State Health Resource CentreChhattisgarh

State Health Training Centre Building,Kalibadi, Raipur - 492001, Chhattisgarh, IndiaTel: 0771-2236175, Tele-Fax: 0771-2236104.e-mail: shrc.cg@gmail.com, Web : www.shsrc.org

SHRC/CAMP/2012-13|?.c|qe| 22/11/2012

To,Shri Amit Garg,Secretary,Community Action Through Motivation Programme,8/668, Anand Nagar, Bodabag,RB/VA(M.P.):486001

Sub : Agreement for operating Mobile Medical Units*

Dear Sir,

Please find attached a copy of the duly signed agreement in relation to operating Mobile

Medical Units under Mukhya Mantri Sahari Swasthya Karyakram (MSSK) in 11 cities of

Chhattisgarh.

Yours sincerely,

(MProgramm^ Coordinator (HR/ADMIN)State Health Resource Centre.

Encl : Agreement.

Additional Technical Capacity to Department of Health & Family Welfare, Government of Chhattisgarh

HUNDRED1RUREES

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CHHATTISGARHSPECIFIC TASK CONTRACT

BETWEEN

§ DIRECTORATE OF HEALTH SERVICES, GOVERNMENT OFg CHHATTISGARH

AND

COMMUNTIY ACTION THROUGH MOTIVTION PROGRAMME(CAMP)

FOR

OPERATIONALISING MOBILE MEDICAL UNITS (MMU)

UNDERMANTRI SHAHARI SWASTHYA KARYAKRAM (MMSSK)

IX

11 CITIES OF THE STATE OF CHHATTISGARH

D 767358

ahis agreement is made and entered into on thisovember, 2012 by and between

day of

'

irectorate of Health Services, having its office at, Old Nurses Hostel,ear DKS Bhawan, Mantralay Parisar, Raipur-492001, Chhattisgarh

P a eiecretat

Community Action ThrouglVMotivationProgramme "CAMP* Rew3(H.P.)

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herein after called "The Directorate" which expression where the contextpermits shall include its successors and assigns as the first party,

And

Community Action Through Motivation Programme "CAMP" 8/668Anand Nager, Boda Bag, Rewa (M.P.) 486001 hereinafter called "TheAgency" which expression where the context permits shall include itsrepresentatives, successors and assigns as the second party.

1. Definitions:

1.1 "CS " will mean Civil Surgeon of a District included in the projectunder this agreement.

1.3 "Commencement month" shall mean the month in which the firstMobile Medical Unit is launched.

1.4 "Effective Date" shall mean the date of inception of the Project whichshall be the date of signing of this Agreement by the Directorate.

1.5 "Mobile Medical Unit" shall mean mobile ambulance / van configuredto deliver the services defined in the scope of work section of thisAgreement.

1.6 "Project" shall mean the provision of health care services deliveredthrough mobile medical units in the 11 cities of Chhattisgarh, theservices being of curative, preventive and rehabilitative nature, to beprovided by the service provider.

1.7 "Specific Task Contract" shall mean this Agreement.1.8 "Schedule" shall mean a schedule or an attachment to this Agreement.

2. Scope of work

The AgeiYcy will be required to organize a fleet of 12 mobile medical units to bedeployed in the 11 cities for the delivery of primary health care services as perthe details given below.

SINo.12345 .67891011

Name of the city (district)

Raipur (Raipur)Bilaspur (Bilaspur)Durg (Durg)Bhilai (Durg)Rajnandgaon (Rajnandgaon)Raigarh (Raigarh)Korba (Korba)Dhamtari (Dhamtari)Jagdalpur (Bastar)Ambikapur (Surguja)Chirmiri (Koriya)

Total

Number of MMUs to belaunched2111111111112

Community Action Through MotivationProgramme'CAMP'Rewi

2.1 Minimum services to be delivered

2.1.1 Each Mobile Medical Unit (MMU) will hold health camps for at least 20days in a month according to a pre-agreed roster that will be jointly drawn by theAgency selected and the concerned district nodal officer nominated by the CS ofthe district in this regard.

2.1.2 During the camp, the following minimum services will be delivered:Curative services• Treatment of minor ailments, including skin diseases, minor surgical

procedures / dressing and suturing• First aid and referral for animal / snake bite cases,• Identification and referral of complicated cases requiring facility

based management• Early detection of TB, Malaria, Leprosy, etc. and other locally

endemic communicable diseases and non communicable diseasessuch as hypertension, diabetes, cataract cases, mental illness,tobacco related illnesses and injuries etc.

