrdquo) or International Finance Corporation (ldquoIFCrdquo) (or any

other consultant or advisor) to bidders or any other person The purpose of this document is solely to provide interested persons with information that

may be useful to them only in getting a brief overview about GoOrsquos Affordable Healthcare Project The document includes statements which reflect

various assumptions and assessments arrived at by the GoO and IFC for the projects Such assumptions assessments and statements do not purport to

contain all the information that interested persons andor bidders may require The information contained in the document may not be appropriate for all

persons and it is not possible for the GoO and IFC its employees its consultants or advisors to consider the investment objectives financial situation and

particular needs of each party who reads the document The assumptions assessments statements and information contained in the document may not

be complete accurate adequate or correct Each person should therefore refer to the bidding documents (including the request for proposal document

(ldquoRFPrdquo) and the draft concession agreement (ldquoDCArdquo)) for more details and conduct its own investigations due diligence (including but not limited to

technical due diligence financial due diligence and legal due diligence) and analysis and should check the accuracy adequacy correctness reliability and

completeness of the assumptions assessments statements and information contained in the document and obtain independent advice from appropriate

sources

Information provided in the document is on a wide range of matters some of which may depend upon interpretation of law The information

given is not intended to be an exhaustive account of statutory requirements and should not be regarded as a complete or authoritative statement of law

The GoO and IFC accepts no responsibility for the accuracy or otherwise for any interpretation or opinion on law expressed in the document

The GoO and IFC its consultants employees and advisors make no representation or warranty and will have no liability to any person under

any law statute rules or regulations or tort or otherwise for any loss damage cost or expense which may arise from or be incurred or suffered on

account of anything contained in the document or otherwise including the accuracy adequacy correctness completeness or reliability of the document

and any assessment assumption statement or information contained in the document or deemed to form part of the document or arising from it in any

way

The GoO and IFC its consultants employees and advisors also accept no liability of any nature whether resulting from negligence or

otherwise howsoever caused arising from reliance of any person upon the content of this document

The GoO andor IFC may in its absolute discretion update amend or supplement the information assessment or assumptions contained in

this document andor the bidding documents for the Affordable Healthcare Project

Notwithstanding anything to the contrary contained in this document the detailed terms and conditions in relation to the Affordable

Healthcare Project have been specified in the RFP and the DCA and the RFP and the DCA shall have an overriding effect over the information specified in

this document in case of a conflict between such information specified in this document and the detailed terms and conditions specified in the RFP and

the DCA

The GoO reserves the right to modify cancel suspend or terminate any aspect of its proposal to undertake the development of any or all of

the hospitals under the Affordable Healthcare Project or any part thereof for any reason and without giving prior notice The issue of this document does

not imply that the GoO is bound to award the projects to any bidder and the GoO reserves the right to reject all or any of the bids without assigning any

reasons whatsoever

Odisha

ODISHA ndash A SNAP SHOT

India Odisha

Population (2011) 1210569573 41974218

Decadal population growth 177 1405

Population Density (2011) 382 270

Urbanization (2011) 312 1669

Literacy (2011) 730 7022

Crude Birth Rate (2012) 216 199

Crude Death Rate (2012) 70 85

Life Expectancy ay Birth (2011) 661 630

Being home to ~347 of Indiarsquos population Odisha is the 9th largest state by area and 11th largest by population

Driven by a low CBR and high CDR the population in the state is growing at a pace lesser than the national average

A higher than national average CDR indicates the need for betterment of health of the people

Though the life expectancy at birth is less in the state the demographic transition in Odisha may be faster This may

transform into the need for higher number of hospitals hospital beds

Decreased urbanization and lower population density may increase the catchment area for hospitals

Odisha

HEALTH INFRASTRUCTURE - A SNAP SHOT

Category Existing

Medical Colleges (Govt) 5+2

District Hospitals 32

Sub Divisional Hospitals 34

CHCs UCHCs 384

PHCs OH UPHCs 1364

Sub Centers 6688

Ayurvedic Dispensaries 619

Ayurvedic Hospitals 5

Homoeopathic Hospitals 4

Homoeopathic Dispensaries 561

Total Institutions 9698

Odisha has around 36000 hospital beds for 42 million

people (only 08 bed available rsquo000 people)

Large health infrastructure gap of 120000 hospital

beds compared to the WHO average of 35 beds rsquo000

people for low-mid income countries

Huge demand for healthcare Public Sector District

Headquarters Hospitals are heavily congested and over

utilized with 90 hospitals having an occupancy of more

than 100

Private healthcare facilities comprise of only 2759

of the total healthcare facilities in the state indicating

a large headroom for growth of the private sector

The Affordable Healthcare Project

bull Indiarsquos largest Public Private Partnership (PPP) project

in the health sector

bull 25 Hospitals to be developed

PROJECT OBJECTIVE amp SUPPORT FROM THE GOVERNMENT

Affordable and Quality Health Care for All in Odisha The Government of Odisha intends to enhance equitable access to quality and affordable healthcare services to people across

the state

As a part of this initiative the Government is developing hospitals in 25 locations across Odisha in partnership with the private

sector in a Public Private Partnership (PPP) mode under the Affordable Healthcare Project

The hospitals will provide secondary and basic tertiary care services

Support from the Govt of Odisha

Contribution from GoO in the form of Land in the district town Grant Funding and Referrals

Fast track approvals due to high levels of government commitment leading to shorter payback period

Operational and Market risk sharing by the Government to allow for early stabilization

Flexibility for private developer in planning the development options and design features

LandSupport in procuring

Applicable Permits

Grant Funding

Assistance in procuring utilities at

Site like water electricity and

sewerage

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 22 SECONDARY CARE HOSPITALS (SPOKES)

LIST OF THE PROPOSED HOSPITAL PROJECTSHOSPITAL NO 1-8 TO BE BID OUT IN TRANCHE 1 (SHADED IN GREEN)

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

1Jeypore

(Koraput)Cluster Project A 200 Hub

2 Puri Cluster Project A 100 Spoke

3 Bolangir Cluster Project B 200 Hub

4 Jharsuguda Cluster Project B 100 Hub

5 Angul Cluster Project C 200 Spoke

6Barbil

(Kendujhar)Cluster Project C 200 Spoke

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke

8 Bhadrak Individual Project B 100 Spoke

9 Rayagada Individual Project C 100 Spoke

10Phulbani

(Kandhamal)Individual Project D 100 Spoke

11 Boudh Individual Project E 100 Spoke

12Nuapada

Khariar RoadIndividual Project F 100 Spoke

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

13 Malkangiri Individual Project G 100 Spoke

14 Nabrangpur Individual Project H 100 Spoke

15 Subarnapur Individual Project I 100 Spoke

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke

18 Kendrapara Individual Project L 100 Spoke

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke

20 Nayagarh Individual Project N 100 Spoke

21 Deogarh Individual Project O 100 Spoke

22 Bargarh Individual Project P 100 Spoke

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke

24Kalinganagar

(Jajpur)Individual Project R 100 Spoke

25Rourkela

(Sundargarh)Individual Project S 100 Spoke

ESTIMATED PROJECT COST OF PROPOSED HOSPITAL PROJECTSIN CRORES INDIAN RUPEES (INR CRORES)

Hospital Site Location Project Sequence Beds

Project Cost

INR No

1Jeypore

(Koraput)Cluster Project A 200 90

2 Puri Cluster Project A 100 46

3 Bolangir Cluster Project B 200 90

4 Jharsuguda Cluster Project B 100 46

5 Angul Cluster Project C 200 84

6Barbil

(Kendujhar)Cluster Project C 200 84

7Bhawanipatna

(Kalahandi)Individual Project A 100 46

8 Bhadrak Individual Project B 100 46

9 Rayagada Individual Project C 100 46

10Phulbani

(Kandhamal)Individual Project D 100 46

11 Boudh Individual Project E 100 46

12Nuapada

Khariar RoadIndividual Project F 100 46

Hospital Site Location Project Sequence Beds Project Cost

No

13 Malkangiri Individual Project G 100 46

14 Nabrangpur Individual Project H 100 46

15 Subarnapur Individual Project I 100 46

16Paralakhemundi

(Gajapati)Individual Project J 100 46

17Rairangpur

(Mayurbhanj)Individual Project K 100 46

18 Kendrapara Individual Project L 100 46

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 46

20 Nayagarh Individual Project N 100 46

21 Deogarh Individual Project O 100 46

22 Bargarh Individual Project P 100 46

23Jagatsinghpur

Paradeep townIndividual Project Q 100 46

24Kalinganagar

(Jajpur)Individual Project R 100 46

25Rourkela

(Sundargarh)Individual Project S 100 46

BID ROLLOUT

bull All 25 hospitals planned to be bid out in 3-4 tranches with 6-8 hospitals in each

tranche

bull Tranche 1 Bid has been launched for this tranche

bull Bid launched on September 10

bull Bid due date on December 18 2018

bull Hospitals in Tranche 1 Eight (8)

bull 6 hospitals planned to be bid out in pairs

bull Remaining tranches to be launched subsequently

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 2: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

DISCLAIMER

This document is not an agreement and is neither an offer by the Government of Odisha (ldquoGoOrdquo) or International Finance Corporation (ldquoIFCrdquo) (or any

other consultant or advisor) to bidders or any other person The purpose of this document is solely to provide interested persons with information that

may be useful to them only in getting a brief overview about GoOrsquos Affordable Healthcare Project The document includes statements which reflect

various assumptions and assessments arrived at by the GoO and IFC for the projects Such assumptions assessments and statements do not purport to

contain all the information that interested persons andor bidders may require The information contained in the document may not be appropriate for all

persons and it is not possible for the GoO and IFC its employees its consultants or advisors to consider the investment objectives financial situation and

particular needs of each party who reads the document The assumptions assessments statements and information contained in the document may not

be complete accurate adequate or correct Each person should therefore refer to the bidding documents (including the request for proposal document

(ldquoRFPrdquo) and the draft concession agreement (ldquoDCArdquo)) for more details and conduct its own investigations due diligence (including but not limited to

technical due diligence financial due diligence and legal due diligence) and analysis and should check the accuracy adequacy correctness reliability and

completeness of the assumptions assessments statements and information contained in the document and obtain independent advice from appropriate

sources

Information provided in the document is on a wide range of matters some of which may depend upon interpretation of law The information

given is not intended to be an exhaustive account of statutory requirements and should not be regarded as a complete or authoritative statement of law

The GoO and IFC accepts no responsibility for the accuracy or otherwise for any interpretation or opinion on law expressed in the document

The GoO and IFC its consultants employees and advisors make no representation or warranty and will have no liability to any person under

any law statute rules or regulations or tort or otherwise for any loss damage cost or expense which may arise from or be incurred or suffered on

account of anything contained in the document or otherwise including the accuracy adequacy correctness completeness or reliability of the document

and any assessment assumption statement or information contained in the document or deemed to form part of the document or arising from it in any

way

The GoO and IFC its consultants employees and advisors also accept no liability of any nature whether resulting from negligence or

otherwise howsoever caused arising from reliance of any person upon the content of this document

The GoO andor IFC may in its absolute discretion update amend or supplement the information assessment or assumptions contained in

this document andor the bidding documents for the Affordable Healthcare Project

Notwithstanding anything to the contrary contained in this document the detailed terms and conditions in relation to the Affordable

Healthcare Project have been specified in the RFP and the DCA and the RFP and the DCA shall have an overriding effect over the information specified in

this document in case of a conflict between such information specified in this document and the detailed terms and conditions specified in the RFP and

the DCA

The GoO reserves the right to modify cancel suspend or terminate any aspect of its proposal to undertake the development of any or all of

the hospitals under the Affordable Healthcare Project or any part thereof for any reason and without giving prior notice The issue of this document does

not imply that the GoO is bound to award the projects to any bidder and the GoO reserves the right to reject all or any of the bids without assigning any

reasons whatsoever

Odisha

ODISHA ndash A SNAP SHOT

India Odisha

Population (2011) 1210569573 41974218

Decadal population growth 177 1405

Population Density (2011) 382 270

Urbanization (2011) 312 1669

Literacy (2011) 730 7022

Crude Birth Rate (2012) 216 199

Crude Death Rate (2012) 70 85

Life Expectancy ay Birth (2011) 661 630

Being home to ~347 of Indiarsquos population Odisha is the 9th largest state by area and 11th largest by population

Driven by a low CBR and high CDR the population in the state is growing at a pace lesser than the national average

A higher than national average CDR indicates the need for betterment of health of the people

Though the life expectancy at birth is less in the state the demographic transition in Odisha may be faster This may

transform into the need for higher number of hospitals hospital beds

Decreased urbanization and lower population density may increase the catchment area for hospitals

Odisha

HEALTH INFRASTRUCTURE - A SNAP SHOT

Category Existing

Medical Colleges (Govt) 5+2

District Hospitals 32

Sub Divisional Hospitals 34

CHCs UCHCs 384

PHCs OH UPHCs 1364

Sub Centers 6688

Ayurvedic Dispensaries 619

Ayurvedic Hospitals 5

Homoeopathic Hospitals 4

Homoeopathic Dispensaries 561

Total Institutions 9698

Odisha has around 36000 hospital beds for 42 million

people (only 08 bed available rsquo000 people)

Large health infrastructure gap of 120000 hospital

beds compared to the WHO average of 35 beds rsquo000

people for low-mid income countries

Huge demand for healthcare Public Sector District

Headquarters Hospitals are heavily congested and over

utilized with 90 hospitals having an occupancy of more

than 100

Private healthcare facilities comprise of only 2759

of the total healthcare facilities in the state indicating

a large headroom for growth of the private sector

The Affordable Healthcare Project

bull Indiarsquos largest Public Private Partnership (PPP) project

in the health sector

bull 25 Hospitals to be developed

PROJECT OBJECTIVE amp SUPPORT FROM THE GOVERNMENT

Affordable and Quality Health Care for All in Odisha The Government of Odisha intends to enhance equitable access to quality and affordable healthcare services to people across

the state

As a part of this initiative the Government is developing hospitals in 25 locations across Odisha in partnership with the private

sector in a Public Private Partnership (PPP) mode under the Affordable Healthcare Project

