(developing hospitals under public private partnership …
TRANSCRIPT
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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