The hospitals will provide secondary and basic tertiary care services

Support from the Govt of Odisha

Contribution from GoO in the form of Land in the district town Grant Funding and Referrals

Fast track approvals due to high levels of government commitment leading to shorter payback period

Operational and Market risk sharing by the Government to allow for early stabilization

Flexibility for private developer in planning the development options and design features

LandSupport in procuring

Applicable Permits

Grant Funding

Assistance in procuring utilities at

Site like water electricity and

sewerage

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 22 SECONDARY CARE HOSPITALS (SPOKES)

LIST OF THE PROPOSED HOSPITAL PROJECTSHOSPITAL NO 1-8 TO BE BID OUT IN TRANCHE 1 (SHADED IN GREEN)

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

1Jeypore

(Koraput)Cluster Project A 200 Hub

2 Puri Cluster Project A 100 Spoke

3 Bolangir Cluster Project B 200 Hub

4 Jharsuguda Cluster Project B 100 Hub

5 Angul Cluster Project C 200 Spoke

6Barbil

(Kendujhar)Cluster Project C 200 Spoke

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke

8 Bhadrak Individual Project B 100 Spoke

9 Rayagada Individual Project C 100 Spoke

10Phulbani

(Kandhamal)Individual Project D 100 Spoke

11 Boudh Individual Project E 100 Spoke

12Nuapada

Khariar RoadIndividual Project F 100 Spoke

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

13 Malkangiri Individual Project G 100 Spoke

14 Nabrangpur Individual Project H 100 Spoke

15 Subarnapur Individual Project I 100 Spoke

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke

18 Kendrapara Individual Project L 100 Spoke

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke

20 Nayagarh Individual Project N 100 Spoke

21 Deogarh Individual Project O 100 Spoke

22 Bargarh Individual Project P 100 Spoke

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke

24Kalinganagar

(Jajpur)Individual Project R 100 Spoke

25Rourkela

(Sundargarh)Individual Project S 100 Spoke

ESTIMATED PROJECT COST OF PROPOSED HOSPITAL PROJECTSIN CRORES INDIAN RUPEES (INR CRORES)

Hospital Site Location Project Sequence Beds

Project Cost

INR No

1Jeypore

(Koraput)Cluster Project A 200 90

2 Puri Cluster Project A 100 46

3 Bolangir Cluster Project B 200 90

4 Jharsuguda Cluster Project B 100 46

5 Angul Cluster Project C 200 84

6Barbil

(Kendujhar)Cluster Project C 200 84

7Bhawanipatna

(Kalahandi)Individual Project A 100 46

8 Bhadrak Individual Project B 100 46

9 Rayagada Individual Project C 100 46

10Phulbani

(Kandhamal)Individual Project D 100 46

11 Boudh Individual Project E 100 46

12Nuapada

Khariar RoadIndividual Project F 100 46

Hospital Site Location Project Sequence Beds Project Cost

No

13 Malkangiri Individual Project G 100 46

14 Nabrangpur Individual Project H 100 46

15 Subarnapur Individual Project I 100 46

16Paralakhemundi

(Gajapati)Individual Project J 100 46

17Rairangpur

(Mayurbhanj)Individual Project K 100 46

18 Kendrapara Individual Project L 100 46

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 46

20 Nayagarh Individual Project N 100 46

21 Deogarh Individual Project O 100 46

22 Bargarh Individual Project P 100 46

23Jagatsinghpur

Paradeep townIndividual Project Q 100 46

24Kalinganagar

(Jajpur)Individual Project R 100 46

25Rourkela

(Sundargarh)Individual Project S 100 46

BID ROLLOUT

bull All 25 hospitals planned to be bid out in 3-4 tranches with 6-8 hospitals in each

tranche

bull Tranche 1 Bid has been launched for this tranche

bull Bid launched on September 10

bull Bid due date on December 18 2018

bull Hospitals in Tranche 1 Eight (8)

bull 6 hospitals planned to be bid out in pairs

bull Remaining tranches to be launched subsequently

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 3: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

Odisha

ODISHA ndash A SNAP SHOT

India Odisha

Population (2011) 1210569573 41974218

Decadal population growth 177 1405

Population Density (2011) 382 270

Urbanization (2011) 312 1669

Literacy (2011) 730 7022

Crude Birth Rate (2012) 216 199

Crude Death Rate (2012) 70 85

Life Expectancy ay Birth (2011) 661 630

Being home to ~347 of Indiarsquos population Odisha is the 9th largest state by area and 11th largest by population

Driven by a low CBR and high CDR the population in the state is growing at a pace lesser than the national average

A higher than national average CDR indicates the need for betterment of health of the people

Though the life expectancy at birth is less in the state the demographic transition in Odisha may be faster This may

transform into the need for higher number of hospitals hospital beds

Decreased urbanization and lower population density may increase the catchment area for hospitals

Odisha

HEALTH INFRASTRUCTURE - A SNAP SHOT

Category Existing

Medical Colleges (Govt) 5+2

District Hospitals 32

Sub Divisional Hospitals 34

CHCs UCHCs 384

PHCs OH UPHCs 1364

Sub Centers 6688

Ayurvedic Dispensaries 619

Ayurvedic Hospitals 5

Homoeopathic Hospitals 4

Homoeopathic Dispensaries 561

Total Institutions 9698

Odisha has around 36000 hospital beds for 42 million

people (only 08 bed available rsquo000 people)

Large health infrastructure gap of 120000 hospital

beds compared to the WHO average of 35 beds rsquo000

people for low-mid income countries

Huge demand for healthcare Public Sector District

Headquarters Hospitals are heavily congested and over

utilized with 90 hospitals having an occupancy of more

than 100

Private healthcare facilities comprise of only 2759

of the total healthcare facilities in the state indicating

a large headroom for growth of the private sector

The Affordable Healthcare Project

bull Indiarsquos largest Public Private Partnership (PPP) project

in the health sector

bull 25 Hospitals to be developed

PROJECT OBJECTIVE amp SUPPORT FROM THE GOVERNMENT

Affordable and Quality Health Care for All in Odisha The Government of Odisha intends to enhance equitable access to quality and affordable healthcare services to people across

the state

As a part of this initiative the Government is developing hospitals in 25 locations across Odisha in partnership with the private

sector in a Public Private Partnership (PPP) mode under the Affordable Healthcare Project

The hospitals will provide secondary and basic tertiary care services

Support from the Govt of Odisha

Contribution from GoO in the form of Land in the district town Grant Funding and Referrals

Fast track approvals due to high levels of government commitment leading to shorter payback period

Operational and Market risk sharing by the Government to allow for early stabilization

Flexibility for private developer in planning the development options and design features

LandSupport in procuring

Applicable Permits

Grant Funding

Assistance in procuring utilities at

Site like water electricity and

sewerage

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 22 SECONDARY CARE HOSPITALS (SPOKES)

LIST OF THE PROPOSED HOSPITAL PROJECTSHOSPITAL NO 1-8 TO BE BID OUT IN TRANCHE 1 (SHADED IN GREEN)

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

1Jeypore

(Koraput)Cluster Project A 200 Hub

2 Puri Cluster Project A 100 Spoke

3 Bolangir Cluster Project B 200 Hub

4 Jharsuguda Cluster Project B 100 Hub

5 Angul Cluster Project C 200 Spoke

6Barbil

(Kendujhar)Cluster Project C 200 Spoke

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke

8 Bhadrak Individual Project B 100 Spoke

9 Rayagada Individual Project C 100 Spoke

10Phulbani

(Kandhamal)Individual Project D 100 Spoke

11 Boudh Individual Project E 100 Spoke

12Nuapada

Khariar RoadIndividual Project F 100 Spoke

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

13 Malkangiri Individual Project G 100 Spoke

14 Nabrangpur Individual Project H 100 Spoke

15 Subarnapur Individual Project I 100 Spoke

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke

18 Kendrapara Individual Project L 100 Spoke

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke

20 Nayagarh Individual Project N 100 Spoke

21 Deogarh Individual Project O 100 Spoke

22 Bargarh Individual Project P 100 Spoke

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke

24Kalinganagar

(Jajpur)Individual Project R 100 Spoke

25Rourkela

(Sundargarh)Individual Project S 100 Spoke

ESTIMATED PROJECT COST OF PROPOSED HOSPITAL PROJECTSIN CRORES INDIAN RUPEES (INR CRORES)

Hospital Site Location Project Sequence Beds

Project Cost

INR No

1Jeypore

(Koraput)Cluster Project A 200 90

2 Puri Cluster Project A 100 46

3 Bolangir Cluster Project B 200 90

4 Jharsuguda Cluster Project B 100 46

5 Angul Cluster Project C 200 84

6Barbil

(Kendujhar)Cluster Project C 200 84

7Bhawanipatna

(Kalahandi)Individual Project A 100 46

8 Bhadrak Individual Project B 100 46

9 Rayagada Individual Project C 100 46

10Phulbani

(Kandhamal)Individual Project D 100 46

11 Boudh Individual Project E 100 46

12Nuapada

Khariar RoadIndividual Project F 100 46

Hospital Site Location Project Sequence Beds Project Cost

No

13 Malkangiri Individual Project G 100 46

14 Nabrangpur Individual Project H 100 46

15 Subarnapur Individual Project I 100 46

16Paralakhemundi

(Gajapati)Individual Project J 100 46

17Rairangpur

(Mayurbhanj)Individual Project K 100 46

18 Kendrapara Individual Project L 100 46

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 46

20 Nayagarh Individual Project N 100 46

21 Deogarh Individual Project O 100 46

22 Bargarh Individual Project P 100 46

23Jagatsinghpur

Paradeep townIndividual Project Q 100 46

24Kalinganagar

(Jajpur)Individual Project R 100 46

25Rourkela

(Sundargarh)Individual Project S 100 46

BID ROLLOUT

bull All 25 hospitals planned to be bid out in 3-4 tranches with 6-8 hospitals in each

tranche

bull Tranche 1 Bid has been launched for this tranche

bull Bid launched on September 10

bull Bid due date on December 18 2018

bull Hospitals in Tranche 1 Eight (8)

bull 6 hospitals planned to be bid out in pairs

bull Remaining tranches to be launched subsequently

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 4: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

ODISHA ndash A SNAP SHOT

India Odisha

Population (2011) 1210569573 41974218

Decadal population growth 177 1405

Population Density (2011) 382 270

Urbanization (2011) 312 1669

Literacy (2011) 730 7022

Crude Birth Rate (2012) 216 199

Crude Death Rate (2012) 70 85

Life Expectancy ay Birth (2011) 661 630

Being home to ~347 of Indiarsquos population Odisha is the 9th largest state by area and 11th largest by population

Driven by a low CBR and high CDR the population in the state is growing at a pace lesser than the national average

A higher than national average CDR indicates the need for betterment of health of the people

Though the life expectancy at birth is less in the state the demographic transition in Odisha may be faster This may

transform into the need for higher number of hospitals hospital beds

Decreased urbanization and lower population density may increase the catchment area for hospitals

Odisha

HEALTH INFRASTRUCTURE - A SNAP SHOT

Category Existing

Medical Colleges (Govt) 5+2

District Hospitals 32

Sub Divisional Hospitals 34

CHCs UCHCs 384

PHCs OH UPHCs 1364

Sub Centers 6688

Ayurvedic Dispensaries 619

Ayurvedic Hospitals 5

Homoeopathic Hospitals 4

Homoeopathic Dispensaries 561

Total Institutions 9698

Odisha has around 36000 hospital beds for 42 million

people (only 08 bed available rsquo000 people)

Large health infrastructure gap of 120000 hospital

beds compared to the WHO average of 35 beds rsquo000

people for low-mid income countries

Huge demand for healthcare Public Sector District

Headquarters Hospitals are heavily congested and over

utilized with 90 hospitals having an occupancy of more

than 100

Private healthcare facilities comprise of only 2759

of the total healthcare facilities in the state indicating

a large headroom for growth of the private sector

The Affordable Healthcare Project

bull Indiarsquos largest Public Private Partnership (PPP) project

in the health sector

bull 25 Hospitals to be developed

PROJECT OBJECTIVE amp SUPPORT FROM THE GOVERNMENT

Affordable and Quality Health Care for All in Odisha The Government of Odisha intends to enhance equitable access to quality and affordable healthcare services to people across

the state

As a part of this initiative the Government is developing hospitals in 25 locations across Odisha in partnership with the private

sector in a Public Private Partnership (PPP) mode under the Affordable Healthcare Project

The hospitals will provide secondary and basic tertiary care services

Support from the Govt of Odisha

Contribution from GoO in the form of Land in the district town Grant Funding and Referrals

Fast track approvals due to high levels of government commitment leading to shorter payback period

Operational and Market risk sharing by the Government to allow for early stabilization

Flexibility for private developer in planning the development options and design features

LandSupport in procuring

Applicable Permits

Grant Funding

Assistance in procuring utilities at

Site like water electricity and

sewerage

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 22 SECONDARY CARE HOSPITALS (SPOKES)

LIST OF THE PROPOSED HOSPITAL PROJECTSHOSPITAL NO 1-8 TO BE BID OUT IN TRANCHE 1 (SHADED IN GREEN)

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

1Jeypore

(Koraput)Cluster Project A 200 Hub

2 Puri Cluster Project A 100 Spoke

3 Bolangir Cluster Project B 200 Hub

4 Jharsuguda Cluster Project B 100 Hub

5 Angul Cluster Project C 200 Spoke

6Barbil

(Kendujhar)Cluster Project C 200 Spoke

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke

8 Bhadrak Individual Project B 100 Spoke

9 Rayagada Individual Project C 100 Spoke

10Phulbani

(Kandhamal)Individual Project D 100 Spoke

11 Boudh Individual Project E 100 Spoke

12Nuapada

Khariar RoadIndividual Project F 100 Spoke

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

13 Malkangiri Individual Project G 100 Spoke

14 Nabrangpur Individual Project H 100 Spoke

15 Subarnapur Individual Project I 100 Spoke

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke

18 Kendrapara Individual Project L 100 Spoke

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke

20 Nayagarh Individual Project N 100 Spoke

21 Deogarh Individual Project O 100 Spoke

22 Bargarh Individual Project P 100 Spoke

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke

24Kalinganagar

(Jajpur)Individual Project R 100 Spoke

25Rourkela

(Sundargarh)Individual Project S 100 Spoke

ESTIMATED PROJECT COST OF PROPOSED HOSPITAL PROJECTSIN CRORES INDIAN RUPEES (INR CRORES)

Hospital Site Location Project Sequence Beds

Project Cost

INR No

1Jeypore

(Koraput)Cluster Project A 200 90

2 Puri Cluster Project A 100 46

3 Bolangir Cluster Project B 200 90

4 Jharsuguda Cluster Project B 100 46

5 Angul Cluster Project C 200 84

6Barbil

(Kendujhar)Cluster Project C 200 84

7Bhawanipatna

(Kalahandi)Individual Project A 100 46

8 Bhadrak Individual Project B 100 46

9 Rayagada Individual Project C 100 46

10Phulbani

(Kandhamal)Individual Project D 100 46

11 Boudh Individual Project E 100 46

12Nuapada

Khariar RoadIndividual Project F 100 46

Hospital Site Location Project Sequence Beds Project Cost

No

13 Malkangiri Individual Project G 100 46

14 Nabrangpur Individual Project H 100 46

15 Subarnapur Individual Project I 100 46

16Paralakhemundi

(Gajapati)Individual Project J 100 46

17Rairangpur

(Mayurbhanj)Individual Project K 100 46

18 Kendrapara Individual Project L 100 46

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 46

20 Nayagarh Individual Project N 100 46

21 Deogarh Individual Project O 100 46

22 Bargarh Individual Project P 100 46

23Jagatsinghpur

Paradeep townIndividual Project Q 100 46

24Kalinganagar

(Jajpur)Individual Project R 100 46

25Rourkela

(Sundargarh)Individual Project S 100 46

BID ROLLOUT

bull All 25 hospitals planned to be bid out in 3-4 tranches with 6-8 hospitals in each

tranche

bull Tranche 1 Bid has been launched for this tranche

bull Bid launched on September 10

bull Bid due date on December 18 2018

bull Hospitals in Tranche 1 Eight (8)

bull 6 hospitals planned to be bid out in pairs

bull Remaining tranches to be launched subsequently

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 5: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

HEALTH INFRASTRUCTURE - A SNAP SHOT

Category Existing

Medical Colleges (Govt) 5+2

District Hospitals 32

Sub Divisional Hospitals 34

CHCs UCHCs 384

PHCs OH UPHCs 1364

Sub Centers 6688

Ayurvedic Dispensaries 619

Ayurvedic Hospitals 5

Homoeopathic Hospitals 4

Homoeopathic Dispensaries 561

Total Institutions 9698

Odisha has around 36000 hospital beds for 42 million

people (only 08 bed available rsquo000 people)

Large health infrastructure gap of 120000 hospital

beds compared to the WHO average of 35 beds rsquo000

people for low-mid income countries

Huge demand for healthcare Public Sector District

Headquarters Hospitals are heavily congested and over

utilized with 90 hospitals having an occupancy of more

than 100

Private healthcare facilities comprise of only 2759

of the total healthcare facilities in the state indicating

a large headroom for growth of the private sector

The Affordable Healthcare Project

bull Indiarsquos largest Public Private Partnership (PPP) project

in the health sector

bull 25 Hospitals to be developed

PROJECT OBJECTIVE amp SUPPORT FROM THE GOVERNMENT

Affordable and Quality Health Care for All in Odisha The Government of Odisha intends to enhance equitable access to quality and affordable healthcare services to people across

the state

As a part of this initiative the Government is developing hospitals in 25 locations across Odisha in partnership with the private

sector in a Public Private Partnership (PPP) mode under the Affordable Healthcare Project

The hospitals will provide secondary and basic tertiary care services

Support from the Govt of Odisha

Contribution from GoO in the form of Land in the district town Grant Funding and Referrals

Fast track approvals due to high levels of government commitment leading to shorter payback period

Operational and Market risk sharing by the Government to allow for early stabilization

Flexibility for private developer in planning the development options and design features

LandSupport in procuring

Applicable Permits

Grant Funding

Assistance in procuring utilities at

Site like water electricity and

sewerage

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 22 SECONDARY CARE HOSPITALS (SPOKES)

LIST OF THE PROPOSED HOSPITAL PROJECTSHOSPITAL NO 1-8 TO BE BID OUT IN TRANCHE 1 (SHADED IN GREEN)

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

1Jeypore

(Koraput)Cluster Project A 200 Hub

2 Puri Cluster Project A 100 Spoke

3 Bolangir Cluster Project B 200 Hub

4 Jharsuguda Cluster Project B 100 Hub

5 Angul Cluster Project C 200 Spoke

6Barbil

(Kendujhar)Cluster Project C 200 Spoke

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke

8 Bhadrak Individual Project B 100 Spoke

9 Rayagada Individual Project C 100 Spoke

10Phulbani

(Kandhamal)Individual Project D 100 Spoke

11 Boudh Individual Project E 100 Spoke

12Nuapada

Khariar RoadIndividual Project F 100 Spoke

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

13 Malkangiri Individual Project G 100 Spoke

14 Nabrangpur Individual Project H 100 Spoke

15 Subarnapur Individual Project I 100 Spoke

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke

18 Kendrapara Individual Project L 100 Spoke

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke

20 Nayagarh Individual Project N 100 Spoke

21 Deogarh Individual Project O 100 Spoke

22 Bargarh Individual Project P 100 Spoke

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke

24Kalinganagar

(Jajpur)Individual Project R 100 Spoke

25Rourkela

(Sundargarh)Individual Project S 100 Spoke

ESTIMATED PROJECT COST OF PROPOSED HOSPITAL PROJECTSIN CRORES INDIAN RUPEES (INR CRORES)

Hospital Site Location Project Sequence Beds

Project Cost

INR No

1Jeypore

(Koraput)Cluster Project A 200 90

2 Puri Cluster Project A 100 46

3 Bolangir Cluster Project B 200 90

4 Jharsuguda Cluster Project B 100 46

5 Angul Cluster Project C 200 84

6Barbil

(Kendujhar)Cluster Project C 200 84

7Bhawanipatna

(Kalahandi)Individual Project A 100 46

8 Bhadrak Individual Project B 100 46

9 Rayagada Individual Project C 100 46

10Phulbani

(Kandhamal)Individual Project D 100 46

11 Boudh Individual Project E 100 46

12Nuapada

Khariar RoadIndividual Project F 100 46

Hospital Site Location Project Sequence Beds Project Cost

No

13 Malkangiri Individual Project G 100 46

14 Nabrangpur Individual Project H 100 46

15 Subarnapur Individual Project I 100 46

16Paralakhemundi

(Gajapati)Individual Project J 100 46

17Rairangpur

(Mayurbhanj)Individual Project K 100 46

18 Kendrapara Individual Project L 100 46

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 46

20 Nayagarh Individual Project N 100 46

21 Deogarh Individual Project O 100 46

22 Bargarh Individual Project P 100 46

23Jagatsinghpur

Paradeep townIndividual Project Q 100 46

24Kalinganagar

(Jajpur)Individual Project R 100 46

25Rourkela

(Sundargarh)Individual Project S 100 46

BID ROLLOUT

bull All 25 hospitals planned to be bid out in 3-4 tranches with 6-8 hospitals in each

tranche

bull Tranche 1 Bid has been launched for this tranche

bull Bid launched on September 10

bull Bid due date on December 18 2018

bull Hospitals in Tranche 1 Eight (8)

bull 6 hospitals planned to be bid out in pairs

bull Remaining tranches to be launched subsequently

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 6: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

The Affordable Healthcare Project

bull Indiarsquos largest Public Private Partnership (PPP) project

in the health sector

bull 25 Hospitals to be developed

PROJECT OBJECTIVE amp SUPPORT FROM THE GOVERNMENT

Affordable and Quality Health Care for All in Odisha The Government of Odisha intends to enhance equitable access to quality and affordable healthcare services to people across

the state

As a part of this initiative the Government is developing hospitals in 25 locations across Odisha in partnership with the private

sector in a Public Private Partnership (PPP) mode under the Affordable Healthcare Project

The hospitals will provide secondary and basic tertiary care services

Support from the Govt of Odisha

Contribution from GoO in the form of Land in the district town Grant Funding and Referrals

Fast track approvals due to high levels of government commitment leading to shorter payback period

Operational and Market risk sharing by the Government to allow for early stabilization

Flexibility for private developer in planning the development options and design features

LandSupport in procuring

Applicable Permits

Grant Funding

Assistance in procuring utilities at

Site like water electricity and

sewerage

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 22 SECONDARY CARE HOSPITALS (SPOKES)

LIST OF THE PROPOSED HOSPITAL PROJECTSHOSPITAL NO 1-8 TO BE BID OUT IN TRANCHE 1 (SHADED IN GREEN)

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

1Jeypore

(Koraput)Cluster Project A 200 Hub

2 Puri Cluster Project A 100 Spoke

3 Bolangir Cluster Project B 200 Hub

4 Jharsuguda Cluster Project B 100 Hub

5 Angul Cluster Project C 200 Spoke

6Barbil

(Kendujhar)Cluster Project C 200 Spoke

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke

8 Bhadrak Individual Project B 100 Spoke

9 Rayagada Individual Project C 100 Spoke

10Phulbani

(Kandhamal)Individual Project D 100 Spoke

11 Boudh Individual Project E 100 Spoke

12Nuapada

Khariar RoadIndividual Project F 100 Spoke

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

13 Malkangiri Individual Project G 100 Spoke

14 Nabrangpur Individual Project H 100 Spoke

15 Subarnapur Individual Project I 100 Spoke

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke

18 Kendrapara Individual Project L 100 Spoke

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke

20 Nayagarh Individual Project N 100 Spoke

21 Deogarh Individual Project O 100 Spoke

22 Bargarh Individual Project P 100 Spoke

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke

24Kalinganagar

(Jajpur)Individual Project R 100 Spoke

25Rourkela

(Sundargarh)Individual Project S 100 Spoke

ESTIMATED PROJECT COST OF PROPOSED HOSPITAL PROJECTSIN CRORES INDIAN RUPEES (INR CRORES)

Hospital Site Location Project Sequence Beds

Project Cost

INR No

1Jeypore

(Koraput)Cluster Project A 200 90

2 Puri Cluster Project A 100 46

3 Bolangir Cluster Project B 200 90

4 Jharsuguda Cluster Project B 100 46

5 Angul Cluster Project C 200 84

6Barbil

(Kendujhar)Cluster Project C 200 84

7Bhawanipatna

(Kalahandi)Individual Project A 100 46

8 Bhadrak Individual Project B 100 46

9 Rayagada Individual Project C 100 46

10Phulbani

(Kandhamal)Individual Project D 100 46

11 Boudh Individual Project E 100 46

12Nuapada

Khariar RoadIndividual Project F 100 46

Hospital Site Location Project Sequence Beds Project Cost

No

13 Malkangiri Individual Project G 100 46

14 Nabrangpur Individual Project H 100 46

15 Subarnapur Individual Project I 100 46

16Paralakhemundi

(Gajapati)Individual Project J 100 46

17Rairangpur

(Mayurbhanj)Individual Project K 100 46

18 Kendrapara Individual Project L 100 46

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 46

20 Nayagarh Individual Project N 100 46

21 Deogarh Individual Project O 100 46

22 Bargarh Individual Project P 100 46

23Jagatsinghpur

Paradeep townIndividual Project Q 100 46

24Kalinganagar

(Jajpur)Individual Project R 100 46

25Rourkela

(Sundargarh)Individual Project S 100 46

BID ROLLOUT

bull All 25 hospitals planned to be bid out in 3-4 tranches with 6-8 hospitals in each

tranche

bull Tranche 1 Bid has been launched for this tranche

bull Bid launched on September 10

bull Bid due date on December 18 2018

bull Hospitals in Tranche 1 Eight (8)

bull 6 hospitals planned to be bid out in pairs

bull Remaining tranches to be launched subsequently

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 7: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

PROJECT OBJECTIVE amp SUPPORT FROM THE GOVERNMENT

Affordable and Quality Health Care for All in Odisha The Government of Odisha intends to enhance equitable access to quality and affordable healthcare services to people across

the state

As a part of this initiative the Government is developing hospitals in 25 locations across Odisha in partnership with the private

sector in a Public Private Partnership (PPP) mode under the Affordable Healthcare Project

The hospitals will provide secondary and basic tertiary care services

Support from the Govt of Odisha

Contribution from GoO in the form of Land in the district town Grant Funding and Referrals

Fast track approvals due to high levels of government commitment leading to shorter payback period

Operational and Market risk sharing by the Government to allow for early stabilization

Flexibility for private developer in planning the development options and design features

LandSupport in procuring

Applicable Permits

Grant Funding

Assistance in procuring utilities at

Site like water electricity and

sewerage

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 22 SECONDARY CARE HOSPITALS (SPOKES)

LIST OF THE PROPOSED HOSPITAL PROJECTSHOSPITAL NO 1-8 TO BE BID OUT IN TRANCHE 1 (SHADED IN GREEN)

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

1Jeypore

(Koraput)Cluster Project A 200 Hub

2 Puri Cluster Project A 100 Spoke

3 Bolangir Cluster Project B 200 Hub

4 Jharsuguda Cluster Project B 100 Hub

5 Angul Cluster Project C 200 Spoke

6Barbil

(Kendujhar)Cluster Project C 200 Spoke

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke

8 Bhadrak Individual Project B 100 Spoke

9 Rayagada Individual Project C 100 Spoke

10Phulbani

(Kandhamal)Individual Project D 100 Spoke

11 Boudh Individual Project E 100 Spoke

12Nuapada

Khariar RoadIndividual Project F 100 Spoke

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

13 Malkangiri Individual Project G 100 Spoke

14 Nabrangpur Individual Project H 100 Spoke

15 Subarnapur Individual Project I 100 Spoke

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke

18 Kendrapara Individual Project L 100 Spoke

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke

20 Nayagarh Individual Project N 100 Spoke

21 Deogarh Individual Project O 100 Spoke

22 Bargarh Individual Project P 100 Spoke

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke

24Kalinganagar

(Jajpur)Individual Project R 100 Spoke

25Rourkela

(Sundargarh)Individual Project S 100 Spoke

ESTIMATED PROJECT COST OF PROPOSED HOSPITAL PROJECTSIN CRORES INDIAN RUPEES (INR CRORES)

Hospital Site Location Project Sequence Beds

Project Cost

INR No

1Jeypore

(Koraput)Cluster Project A 200 90

2 Puri Cluster Project A 100 46

3 Bolangir Cluster Project B 200 90

4 Jharsuguda Cluster Project B 100 46

5 Angul Cluster Project C 200 84

6Barbil

(Kendujhar)Cluster Project C 200 84

7Bhawanipatna

(Kalahandi)Individual Project A 100 46

8 Bhadrak Individual Project B 100 46

9 Rayagada Individual Project C 100 46

10Phulbani

(Kandhamal)Individual Project D 100 46

11 Boudh Individual Project E 100 46

12Nuapada

Khariar RoadIndividual Project F 100 46

Hospital Site Location Project Sequence Beds Project Cost

No

13 Malkangiri Individual Project G 100 46

14 Nabrangpur Individual Project H 100 46

15 Subarnapur Individual Project I 100 46

16Paralakhemundi

(Gajapati)Individual Project J 100 46

17Rairangpur

(Mayurbhanj)Individual Project K 100 46

18 Kendrapara Individual Project L 100 46

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 46

20 Nayagarh Individual Project N 100 46

21 Deogarh Individual Project O 100 46

22 Bargarh Individual Project P 100 46

23Jagatsinghpur

Paradeep townIndividual Project Q 100 46

24Kalinganagar

(Jajpur)Individual Project R 100 46

25Rourkela

(Sundargarh)Individual Project S 100 46

BID ROLLOUT

bull All 25 hospitals planned to be bid out in 3-4 tranches with 6-8 hospitals in each

tranche

bull Tranche 1 Bid has been launched for this tranche

bull Bid launched on September 10

bull Bid due date on December 18 2018

bull Hospitals in Tranche 1 Eight (8)

bull 6 hospitals planned to be bid out in pairs

bull Remaining tranches to be launched subsequently

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 8: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 22 SECONDARY CARE HOSPITALS (SPOKES)

LIST OF THE PROPOSED HOSPITAL PROJECTSHOSPITAL NO 1-8 TO BE BID OUT IN TRANCHE 1 (SHADED IN GREEN)

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

1Jeypore

(Koraput)Cluster Project A 200 Hub

2 Puri Cluster Project A 100 Spoke

3 Bolangir Cluster Project B 200 Hub

4 Jharsuguda Cluster Project B 100 Hub

5 Angul Cluster Project C 200 Spoke

6Barbil

(Kendujhar)Cluster Project C 200 Spoke

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke

8 Bhadrak Individual Project B 100 Spoke

9 Rayagada Individual Project C 100 Spoke

10Phulbani

(Kandhamal)Individual Project D 100 Spoke

11 Boudh Individual Project E 100 Spoke

12Nuapada

Khariar RoadIndividual Project F 100 Spoke

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

13 Malkangiri Individual Project G 100 Spoke

14 Nabrangpur Individual Project H 100 Spoke

15 Subarnapur Individual Project I 100 Spoke

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke

18 Kendrapara Individual Project L 100 Spoke

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke

20 Nayagarh Individual Project N 100 Spoke

21 Deogarh Individual Project O 100 Spoke

22 Bargarh Individual Project P 100 Spoke

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke

24Kalinganagar

(Jajpur)Individual Project R 100 Spoke

25Rourkela

(Sundargarh)Individual Project S 100 Spoke

ESTIMATED PROJECT COST OF PROPOSED HOSPITAL PROJECTSIN CRORES INDIAN RUPEES (INR CRORES)

Hospital Site Location Project Sequence Beds

Project Cost

INR No

1Jeypore

(Koraput)Cluster Project A 200 90

2 Puri Cluster Project A 100 46

3 Bolangir Cluster Project B 200 90

4 Jharsuguda Cluster Project B 100 46

5 Angul Cluster Project C 200 84

6Barbil

(Kendujhar)Cluster Project C 200 84

7Bhawanipatna

(Kalahandi)Individual Project A 100 46

8 Bhadrak Individual Project B 100 46

9 Rayagada Individual Project C 100 46

10Phulbani

(Kandhamal)Individual Project D 100 46

11 Boudh Individual Project E 100 46

12Nuapada

Khariar RoadIndividual Project F 100 46

Hospital Site Location Project Sequence Beds Project Cost

No

13 Malkangiri Individual Project G 100 46

14 Nabrangpur Individual Project H 100 46

15 Subarnapur Individual Project I 100 46

16Paralakhemundi

(Gajapati)Individual Project J 100 46

17Rairangpur

(Mayurbhanj)Individual Project K 100 46

18 Kendrapara Individual Project L 100 46

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 46

20 Nayagarh Individual Project N 100 46

21 Deogarh Individual Project O 100 46

22 Bargarh Individual Project P 100 46

23Jagatsinghpur

Paradeep townIndividual Project Q 100 46

24Kalinganagar

(Jajpur)Individual Project R 100 46

25Rourkela

(Sundargarh)Individual Project S 100 46

BID ROLLOUT

bull All 25 hospitals planned to be bid out in 3-4 tranches with 6-8 hospitals in each

tranche

bull Tranche 1 Bid has been launched for this tranche

bull Bid launched on September 10

bull Bid due date on December 18 2018

bull Hospitals in Tranche 1 Eight (8)

bull 6 hospitals planned to be bid out in pairs

bull Remaining tranches to be launched subsequently

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 9: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

LIST OF THE PROPOSED HOSPITAL PROJECTSHOSPITAL NO 1-8 TO BE BID OUT IN TRANCHE 1 (SHADED IN GREEN)

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

1Jeypore

(Koraput)Cluster Project A 200 Hub

2 Puri Cluster Project A 100 Spoke

3 Bolangir Cluster Project B 200 Hub

4 Jharsuguda Cluster Project B 100 Hub

5 Angul Cluster Project C 200 Spoke

6Barbil

(Kendujhar)Cluster Project C 200 Spoke

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke

8 Bhadrak Individual Project B 100 Spoke

9 Rayagada Individual Project C 100 Spoke

10Phulbani

(Kandhamal)Individual Project D 100 Spoke

11 Boudh Individual Project E 100 Spoke

12Nuapada

Khariar RoadIndividual Project F 100 Spoke

Hospital Site Location Project Sequence Beds

Hospital

TypeNo

13 Malkangiri Individual Project G 100 Spoke

14 Nabrangpur Individual Project H 100 Spoke

15 Subarnapur Individual Project I 100 Spoke

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke

18 Kendrapara Individual Project L 100 Spoke

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke

20 Nayagarh Individual Project N 100 Spoke

21 Deogarh Individual Project O 100 Spoke

22 Bargarh Individual Project P 100 Spoke

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke

24Kalinganagar

(Jajpur)Individual Project R 100 Spoke

25Rourkela

(Sundargarh)Individual Project S 100 Spoke

ESTIMATED PROJECT COST OF PROPOSED HOSPITAL PROJECTSIN CRORES INDIAN RUPEES (INR CRORES)

Hospital Site Location Project Sequence Beds

Project Cost

INR No

1Jeypore

(Koraput)Cluster Project A 200 90

2 Puri Cluster Project A 100 46

3 Bolangir Cluster Project B 200 90

4 Jharsuguda Cluster Project B 100 46

5 Angul Cluster Project C 200 84

6Barbil

(Kendujhar)Cluster Project C 200 84

7Bhawanipatna

(Kalahandi)Individual Project A 100 46

8 Bhadrak Individual Project B 100 46

9 Rayagada Individual Project C 100 46

10Phulbani

(Kandhamal)Individual Project D 100 46

11 Boudh Individual Project E 100 46

12Nuapada

Khariar RoadIndividual Project F 100 46

Hospital Site Location Project Sequence Beds Project Cost

No

13 Malkangiri Individual Project G 100 46

14 Nabrangpur Individual Project H 100 46

15 Subarnapur Individual Project I 100 46

16Paralakhemundi

(Gajapati)Individual Project J 100 46

17Rairangpur

(Mayurbhanj)Individual Project K 100 46

18 Kendrapara Individual Project L 100 46

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 46

20 Nayagarh Individual Project N 100 46

21 Deogarh Individual Project O 100 46

22 Bargarh Individual Project P 100 46

23Jagatsinghpur

Paradeep townIndividual Project Q 100 46

24Kalinganagar

(Jajpur)Individual Project R 100 46

25Rourkela

(Sundargarh)Individual Project S 100 46

BID ROLLOUT

bull All 25 hospitals planned to be bid out in 3-4 tranches with 6-8 hospitals in each

tranche

bull Tranche 1 Bid has been launched for this tranche

bull Bid launched on September 10

bull Bid due date on December 18 2018

bull Hospitals in Tranche 1 Eight (8)

bull 6 hospitals planned to be bid out in pairs

bull Remaining tranches to be launched subsequently

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 10: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

ESTIMATED PROJECT COST OF PROPOSED HOSPITAL PROJECTSIN CRORES INDIAN RUPEES (INR CRORES)

Hospital Site Location Project Sequence Beds

Project Cost

INR No

1Jeypore

(Koraput)Cluster Project A 200 90

2 Puri Cluster Project A 100 46

3 Bolangir Cluster Project B 200 90

4 Jharsuguda Cluster Project B 100 46

5 Angul Cluster Project C 200 84

6Barbil

(Kendujhar)Cluster Project C 200 84

7Bhawanipatna

(Kalahandi)Individual Project A 100 46

8 Bhadrak Individual Project B 100 46

9 Rayagada Individual Project C 100 46

10Phulbani

(Kandhamal)Individual Project D 100 46

11 Boudh Individual Project E 100 46

12Nuapada

Khariar RoadIndividual Project F 100 46

Hospital Site Location Project Sequence Beds Project Cost

No

13 Malkangiri Individual Project G 100 46

14 Nabrangpur Individual Project H 100 46

15 Subarnapur Individual Project I 100 46

16Paralakhemundi

(Gajapati)Individual Project J 100 46

17Rairangpur

(Mayurbhanj)Individual Project K 100 46

18 Kendrapara Individual Project L 100 46

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 46

20 Nayagarh Individual Project N 100 46

21 Deogarh Individual Project O 100 46

22 Bargarh Individual Project P 100 46

23Jagatsinghpur

Paradeep townIndividual Project Q 100 46

24Kalinganagar

(Jajpur)Individual Project R 100 46

25Rourkela

(Sundargarh)Individual Project S 100 46

BID ROLLOUT

bull All 25 hospitals planned to be bid out in 3-4 tranches with 6-8 hospitals in each

tranche

bull Tranche 1 Bid has been launched for this tranche

bull Bid launched on September 10

bull Bid due date on December 18 2018

bull Hospitals in Tranche 1 Eight (8)

bull 6 hospitals planned to be bid out in pairs

bull Remaining tranches to be launched subsequently

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 11: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

BID ROLLOUT

bull All 25 hospitals planned to be bid out in 3-4 tranches with 6-8 hospitals in each

tranche

bull Tranche 1 Bid has been launched for this tranche

bull Bid launched on September 10

bull Bid due date on December 18 2018

bull Hospitals in Tranche 1 Eight (8)

bull 6 hospitals planned to be bid out in pairs

bull Remaining tranches to be launched subsequently

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 12: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

FINANCIAL PROTECTION SCHEMES IN ODISHA

Biju Swasthya Kalyan Yojana (BSKY) - Launched on 15th August 2018

(1) About 70 of Odisharsquos population covered for secondary and tertiary care

level conditions requiring hospitalisation

(2) All beneficiaries under RSBY BKKY and eligible families under OSTF will

get health coverage of Rs 5 lakhs per annum Over 70 lakhs families will be

covered benefitted

Families with women members will get additional health coverage of Rs 2

lakhs per annum Thus families with women members will get health

coverage of Rs 7 lakhs per annum

Chief Minister Relief Fund (CMRF) - Over and above funds are also sanctioned for treatment of critical cases without

any financial limit

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 13: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

CONVERGENCE WITH BSKY FOCUS ON AFFORDABILITY

The Project synergizes substantially with the BSKY to promote affordability Strong Institutional mechanism for monitoring clinical quality

The Project leverages the strong Payor system developed for the BSKY to ensure timely payments

Convergence with BSKY enhances Fiscal Sustainability of the project

Payor

BSKY

Providers

Including

Hospitals

developed

under the AHP

Affordable healthcare accessible to the

people of Odisha

Budgetary Support

Institutional Capacity

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 14: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

PROJECT DESIGN PHILOSOPHY

The Project design philosophy is based on POLICY MODULARITY CONVERGENCEand OPTIMIZED and FAIR distribution of risks Policy Modularity

Project structure is adaptable to the rapidly evolving health ecosystem in the country over then next 30 years

Optimized amp Fair Risk Distribution

Risk is allocated to the party best placed to manage the same

Risk is valued according to actual locational and operational factors

Substantial ldquoskin in the gamerdquo of the Government through VGF contribution

Convergence

Project leverages existing programs for Institutional Capacity and Fiscal Sustainability

The Project is deeply convergent with the Biju Swasthya Kalyan Yojana (BSKY) or its alternate successor schemes that

may be launched in the future

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 15: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

Projects in Tranche 1

The Affordable Healthcare Project

Bids invited for 8 hospitals

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 16: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke

Project

Category

Fixed VGFMaximum Additional

VGF

Fixed Grant at

100 Capacity

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

VGF Viability Gap Funding or grant available from the government Please read the remaining document for more details

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 17: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

100 Bed Secondary Care Spoke Hospitals

200 Bed Secondary Care Spoke Hospitals

200 Bed Tertiary Care Hub Hospitals

100 Bed Tertiary Care Hub Hospital

PROJECT LOCATIONS 3 TERTIARY CARE HOSPITALS (HUBS) amp 5 SECONDARY CARE HOSPITALS (SPOKES)

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 18: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

The Affordable Healthcare Project

Transaction Structure

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 19: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

COMMERCIAL ARRANGEMENT

Govt of Odisha

Concessionaire

Net VGF

required from

the state

concession

Regulators including

NABH Accreditation

Public BeneficiariesInsurance RSBY BKKY

NHPS OSTF

to be determined by competitive bidding

Builder

Financiers

Other Partners

Other Stakeholders

bull Equity

bull Debt

bull Operations

bull Construction

Private Beneficiaries

Self paidPaid for by GoO

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 20: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

PROJECT TRANSACTION STRUCTURE (15)

ELEMENT STRUCTURE

Project Structure bull Concession- (Design Build Finance Operate and Transfer - DBFOT)

Concession Duration amp Renewal bull 32 years 2+30 Years duration renewal on mutual agreement

Private Sector

bull Design finance construct and equip the Hospital

bull Manage operate and maintain the Hospital

bull Take market risk and partial tariff risk

Government Role

bull Provide Viability Gap Funding (VGF) for upto first 7 years

bull Empanel under Biju Swastha Kalyan Yojana (BSKY) Other successor

substitutes programs in the future

bull Provide sufficient unencumbered land

bull Set Tariffs referral of Select (Government Social health insurance) Patients

monitor

Land Offeredbull 2-4 acres unencumbered located near national or state highway

bull Land to be provided to the private sector operator on lease

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 21: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

PROJECT TRANSACTION STRUCTURE (25)

ELEMENT STRUCTURE

Project Commissioning

Phasing

(Main construction

commissioning milestones)

Phase I (On starting operations)

i Completion of earth evacuation foundation works super structure upto floor roof casting for

100 bed capacity

ii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances for 50 bed capacity

Phase II (to be achieved within 4 years of operations)

iii Completion of civil services and finishing works equipment installation manpower

recruitment statutory clearances to reach 100 bed capacity

Hospital Numbers 25 Hospitals

Hospital Configuration

bull 200 bed hub hospitals (with Neurosurgery and Cardiac Sciences)

bull 100 bed special hub hospitals (with Neuro-sciences Neonatology and Urology) ndash in

Jharsuguda

bull 200 bed spoke secondary-care hospitals

bull 100 bed spoke secondary-care hospitals

bull Atleast 50 of beds to be General Ward beds

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 22: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

PROJECT TRANSACTION STRUCTURE (35)

ELEMENT STRUCTURE

Specialities in Spokes (100 amp

200 Beds)

bull General Surgery General Medicine OBampG Pediatrics Orthopedics Anesthesiology

Ophthalmology ENT Dental Radiology Pathology Psychiatry Dermatology Critical-care

Emergency amp Trauma

Specialities in Hub Hospitalsbull As in Spokes PLUS Cardiology (non-invasive only) and Neurosurgery

bull Jharsuguda As in Spokes PLUS Neurology Neurosurgery Urology and Neonatology

Capacity Reserved for Select

Patients (Government patients)

bull No separate physical capacity reserved for Select patients

bull Select patients to be treated in General Wards subject to availability of beds

bull Private Partner free to treat market patients as well

Viability Gap Funding (VGF) to

be provided by the Government

bull FIXED AMOUNT equivalent to around 30 or 60 of the Project Cost (as has been pre-

estimated by the Government)

bull Exact VGF depends on the type of hospital and location

bull To be paid linked to construction and commissioning milestones in years 1 to 2 (or 3 in some

cases)

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 23: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

PROJECT TRANSACTION STRUCTURE (45)

ELEMENT STRUCTURE

Additional VGF (AVGF)

bull Bid Criteria (subject to maximum limits)

bull To be paid out in 6 tranches from Years 2 3 to 7 of Effective date

bull Negative VGF allowed (ldquopremiumrdquo to be paid to the Government)

bull Amount of AVGF or ldquoPremiumrdquo in any year can be as per individual requirements and business

projections of the bidder (subject to limits)

Grant on commissioning of

100 planned capacity

bull Fixed Grant to be paid upon commissioning of 100 of capacity by year 5 of effective date

(when the project is launched)

Convergence with State

National Insurance Programs

bull Be integrated with state national programs eg NHPS BSKY Other successor substitute

programs

bull Tariffs may be revised to reflect quality of the facilities

Tariffs for Select Patients (for

In-patient services only

including diagnostic services)

bull Select patients will be Government referred patients or patients availing benefits under social

health insurance assurance programs such as Biju Swasthya Kalyan Yojana (BSKY)

bull Select Patients required to be treated in General Wards only

bull Any Select patient who are enrolled in prevailing social insurance assurance programs will be

treated at the rates under the program

bull OSTF patient swill be treated at OSTF prescribed rates

bull All other Select patients to be treated at NHPSBSKY rates

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 24: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

PROJECT TRANSACTION STRUCTURE (55)

ELEMENT STRUCTURE

Tariffs for Non-Select Private

Patients (for In-patient services)bull Market rates as determined by the private partner

Tariffs for Out Patient and

diagnostic servicesbull Market rates as determined by the private partner

Qualitybull All sites to conform to and become accredited with National Accreditation Board for Hospitals

and Healthcare Facilities (NABH) India within 4 years of operations

Tariff Risk Mitigationbull Private partner provided revenue downside protection for limited period against reduction in

tariff rates or major policy changes

Leveraging Emerging

Trends

bull Project encourages leveraging of emerging technologies such as tele ICU services tele-

radiology to overcome shortage of staff

bull Outsourcing of non-core clinical services such as diagnostics ENT Dental ophthalmology

dialysis tele-ICU etc allowed

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 25: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

TECHNOLOGY amp SERVICE ENABLERS

Technology Service Enablers Remarks

Tele-Radiology bull Teleradiology allowed no need to place local Radiologists

Tele-ICU Servicesbull Remote ICU services from qualified service provider allowed in lieu of critical care

specialists 1 tele-ICU bed 50 beds

Outsourcing of Diagnostic Services bull Radiology and Lab services can be outsourced to NABL NABH accredited labs

Outsourcing of Non-core clinical Servicesbull All clinical services can be outsourced to third parties except for ldquoCore-clinical

servicerdquo (mostly the broad specialities and superspecialities) eg Eye ENT Dental

Skin etc

Outsourcing of Operations amp Management

(OampM)

bull OampM of the hospital can be subcontracted to associate entities (entities controlled by

the technical partner)

Outsourcing of non-clinical servicesbull All non-clinical services (except for core management) can be outsourced Eg

laundry housekeeping maintenance

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 26: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

PROJECT MILESTONES AND PAYMENT TIMELINES

Tranche Milestone Estimated years from the Effective Date Grant Type

1Completion of structure of 100 of target capacity (will have sub-

tranches)1 bull Fixed payment based on Hospital

type

2Completion of building with finishing necessary to operate 50 of

target capacity (will have sub-tranches) including plumbing

faccedilade STP WTP Fire fighting electrical and safety

2 bull Fixed payment based on Hospital type

3Commissioning of operations (at least 50 of target capacity to

be made operational)2 bull Variable to be quoted by bidder or

bull Fixed for certain Hospital types

4 First anniversary of operations 3 bull Variable to be quoted by bidder

5 Second anniversary of operations 4 bull Variable to be quoted by bidder

6 Third anniversary of operations AND commission 100 of

capacity5 bull Variable to be quoted by bidder

7 Fourth anniversary of operations with tranche A paid 6 bull Variable to be quoted by bidder

8 Fifth anniversary of operations with tranche A paid 7 bull Variable to be quoted by bidder

AFixed Payment Commissioning of 100 planned capacity within

year 5 of Effective Date will lapse post that (not considered for

evaluation)

5 bull Fixed payment based on Hospital type

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 27: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …

DETAILS OF THE PROPOSED HOSPITALS TRANCHE 1

BIDDING LAUNCHED ON SEP 10 2018

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

1 Jeypore (Koraput) Cluster Project A 200 Hub A2 51 118 15

2 Puri Cluster Project A 100 Spoke B 14 79 6

3 Bolangir Cluster Project B 200 Hub A2 51 118 15

4 Jharsuguda Cluster Project B 100 Hub B 14 79 6

5 Angul Cluster Project C 200 Spoke A3 25 1255 10

6 Barbil (Kendujhar) Cluster Project C 200 Spoke A3 25 1255 10

7Bhawanipatna

(Kalahandi)Individual Project A 100 Spoke C 285 94 6

8 Bhadrak Individual Project B 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (12)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

9 Rayagada Individual Project C 100 Spoke C 285 94 6

10 Phulbani (Kandhamal) Individual Project D 100 Spoke C 285 94 6

11 Boudh Individual Project E 100 Spoke C 285 94 6

12Nuapada Khariar

RoadIndividual Project F 100 Spoke C 285 94 6

13 Malkangiri Individual Project G 100 Spoke C 285 94 6

14 Nabrangpur Individual Project H 100 Spoke C 285 94 6

15 Subarnapur Individual Project I 100 Spoke C 285 94 6

16Paralakhemundi

(Gajapati)Individual Project J 100 Spoke C 285 94 6

17Rairangpur

(Mayurbhanj)Individual Project K 100 Spoke B 14 79 6

18 Kendrapara Individual Project L 100 Spoke B 14 79 6

DETAILS OF THE PROPOSED HOSPITALS BIDS TO BE ANNOUNCED (22)

Hospital Site Location Type Beds Hub Spoke2 Project

Category

Fixed VGF3 Maximum Additional

VGF4

Fixed Grant at

100 Capacity5

No (INR crores) (INR crores) (INR crores)

19Kamakhyanagar

(Dhenkanal)Individual Project M 100 Spoke B 14 79 6

20 Nayagarh Individual Project N 100 Spoke B 14 79 6

21 Deogarh Individual Project O 100 Spoke B 14 79 6

22 Bargarh Individual Project P 100 Spoke B 14 79 6

23Jagatsinghpur

Paradeep townIndividual Project Q 100 Spoke B 14 79 6

24 Kalinganagar (Jajpur) Individual Project R 100 Spoke B 14 79 6

25 Rourkela (Sundargarh) Individual Project S 100 Spoke B 14 79 6

Note

1 Bids for Tranche 1 (Hospital Nos 1-8) are invited bids for the other hospitals will be invited subsequently in 2-3 additional tranches

2 Please see the project transaction structure for description of Hubs and Spokes

3 VGF Viability Gap Funding to be provided by the Government of Odisha Fixed VGF will be paid against attainment of construction milestones

4 This is a cumulative figure Additional VGF (AVGF) will be paid at the end of each year of satisfactory operations for the first 5 years of

operations

5 Fixed Grant will be payable on attainment of 100 operational capacity

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in INR crore unless

otherwise specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category

A1

Project

Category

A2

Project

Category A3

Project Category

B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

1

Initialization of construction works

completion of foundation works

and structure work for 50 of bed

capacity

1 T1 - Fixed 12 12 12 7 7

2

Completion of civil works services

work and finishing work to make

50 of bed capacity operational

2 T2 ndashFixed 13 23 13 7 135

3

Equipment installation amp

commissioning manpower

recruitment amp training statutory

clearances and commissioning of

Phase I (50 of bed capacity)

2T3 ndashFixed or

Variable

125

(maximum

upper limit of

AVGF)

16

(Fixed)

125 (maximum

upper limit of

AVGF)

7

(maximum upper

limit of AVGF)

8

(Fixed)

4 First anniversary of operations 3 T4 Bid Variable

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

29

(maximum

upper limit of

AVGF)

17

(maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

5 Second anniversary of operations 4 T5 Bid Variable

25 (maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25 (maximum

upper limit of

AVGF)

17 (maximum

upper limit of

AVGF)

21

(maximum

upper limit

of AVGF)

FIXED AND ADDITIONAL VGFPREMIUM LIMITS

Tranche

Milestone Year VGF Type Maximum Amount of VGF

All figures in Rs crore unless otherwise

specified

Anniversary of

effective date

(filled in by the

bidder)

Project

Category A1

Project

Category A2

Project

Category A3

Project

Category B

Project

Category C

Hospital Beds Planned 200 200 200 100 100

6Third anniversary of operations AND

commission 100 of capacity5

T6 Bid

Variable

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

25

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

19

(maximum

upper limit of

AVGF)

7Fourth anniversary of operations with

tranche A paid6

T7 Bid

Variable

11

(maximmum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

11

(maximum

upper limit of

AVGF)

8

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

8Fifth anniversary of operations with

tranche A paid7

T8 Bid

Variable

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

13

(maximum

upper limit of

AVGF)

10

(maximum

upper limit of

AVGF)

14

(maximum

upper limit of

AVGF)

A

Equipment installation amp

commissioning manpower recruitment

amp training statutory clearances and

commissioning of Phase II (remaining

50 of bed capacity) within 5 years of

effective date

5

Fixed based

on hospital

type

15 15 10 6 6

KEY TECHNICAL FEATURES

PROJECT FACILITIES-BED MIX

( Schedule 3)

Bed Configuration

200 Beds

(HUB)

200 Beds

(SPOKE)

100 Beds

(SPOKE)

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Beds

Phase-I

Beds

Phase-II

Single Private beds 10 12 10 12 5 5

Twin Sharing beds 28 28 28 28 14 14

General ward beds 42 42 42 42 21 21

ICU beds 10 10 10 10 5 5

NICU beds 6 6 6 6 3 3

Isolation beds 4 2 4 2 2 2

Total Beds 100 100 100 100 50 50

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bed Tertiary Care HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging

(xiv)Dentaland

(xv) Psychiatry

All clinical services as mentioned in Phase I including additional

services as below

(i) Cardiology - Invasive and Non-invasive Cardiology

(ii) Neurology ndash Neuro medicine and Neuro Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical

Care specialist cover Such services to be procured from NABH

accredited facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Tertiary Care Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

(ii) Neurology

(iii) Neonatorlogy

(iv) Nephrology

(v) Urology Renal Surgery

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to all 200 bedded Secondary Care Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

HOSPITAL MINIMUM SPECIALTY MIXndash CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II(i) Emergency and Trauma

(ii) Dedicated OPD for Medicine Surgery Orthopedics Obstetrics amp

Gynecology ENT Ophthalmology and Dental

(iii) Internal Medicine

(iv) General Surgery

(v) Obstetrics amp Gynecology including Family Planning and Post Partum

services

(vi) Pediatrics including neonatology and immunization

(vii) Orthopedics

(viii)Critical care Intensive care

(ix) Anesthesia

(x) Ophthalmology

(xi) ENT

(xii) Skin amp Venereal diseases

(xiii)Radiology including Imaging and

(xiv)Dental

All clinical services as mentioned in Phase I including additional

services as below

(i) Psychiatry

Note

bull Tele-ICU services for minimum 2 ICU Beds per 100 Beds to be

provisioned in case Operator is not able to provide 24x7 Critical Care

specialist cover Such services to be procured from NABH accredited

facility only

bull PACS is mandatory if the Concessionaire is not able to provide

fulltime Radiologist

Applicable to all 200 bed HUB hospitals in the proposed locations at ndash Koraput and Bolangir

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

histopathology microbiology serology and immunology)

(ii) Radiology services (CT ScanX-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Pulmonary Function Test

(vi) Audiometry

(vii)Dialysis services

(viii)Blood transfusion

(ix) Physiotherapy amp rehabilitation and

(x) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) MRI

(ii) Holter monitoring

(iii) Endoscopy amp colonoscopy

(iv) Bronchoscopy

(v) Echocardiography (ECHO)

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 200 bedded Spoke hospital in the proposed locations at ndash Angul and Barbil

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (CT Scan X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) Holter monitoring

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hospitals in the proposed locations at Bhawanipatna (Kalahandi) and Bhadrak

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

Applicable to 100 bed Hub Hospital in the proposed locations at Jharsuguda

Phase I Phase II

(i) Laboratory services (hematology biochemistry pathology

microbiology)

(ii) Radiology services (X-ray and Ultrasonography)

(iii) Electrocardiography (ECG)

(iv) Tread Mill Test (TMT)

(v) Audiometry

(vi) Dialysis services

(vii)Blood storage amp transfusion

(viii)Physiotherapy amp rehabilitation

(ix) Drugs and Pharmacy

All diagnostics amp other para clinical services as

mentioned in Phase I including additional services as

below

(i) CT Scan

(ii) Pulmonary Function Test

DIAGNOSTIC amp PARA CLINICAL SERVICES

(Schedule 3)

HUMAN RESOURCE DEPLOYMENT amp QUALIFICATION

(Schedule 5)

The minimum indicative ratio of Doctor Nurse Beds is equal to1410 in each shift during all Phases of hospital operation

Doctors Nurses Technician

(i) Senior Consultants MDMS DNB MCh DM

(ii) Consultants MD MS DNB MCh DM

(iii) Senior Residents MBBS with minimum 5

years of post-qualification experience in

providing clinical services

(iv) Junior Residents MBBS

(i) Nursing Superintendent MSc Nursing with

at least 5 years of experience BSc Nursing

(minimum 7 years of experience)

(ii) Deputy Nursing Superintendent MSc

Nursing with at least 3 years experience

BSc Nursing Dip Nursing GNM with 5 years

of experience

(iii) Senior Nurses GNM Dip NursingANM with

at least 3 years experience

(iv) Shift duty nurses GNM Diploma (Nursing)

with at least 1 year experience or ANM with at

least 3 yearsrsquo experience

(i) OT Technicians

(ii) Laboratory Technicians

(iii) Radiology Technicians

(iv) Dialysis Technicians

(v) Emergency Trained Experts

Technicians

(vi) Critical Care Technicians

(vii) Cath Lab Technicians (in HUBs)

(viii)Physiotherapist

(ix) Pharmacist

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Hospital

Operations

Healthcare

Services to Select

Patients

Compliance with the

minimum Bed Days of 3650 per annum

commencing from Phase I COD

For every additional

Licenced Bed beyond 50 of the Bed

Capacity 60 Bed

Days per annum for each such

additional Licenced Bed maximum up-

to 6000 Bed Days per annum

commencing from COD of Phase-I

INR 5000 per Bed-Day shortfall from the minimum Bed Days as

stipulated under this KPI The rate of Damages specified above

shall be increased in

accordance with Inflation Index Formula commencing from the 2nd

anniversary of COD of Phase-I

Provided that this KPI shall be applicable only if the Hospital is

empanelled under Government Health Schemes

Patient Care Over charging of

fees from Select

Patients under

Government Health

Schemes

Compliance with the rates specified

under

the relevant Government Health

Scheme

01 of the Operation Performance Security for every default

The rate of Damages specified above shall be increased in

accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase I

Patient Care Round the clock

coverage of onsite

critical care

specialists (or at

least 1 acceptable

Tele-ICU beds per

50 Licenced Beds)

Availability of such services for at least

162 days in every six monthly period

commencing from COD of Phase-I

Damages equal to INR 50000 per day for every day of non-

availability

of such services below 162 days in every six monthly period

commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

Patient Care Round the clock

coverage of at least

1 Resident Medical

Officer for each 20

Licenced Beds

Availability of such services for at

least

162 days in every six monthly

period

commencing from COD of Phase-

I

Damages equal to INR 10000 per day for every day of non-

availability of such services below 162 days in every six monthly

period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Equipment

Management

Availabilityuptime of CT

Scan and Ventilators

Availability of equipment for at

least 162 days in every six

monthly period commencing from

COD of Phase-I

Damages equal to INR 5000 per day per equipment for every day

of non-availability of such equipment below 162 days in

every six monthly period commencing from COD of Phase-I

The rate of Damages specified above shall be increased in

accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Website

management

Development of

website of the Hospital in

accordance with

Schedule 19

Number of days when the website

is unavailable

Damages equal to INR 5000 per day on which such website is

unavailable The rate of Damages specified above shall be

increased in accordance with Inflation Index Formula commencing

from the 1st anniversary of COD of Phase-I

KEY PERFORMANCE INDICATOR(Schedule 14)

Type KPI Baseline Damages

MIS Development and

maintenance of hospital MIS in

accordance with Schedule 19

and updated from time to time by

the Concessionaire in

accordance with the

requirements of the Authority

Availability of updated MIS

for at least 162 days in every

six monthly period

commencing from COD of

Phase-I

Damages equal to INR 5000 per day on which such website is not

updated The rate of Damages specified above shall be increased

in accordance with Inflation Index Formula commencing from the 1st

anniversary of COD of Phase-I

Patient

Satisfaction

Patient Satisfaction

Index of OPD and IPD through

Patient Satisfaction Survey in

accordance with Schedule 26

Satisfaction Index ge 3

out of 5

The Damage shall be calculated in an amount equal to 1 of the

Operation Performance Security for Satisfaction Index less than 3

out of 5 (measured half yearly) The rate of Damages specified

above shall be increased in accordance with Inflation Index

Formula commencing from the 1st anniversary of COD of Phase-I

NABH

accreditation

Receiving of NABH

accreditation

Receipt of entry level

NABH accreditation within

24 (twenty four) months from

COD of Phase-I

Receipt of final NABH

accreditation within 48

(forty eight) months

from COD of Phase-I

3 of the Operation Performance Security for every month or part

thereof during which the default continues

PROJECT DEVELOPMENT SCHEDULE

(Schedule 10)

200 Bed Hub 200 Bed Spoke 100 Bed Hospitals

Phase I Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 100 Beds -

within 852 days from ED

Commenced Operations of 50 Beds -

within 701 days from ED

Phase II Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

100 Beds - within 1811 days from ED

Commenced Operations of additional

50 Beds - within 1809 days from ED

NOTE

200 Bedded Hub Hospitals Bolangir Jeypore

200 Bedded Spoke Hospitals Angul Barbil

100 Bedded Hospitals All 100 bed hospitals including Jharsuguda

SALIENT FEATURES OF THE PROPOSED

BIDDING PROCESS AND CONCESSION

OVERVIEW

bull Single stage bidding process (Clause 231 RFP)

bull Hospital projects categorized as Cluster Projects and Individual Projects (Clause 232 RFP)

bull RFP and DCA (PFD version) will be made available free of cost to the bidders (Clause 211 RFP)

bull Bidders need to complete registration by payment of INR 20000 as bidding process fee (Clause 211 (b) RFP)

bull On completion of registration process bidders free to bid for as many Cluster Projects and Individual Projects

they may like (Clause 211 RFP)

bull Presently Bids will be invited only for Phase I projects (Clause 239)

bull In case of a Consortium only 1 member of such Consortium will be required to have completed the registration

process (Clause 211 RFP)

bull Bidders may download an information binder from Authorityrsquos website which contains information about

demography socio-economic background of people prevalent diseases etc in connection with all projectsrsquo

districts (Clause 221 RFP)

BIDDING PROCESS

bull Separate Technical Bids and Financial Bids invited for each Cluster Project and Individual Project ie separate

bidding process for each Cluster Project and Individual Project (Clause 231 and 232 RFP)

bull Financial Bids will be evaluated only for those Bidder who satisfy the Minimum Eligibility Criteria (Clause 632

RFP)

bull Financial Bids for each of the project is invited on the basis of additional viability gap funding sought by the

Bidders (ldquoAdditional Grantrdquo) or premium to be paid by the Bidders (ldquoPremiumrdquo) in each case in INR in tranches

(Clause 235 RFP)

bull Bidders shall be free to (a) seek an Additional Grant from the Authority (b) seek neither an Additional Grant nor

offer a Premium or (c) offer to the Authority a Premium or any combination thereof in tranches (Clause 235

RFP)

bull Additional Grant will be quoted as a negative value in INR (Clause 235 RFP)

bull Premium will be quoted as a positive value in INR (Clause 235 RFP)

bull Financial Bids of Qualified Bidders will be assessed on the basis of the net present value of the Additional Grant

andor Premium (Clause 235 RFP)

bull Bid Variable = NPV of Premium plus NPV of Additional Grant (Clause 235 RFP)

bull The Qualified Bidder quoting the highest Bid Variable will be awarded the project (Clause 236 RFP)

BIDDING PROCESS

CONSORTIUM REQUIREMENTS

bull A Bidder can be an entity or a group of entities ie a Consortium (Clause 211 RFP)

bull Bidders can form different Consortium for each Project (whether a Cluster Project andor an Individual Project)

(Clause 211 RFP)

bull A Consortium can have a maximum of 4 members (Clause 279 RFP)

bull A Consortium will be required to have

i) Lead Financial Member Will be required to meet 50 of the Financial Capacity required for the

concerned project (Clause 279 RFP)

ii) Lead Technical Member Will be responsible for operating the project (Clause 279 RFP)

bull In case the Bidder is a Consortium only those membersrsquo experience and capacity will be evaluated for satisfaction

of the minimum eligibility criteria (for the concerned project) who will hold at least 10 equity in the SPV (if the

concerned project is awarded to the Consortium) (Clause 279 RFP)

INCENTIVE For winning more than one project

bull A Bidder who is awarded 2 or more Cluster Projects will be entitled to receive an incentive from the Authority

(Clause 2411 RFP)

bull Incentive will be paid on the Cluster Project for which the Bidder has quoted the second highest amount of Bid

Variable amongst the Cluster Projects that are awarded to the Bidder (ldquoIncentive Cluster Projectrdquo) (Clause

2411 RFP)

bull The incentive (ldquoCluster Incentiverdquo) will be a percentage of the Bid Variable quoted by the Bidder for the Incentive

Cluster Project (Clause 2414 RFP)

bull Similar mechanism for payment of incentive for Individual Projects as well (Clause 2421 RFP)

Incentive Award of 2 Cluster

Projects in total

Award of 3

Cluster Projects

in total

Percentage of the Bid

Variable quoted for the

Incentive Cluster Project

5 9

QUALIFICATION CRITERIA (RFP APPENDIX II)

S NoCapacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 300 100 100

2Net Worth (in INR crores) for immediately preceding financial year ending

March 31 201830 20 10

3Average annual Turnover (in INR million) for immediately preceding 2

(two) financial years ending March 31 201845 30 15

Eligibility Criteria

(to be evaluated only once and will not be adjusted on account of capacity deduction)

4

Minimum Accredited Beds (NABH or other reputed international

accreditations- JCI Canada Australia Japan UK amp South Africa) under

management

50 50 NA

5Interventions performed in basic secondary care specialities (specified per

speciality) (as detailed in RFP)5600 3600 2500

6Key Secondary care Specialists employed by the bidder (as detailed in

RFP)12 8 6

7 Neonatal intensive care unit 10 2 2

QUALIFICATION CRITERIA

bull The Bidder has designed itself built itself refurbished itself as the case may be or paid for designing or

construction of at least 2 (two) hospital buildings with at least 1 (one) hospital building having a built up of at

least 80000 (eighty thousand) square feet in 10 (ten) years immediately preceding the Bid Due Date (RFP

Appendix II )

bull If the Bidder itself does not have the aforesaid experience of designing the Bidder will submit a joint

undertaking with an eligible design consultant that if the Bidder is awarded the concerned project the SPV and

the design consultant will enter into a design consultancy agreement (RFP Appendix II)

bull A design consultant for being eligible will be required to have experience of designing at least 5 (five) hospital

buildings with at least 1 (one) hospital building having a built up of at least 80000 (eighty thousand) square

feet in 10 (ten) years immediately preceding the Bid Due Date (Definition of Design Consultant)

SITE VISIT

bull The Authority will conduct an official site visit for each of the hospitals for registered Bidders (including their

advisors and potential consortium partners) (Clause 291 RFP)

bull Registered Bidders will be permitted to undertake independent verification of the Site at their own cost and

expense (Clause 292 RFP)

bull Any registered Bidder who is interested in undertaking independent Site visit(s) shall be required to intimate

the Authority at least 7 (seven) days prior to the date of visit (Clause 292 RFP)

BID SECURITY AMOUNTS FOR PHASE I PROJECTS (RFP Appendix XII)

S No Project Hospital Location District Cluster Project

Individual Project

Amounts in INR

1 Jeypore Koraput Cluster Project A 12800000

Puri Puri

2 Bolangir Bolangir Cluster Project B 12800000

Jharsuguda Jharsuguda

3 Angul Angul Cluster Project C 16400000

Barbil Keonjhar

4 Bhawanipatna Kalahandi Individual Project A 4600000

5 Bhadrak Bhadrak Individual Project B 4600000

EVALUATION OF BIDS

bull The Technical Bids for all Projects will be evaluated together and results shared with all bidders for 7 days

bull For each Project the Bidders whose Bids are considered responsive and who fulfil the Minimum Eligibility Criteria shall be

declared as qualified bidders for the concerned project (ldquoQualified Biddersrdquo) days (Clause 631 RFP)

bull Financial Bids of only the Qualified Bidders for each Project will be opened and evaluated in the sequence specified in the RFP

days (Clause 632 RFP)

bull Upon award of the first project to the Selected Bidder the overall Technical Capacity and the overall Financial Capacity of the

Selected Bidder (or in case of the Selected Bidder being a Consortium from the overall Technical Capacity and the Financial

Capacity of its Members) shall be reduced by the quantum of capacity deduction specified in the RFP days (Clause 634 RFP)

bull In case of a Consortium the Members will be required to specify (in the Technical Bid) the proportion in which capacity

deduction will apply to them if awarded a project days (Clause 634 RFP)

bull The working of the Capacity Deduction shall be displayed to all the Bidders who have submitted a Bid days (Clause

634 RFP)

EVALUATION OF BIDS

bull The Technical Bids submitted by the Selected Bidder andor its Members after Capacity Deduction (collectively the

ldquoRevaluated Entitiesrdquo) for all remaining Projects will be revaluated days (Clause 635 RFP

bull If as a result of Capacity Deduction the Revaluated Entities do not satisfy the Minimum Eligibility Criteria for other the

remaining Projects for which they have submitted a Bid such Reevaluated Entity shall cease to be a Qualified Bidder for each

such remaining Projects days (Clause 636 RFP)

bull The above steps will be repeated for the evaluation of the Financial Bids for the remaining projects days (Clause 638 RFP)

bull The workingcalculations for Capacity Deduction will be displayed to all bidders (present during evaluation) days (Clause

634 RFP)

bull If there is only 1 Financial Bid eligible to be evaluated pursuant for any project the evaluation of the Financial Bid for such

Project shall be deferred and will be placed at the bottom (in the order of their original sequence) in the Financial Bids

Evaluation Sequence days (Clause 6310 RFP)

EVALUATION OF FINANCIAL BIDS CALCULATION OF NPV (RFP Appendix XI)

QUANTUM OF CAPACITY DEDUCTION

(RFP APPENDIX III)

Sl

No

Capacity Criteria

(will be adjusted in case of award of a project)

Cluster

Project

200 Bed

Individual

Hospital Project

100 Bed

Individual

Hospital Project

1 Total Licensed Beds under management 200 70 70

2 Net Worth (in INR crores) 20 14 7

3 Average annual Turnover (in INR crores) 30 20 10

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull A a sole Bidder has the following Technical Capacity and Financial Capacity

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 400

Financial Capacity

1 Net Worth (in INR) 40 crores

2 Average annual Turnover (in INR) 300 crores

bull A is a Qualified Bidder for the first and second Cluster Projects The Minimum Eligibility Criteria for each Cluster Project is as

follows

S No Criteria Figure

Technical Capacity

1 Total Licensed Beds under management 300

Financial Capacity

1 Net Worth (in INR) 30 crores

2 Average annual Turnover (in INR) 90 crores

bull Financial Bids for all Qualified Bidders for the first Cluster Project are opened and evaluated and A is declared as the Selected

Bidder for the first Cluster Project

bull Subsequently the specified quantum of Capacity Deduction for 1 (one) Cluster Project will be deducted from the overall

Technical Capacity and Financial Capacity of A

bull After such Capacity Deduction Arsquos revised Technical Capacity and Financial Capacity are as follows

S No Criteria Calculations Revised Figure

Revised Technical Capacity

1 Total Licensed Beds under management 400 minus 200 200

Revised Financial Capacity

1 Net Worth (in INR) 40 crores minus 20 crores 20 crores

2 Average annual Turnover (in INR) 300 crores minus 90 cores 210 crores

ILLUSTRATION ON CAPACITY DEDUCTION (CLAUSE 639 RFP)

bull After completion of Capacity Deduction for the first Cluster Project Arsquos Technical Bid for the second Cluster Project shall be

revaluated

bull Since Arsquos revised Technical Capacity and revised Financial Capacity after Capacity Deduction is less than the Minimum

Eligibility Criteria for the second Cluster Project it shall cease to be a Qualified Bidder for the second Cluster Project and its

Financial Bid for the second Cluster Project shall not be opened and evaluated

CONCESSION PERIOD

bull Concession Period of 32 years commencing from the from the date of satisfaction of CPs (Clause 311 DCA)

bull Either Party may seek an extension to the Term of Concession by an additional period not exceeding 30 (thirty)

years by serving a written notice to the other Party at least 450 days prior to the expiry of the Term of Concession

(Clause 311 DCA)

bull The extension of the Term of Concession shall be by mutual agreement between the Parties and on terms and

conditions mutually agreed between the Parties (Clause 311 DCA)

KEY GoO CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Key GoO Conditions Precedent (Clause 421 DCA)

bull Handing over the physical possession of the Site free from any Encumbrance (421 (i))

bull Approval of CAF submitted by Concessionaire for HIPP benefits (only if an application for the same is submitted

by Concessionaire and complies with all requirements) (421 (ii))

bull Approvals for land use (421 (iii))

bull Procuring and providing the necessary infrastructure for electricity connectivity up to the boundary limits of the

Site (421 (iv))

bull Construction of permanent approach roads (unless there is an existing road) (421 (v))

bull Procuring and providing the necessary infrastructure for sewage disposal and other utilities up to the boundary

limits of the Site (421 (vi))

bull Depositing funds equivalent to the first Tranche of Fixed Grant in the Escrow Account (421 (vii))

bull Appointment of Independent Engineer and Monitoring Agency (421 (viii) and (ix))

KEY CONCESSIONARE CONDITIONS PRECEDENT UNDER CONCESSION

AGREEMENT

Key Concessionaire Conditions Precedent(Clause 422 DCA)

bull Submission of Construction Documents to the Authority and the Independent Engineer for their approval

(422 (ix))

bull Procuring Applicable Permits for commencement of construction works (for Phase I and Phase II) (422

(ii))

bull Execution of a Design Consultancy Agreement with the Design Consultant (422 (x))

bull Execution of an EPC Contract with the EPC Contractor (422 (xi))person who has (a) developed and constructed at least 5 (five) hospitals each having a built up area of at least 100000 (one lakh) sq ft (square feet) in

the 10 (ten) years immediately preceding the Execution Date and (b) has an average turnover of at least [Rs 400000000 (Rupees Forty Crores for 100

beds)][Rs 600000000 (Rupees Sixty Crores) for 200 beds] in 3 (three) Financial Years immediately preceding the Execution Date with whom the

Concessionaire has entered into an EPC Contract

bull Achievement of financial close and execution of the Financing Agreements (422 (xiii))

KEY CONDITIONS PRECEDENT UNDER CONCESSION AGREEMENT

Joint CPs (Clause 423 DCA)

bull Execution of the Lease Deed

bull Execution and procuring the execution the Escrow Agreement by the Escrow Bank and opening and establishing

the Escrow Account

bull Execution of and procuring execution of the Substitution Agreement simultaneously with execution of the

Financing Agreements

bull Constitution of the Project Level Coordination Committee

CONSEQUENCES OF FAILURE TO SATISFY CONDITIONS PRECEDENT

bull Damages for delay in fulfilment of CPs by either party - 01 of construction performance security for each dayrsquos

delay until the fulfilment of such CP subject to a maximum amount equal to 20 of the construction performance

security (Clause 44 DCA)

bull Maximum time period allowed for completion of CPs with payment of damages 360 days from the execution date

or any extended period mutually agreed by the Parties post which agreement will be deemed to be mutually

terminated (Clause 45 DCA)

CHANGE IN OWNERSHIP

bull Concessionaire has to ensure the following shareholding (if selected bidder is Consortium) (Clause

431 + Clause 53 DCA)

All Members to hold the percentages as specified in the letter comprising the Bid until COD of PhasendashI

Evaluated Members to hold at least 5 equity until COD of Phase-II

Lead Technical Member to hold at least 10 equity throughout the concession period

Lead Financial Member to hold at least 26 equity until 10 years from the COD of Phase ndashII

Lead Technical Member and the Lead Financial Member shall cumulatively hold 51 equity until 10 (ten)

years from the COD of Phase ndash II

bull Concessionaire has to ensure the following shareholding (if selected bidder is a single bidder)

Selected bidder to hold 100 equity until COD of Phase ndash I

Selected bidder to hold 51 equity until 10 years from COD of Phase ndash II and

Selected bidder to hold 10 equity throughout the Concession Period

bull Change in ownership is permitted prior to lock in with the prior consent of the Authority and the transferee

shareholder establishing that it possesses the same qualifications as of the transferor shareholder (which was

counted towards the satisfaction of the Minimum Eligibility Criteria for the Project) (Clause 533 DCA)

KEY CONCESSIONAIRE OBLIGATIONS

bull Empanel the Hospital under NHPS BSKY (as applicable) BKKY and OSTF on or prior to the achievement of

COD of Phase I (Clause 518)

bull Empanel the Hospital under new Government Health Scheme notified by GOO subject to reimbursement of

additional capital costs for empanelment by GOO (Clause 519)

bull No solicitation of doctors nurses laboratory technicians or other paramedical staff employed in the State

Government hospitals with a view to engage or employ them during their employment with the State

Government (Clause 5110)

bull All contracts for goods and services to be awarded on fair transparent and efficient manner (Clause 522)

bull Core clinical services can only be subcontracted to Lead Technical Member or its associate (Clause

527)

PERFORMANCE SECURITY

Construction Performance Security The Concessionaire has to submit a construction performance security (in

form of bank guarantee) within 30 days from the execution date to be released after 6 months of COD of Phase-II

(Clause 911 + Clause 913)

Operation Performance Security (Clause 921)

bull The Concessionaire has to submit an operational performance security (in form of bank guarantee) at least 30

days prior to the Scheduled Completion Date of Phase I

bull The amount of Operation Performance Security has to be notionally revised annually on each anniversary of the

COD of Phase I in accordance with the Inflation Index Formula

bull Every 5 years the Concessionaire has to submit a fresh bank guarantee for the amount equal to notional value of

the performance security for that year

CONSTRUCTION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 8)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 410

2 Puri Puri 230

3 Bolangir Bolangir 410

4 Jharsuguda Jharsuguda 230

5 Angul Angul 410

6 Barbil Keonjhar 410

7 Bhawanipatna Kalahandi 230

8 Bhadrak Bhadrak 230

9 Rayagada Rayagada 230

10 Phulbani Kandhamal 230

11 Boudh Boudh 230

12 NuapadaKhariar Nuapada 230

13 Malkangiri Malkangiri 230

14 Nabarangpur Nabarangpur 230

15 Subarnapur Subarnapur 230

16 Paralakhemundi Gajapati 230

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 230

18 Kendrapara Kendrapara 230

19 Kamakhyanagar Dhenkanal 230

20 Nayagarh Nayagarh 230

21 Deogarh Deogarh 230

22 Bargarh Bargarh 230

23 Jagatsinghpur Jagatsinghpur 230

24 Kalinganagar Jajpur 230

25 Rourkela Sundargarh 230

OPERATION PERFORMANCE SECURITY AMOUNTS

(TECHNICAL SCHEDULE 9)

Sl

No

Location District Amount in

INR Crores

1 Jeypore Koraput 200

2 Puri Puri 140

3 Bolangir Bolangir 200

4 Jharsuguda Jharsuguda 140

5 Angul Angul 200

6 Barbil Keonjhar 200

7 Bhawanipatna Kalahandi 140

8 Bhadrak Bhadrak 140

9 Rayagada Rayagada 140

10 Phulbani Kandhamal 140

11 Boudh Boudh 140

12 NuapadaKhariar Nuapada 140

13 Malkangiri Malkangiri 140

14 Nabarangpur Nabarangpur 140

15 Subarnapur Subarnapur 140

16 Paralakhemundi Gajapati 140

Sl

No

Location District Amount in

INR Crores

17 Rairangpur Mayurbhanj 140

18 Kendrapara Kendrapara 140

19 Kamakhyanagar Dhenkanal 140

20 Nayagarh Nayagarh 140

21 Deogarh Deogarh 140

22 Bargarh Bargarh 140

23 Jagatsinghpur Jagatsinghpur 140

24 Kalinganagar Jajpur 140

25 Rourkela Sundargarh 140

ADDITIONAL CAPACITY (CLAUSE 1251 DCA)

bull Anytime during the concession period the Concessionaire may construct additional capacity exceeding the current

envisaged bed capacity with the prior approval of the Authority

bull In the event that the Authority grants approval for additional beds the provisions of the Agreement may be

required to be amended to provide for such approved additional capacity including but not limited to the

provisions relating to Key Performance Indicators and Termination Payments

SELECT PATIENTS

bull Select Patients will be as follows (Clause 431 DCA)

(a) inpatients covered under Govt health schemes and

(b) inpatients (other than those covered under Govt health schemes) for which GoO will pay (ldquoNon -

Government Scheme Select Patientsrdquo)

bull A minimum of 50 of the Bed Capacity (excluding ICU Beds) in the Hospital will be available for the treatment of

the Select Patients (subject to availability) (Clause 22101 DCA)

bull Prior approval of Clinical Panel is required for treatment of Non - Government Scheme Select Patients (Clause

223 DCA)

bull Clinical Panel to audit healthcare services provided to all Select Patients at least twice in a year (Clause 2234

DCA)

PAYMENT FOR PROVISION OF SERVICES TO SELECT PATIENTS

bull Authority to announce an annual budget for the treatment of Non - Government Scheme Select Patients (Clause

2733 (a) DCA)

bull If Authority fails to issue the Annual Expenditure Budget for Non - Government Scheme Select Patients for a

Financial Year the Concessionaire shall not be liable to provide Healthcare Services to the Non- Government

Scheme Select Patients for such Financial Year (Clause 2743 (c) DCA)

TARIFF STRUCTURE

bull Select Patients enrolled under any Government Health Scheme

Eg BKKY OSTF BSKY NHPS (as applicable) or any future social health insurance assurance program

Rates applicable under the relevant Government Health Scheme in Odisha will be payable (Clause 2713 (a)

DCA)

bull Non- Government Scheme Select Patients

As per NHPS rates BSKY rates (as applicable) applicable in hospitals in the district where the Hospital is located

with accreditation similar to the Accreditation Standard under which the Hospital is accredited (Clause 2713 (b)

DCA)

bull Inpatients (other than Select Patients)

Concessionaire shall be free to determine demand and collect the Fee for any such Inpatient admitted in the

Hospital (Clause 2713 (c) DCA)

bull Outpatients

The Concessionaire shall be free to determine demand and collect the Fee for the OPD Services in the Hospital

from any Outpatient including a Select Patient availing Outpatient Services (Clause 2714 DCA)

NOTE Inpatient services will be inclusive of treatment bed rates diagnosis medication and other inputs as

applicable under the relevant schemes

TARIFF REVISION

Compensation for change in BKKY and NHPSBSKY

tariffs OR their successive programs (for any

procedure)

Compensation

Within a period of 7 (seven) years of the Effective Date

(Clause 2723)

Concessionaire entitled to claim compensation for the

decrease in tariff rates from the Authority for a period

commencing from the later of the date of notification of

such revised tariff rates under NHPSBSKY (as

applicable) andor BKKY or the COD of Phase-I until the

expiry of 7 years from the Effective Date

After expiry of period of 7 (seven) years from the

Effective Date (Clause 2724 DCA)

Concessionaire entitled to claim compensation for a

period of 12 (twelve) months commencing from the tariff

revision date

TARIFF REVISION

bull Compensation due to introduction of new scheme during 7 years from Effective Date (Clause 2721(a)

DCA)

In respect of procedures performed under the New Scheme (introduced in substitution of NHPS BKKY or OSTF)

in the Hospital Concessionaire will be entitled to claim compensation for the decrease in applicable tariff rates

(being average of NHPS and CGHS rate) from the Authority for a period commencing from the later of the date

of notification of such New Scheme or the COD of Phase-I until the expiry of 7 (seven) years from the Effective

Date

bull Compensation due to introduction of new scheme after 7 years from Effective Date (Clause 2722(a))

In respect of procedures performed under the New Scheme in the Hospital Concessionaire will be entitled to

claim compensation for the decrease in applicable tariff rates (being average of NHPS and CGHS rate) from the

Authority for a period of 12 (twelve) months commencing from the New Scheme date

ESCROW MECHANISM

GoO will identify the Escrow Bank prior to the signing of the Concession Agreement

Following payments to be routed through Escrow Account (Clause 282 DCA)

bull Fixed Grant the Additional Grant (if any) and all other sums payable by Authority to the Concessionairebull all Fees payable by Authority for treatment to the the Non-Government Scheme Select Patientsbull Payment of premium by the Concessionaire to Authority if any

Advance Funding of Escrow Account

bull Fixed Grant (1st Tranche) as a condition precedent (Clause 421 DCA)

bull Fixed Grant (subsequent tranche(s)) each subsequent tranche of fixed grant will be deposited within 6 months ofConcessionairersquos request along with a certificate from its statutory auditor that the Concessionaire has expendedat least 50 of the previous tranche towards meeting the Total Project Cost (Clause 2612 DCA)

bull Additional Grant (1st Tranche) first tranche to be deposited at least 6 months in advance prior to scheduledcompletion date of Phase I (Clause 2622 DCA)

bull Additional Grant (subsequent tranches) each subsequent tranche to be deposited at least 3 months in advance ofthe scheduled completion of the relevant payment milestone(Clause 2622 DCA)

The Concessionaire will be permitted to create security over the amounts lying in the Escrow Account in favor of theSenior Lenders (Clause 352 DCA)

TERMINATION PAYMENT

S No Termination Payment

1 On account of

Concessionaire Default

post Effective Date

(Clause 319 DCA)

a The Authority shall pay to the Concessionaire an amount equal to 100 of

Debt Due less Insurance Cover as on the date of such Termination (Clause

3191 DCA)

b If Insurance Cover is not admitted and paid then 80 of such unpaid claims

shall be included in the computation of Debt Due (Clause 3192(a) DCA)

2 On account of

Authority Default

(Clause 3232 DCA)

The Authority shall pay to the Concessionaire an amount equal to Debt Due

(less Insurance cover) and 150 of the Adjusted Equity

bull Termination Payment on expiry of Concession No termination payments (Clause 3234 DCA)

bull However if any Project Assets have been installed after the 25th anniversary of COD of Phase-II (with prior

written consent of the Authority) a Termination Payment equal to 80 of the Adjusted Depreciated Value of such

Project Assets (Clause 3234 DCA)

bull Additional Termination Payment payable in respect of Specified Assets (ie assets which are installed prior to 25th

anniversary of COD of Phase II but not included in the Financial Package) (Clause 3242 DCA)

FORCE MAJEURE

Force Majeure Events

Non Political Events (examples as act of God strikes or boycotts interrupting supplies judgments or orders etc)

(Clause 312 DCA)

Indirect Political Event (examples an act of war industry-wide or State-wide strikes any political agitation civil

commotion etc) (Clause 313 DCA)

Political Events (examples compulsory acquisition in national interest change in law etc) (Clause 314 DCA)

Termination payment for Force Majeure

Non-Political Event 100 of the Debt Due less Insurance Cover plus 50 of Adjusted Equity (Clause 3191

DCA)

Indirect Political Event Debt Due less Insurance Cover (and 80 of unpaid insurance claims) plus 120 of

Adjusted Equity (Clause 3192 DCA)

Political Event Same as Authority Default (Clause 3193 DCA)

CALCULATION OF ADJUSTED EQUITY AND DEBT DUE

Adjusted Equity (Clause 431 DCA)

bull Adjusted Equity will be calculated with reference to equity actually funded and expended on the Project withadjustments made in accordance with WPI index

bull After 4 years from COD of Phase II Adjusted Equity will be computed by downward revision by 026 everymonth

Debt Due (Clause 431 DCA)

bull Means the aggregate of the following

a) Principal amount of debt provided by senior lenders under financing agreements for financing the total projectcost (excluding any part of principal which was due for repayment 2 years prior to the transfer date)

b) All accrued interests financing fees and charges payable under the financing agreements excluding thefollowing

- interests financing fees and charges which were due for payment1 year prior to transfer date- any penal interests and charges- any pre-payment charges

bull Any new debt to form part of debt due will require a prior approval of the Authority

DEFECTS LIABILITY FOR STRUCTURAL WORKS

bull The Concessionaire shall be responsible for the repair and rectification of the defect(s) in the major components

of the civil structures of the Hospital detected any time before the expiry of 3 (three) years from the date of

Termination (Clause 3421 DCA)

bull Concessionaire shall furnish a bank guarantee for an amount equal to 10 (ten) crores in favour of the Authority

until expiry of 3 (three) years from the date of Termination (Clause 3422 DCA)

INDEPENDENT ENGINEER (ARTICLE 23 DCA)

bull The Authority will appoint a consulting engineering firm on limited tender basis

bull If Concessionaire is required to construct and develop any further capacity then the Independent Engineer will be

re-appointed for the construction period of the further additional capacity

bull The Independent Engineer will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor construction requirements

bull Independent Engineer shall submit regular periodic reports (at least once every month) to the Authority in respect

of its duties and functions

bull Cost of the Independent Engineer will be born shared between the Authority and the Concessionaire

MONITORING AGENCY (ARTICLE 24 DCA)

bull The Authority will appoint a body of relevant experts on basis of an open transparent and competitive bidding

process

bull The Monitoring Agency will discharge its duties and functions substantially in accordance with the terms of

reference

bull Primary function is to monitor KPIs

bull The Monitoring Agency shall submit regular periodic reports (at least once every quarter) to the Authority in

respect of its duties and functions

bull Cost of the Monitoring Agency will be born by the Authority

BID PROCESS SCHEDULE

Event Description Date

Commencement of the Project Registration and purchase of the draft Concession Agreement September 10 2018

Pre-Bid Conference October 10 2018

Last date for independent Site visit To be intimated later

Last date for receiving queries from Bidders October 25 2018

Last date for Project Registration and purchase of the draft Concession Agreement December 16 2018

Bid Start Date November 20 2018

Bid Due Date and time December 18 2018

Opening of Technical Bids December 19 2018

Opening of Financial Bids To be intimated later

PROJECT INFORMATION

bull Project website and dataroom1 Project Website

bull httphealthodishagovinAffordable_Health_ProjectaspGL=1

PROJECT DOCUMENTS

bull Project Tender Documentsbull httphealthodishagovinAHP_Tenderasp

District Profiles and Market DatahttphealthodishagovinAHP_District_ProfileaspGL=7

SAMPLE DISTRICT PROFILE KORAPUT

IPR Rates 2015

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per

Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

1 Jeypore 600 200

2 Puri 3000 1500600

3 Bolangir 600 200

4 Jharsuguda 1500 600

5 Angul 3000 1500600

6 Barbil 1000 400

7 Bhawanipatna 300 100

8 Bhadrak 600 200

9 Rayagada 600 200

10Phulbani

(Kandhamal)300

100

11 Boudh 300 100

12Nuapada

Khariar Road300 100

Serial

NoLocation

Applicable IPR Rates (In INR lakh(s) per Acre

Within Dev Auth

Municipal

Outside Municipal

NAC limits

14 Nabrangpur 300 100

15 Subarnapur 300 100

16Paralakhemundi

(Gajapati)300 100

17 Rairangpur 600 200

18 Kendrapara 300 100

19 Kamakhyanagar 300 100

20 Nayagarh 300 100

21 Deogarh 300 100

22 Bargarh 600 200

23Jagatsinghpur

Paradeep town3000 400

24 Kalinganagar 400 400

25 Rourkela 6000 600200

Annual rent 1 of land value

IPR Rates

Annual rent 1 of land value

Links to Project Documents

bull The project tender documents are available at the following website

httphealthodishagovinAHP_Tenderasp

bull Detailed background market and health sector information on each of the 30 districts in Odisha is

available on the following link httphealthodishagovinAHP_District_ProfileaspGL=7

bull All project related information (including information in 1 and 2 above) is available in the following

link httphealthodishagovinAffordable_Health_ProjectaspGL=1

Pre-Bid Meeting

Name of Meeting Date and Venue

Prebid Meeting for Affordable Healthcare Project

Date 10 October 2018

Time 1100-1700 hrs IST

Venue IDCO conference hall 5th Floor Annex building IDCO Towers Janpath Bhubaneswar India

RSVP ToMr Sarat Chandra Mishra OASAdditional Secretary Health amp Family Welfare DepartmentEmail orhealthnicin saratmishragmailcomMob 9437083882

Copy toDr Pranav MohanInternational Finance CorporationEmail pmohan4ifcorgMob +919910013679

bull Registration forms are available on the project website

httphealthodishagovinAHP_Tenderasp

FOR FURTHER INFORMATION PLEASE CONTACT

Project Proponent

Department of Health amp Family Welfare Govt of Odisha

Secretariat Building

Bhubaneswar 751001 Odisha

Telephone +91 674 2536632

Fax +91 674 2390674 2395235

Website httphealthodishagovin

Email orhealthnicin

Contact Person Shri Sarat Chandra Mishra Additional Secretary

Advisors to Dept of HampFW GoO

International Finance Corporation

Contact Person Dr Pranav Mohan (+91-9910013679)

Email pmohan4ifcorg

Page 28: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 29: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 30: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 31: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 32: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 33: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 34: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 35: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 36: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 37: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 38: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 39: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 40: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 41: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 42: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 43: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 44: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 45: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 46: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 47: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 48: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 49: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 50: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 51: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 52: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 53: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 54: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 55: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 56: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 57: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 58: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 59: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 60: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 61: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 62: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 63: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 64: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 65: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 66: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 67: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 68: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 69: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 70: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 71: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 72: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 73: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 74: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 75: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 76: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 77: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 78: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 79: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 80: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 81: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 82: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 83: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 84: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 85: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 86: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 87: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 88: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 89: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 90: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 91: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 92: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 93: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …
Page 94: (DEVELOPING HOSPITALS UNDER PUBLIC PRIVATE PARTNERSHIP …