Reproductive & Child Health Services• Ante-natal services e.g. injection tetanus toxoid, iron and folic acid

tablets, basic laboratory tests such as hemoglobin, urine for sugarand albumin and referral for other tests as may be required;

• Identification and referral of complicated pregnancies (includingconducting deliveries in exceptional cases);

• Post natal check up of women and children;• Identification of unimmunized children and their vaccination for left

/ missed doses and /or administration of Vitamin-A dose;• Screening of children for identification of malnutrition and their

counseling and referral (where needed); and• Treatment of common childhood illness such as diarrhea,' ARI/Pneumonia, complication of Measles etc.

Family Planning Services• Counseling for spacing and permanent method• Distribution of condoms, oral contraceptives and emergency

contraceptives• IUD insertionDiagnostic services• All tests which can be done with the semi-auto analyzer such as

hemoglobin, total and differential blood count (TLC /DLC), liverfunction test, blood sugar, VDRL etc.

• Urine examination for sugar albumin• Smear for malaria and vaginal smear for trichomonas• Sickle-cell test (at least solubility test)• Promotion of menstrual hygiene among adolescent girls• Promotion of use of bed nets• Distribution of IEC Material on health including personal hygiene,

proper nutrition, hazards of tobacco, diseases, PNDT Act, RT/STI,HIV/AIDS etc.

Note : The IEC material will be provided by the State / district

3Community Action Th^h Motivation

Programme "CAMP' Rev:;,

2.2 Minimum Manpower to be deployed

2.2.0 To deliver the above services, each MMU shall have at least the followingqualified / trained manpower:

• Doctor -1• Auxiliary Nurse cum Midwife (ANM) -1• Laboratory Technician - 1• Pharmacist cum data entry operator -1• Driver-1

2.3 Minimum Equipment and supportive supplies

2.3.0 Every MMU is required to be provided with the following minimum, onboard, equipment during every camp:

• Weighing machine - adult and child• Blood pressure measuring apparatus• Surgical instruments for minor surgeries — at least 3 sets• Disinfectant and provision for on-site boiling• Delivery kits - at least 3 sets• Microscope• Semi-auto analyzer• Supportive supplies such as re-agents for diagnostic tests, lancet and

slides for microscope, pregnancy detection kit, rapid diagnostic kitfor malaria detection, test tubes and other necessary lab supplies.

2.4 Vehicle type

2.4.1 The mobile medical unit will have to be fabricated on 4 wheel driven Tata407 LPT / 709 or equivalent chassis. The fabrication design for the cabin shouldprovide space for the following:

• OPD station for the doctor,• ANM station (ANC /PNC counter),• Examination bed with adequate provision for maintaining privacy and

having sufficient space around it so that it can also be used for conductingdeliveries (in exceptional cases only),

• A semi-auto analyzer and a micro-scope, both mounted / fixed in a mannerthat they are well protected from possible shocks / bumps during travel,

• A registration — cum - medicine dispensing window / counter fitted withlap-top and printer,

• Space for storing medicines, cold box (vaccines) and folding tables / chairs,• Collapsible/ foldable awnings mounted on top of the cabin opening on both

sides of the vehicle to provide protection against direct sun-light (insummers) / rain to the customers / users of the services.

2.4.2 All equipment on board have to be functional during the camp irrespectiveof whether or not electricity / access to electricity is available.

V - ~ : -Community ActionThiougfiMotivation

Proqramme 'CAMP1 Rews (M.P.)

2.5 Other terms and conditions

2.5.1 The duration of camp(s) in a day will be at least for 7 hours (excludingtravel time). The number of camp sites in a day may be one or two depending onthe estimated number of patients expected to be attended to.

2.5.2 The agency will be required to design and implement measures toprovide advance information to the public / potential clients to ensure maximumutilization.

2.5.3 The MMUs will be fabricated on new vehicles; used vehicles (with orwithout a fabricated cabin) will not be acceptable.

2.5.4 Every MMU will be fitted with a GPS based location tracking system toenable real time tracking.

2.5.5 The Agency will be required to set up a State office at Raipur to enablecentralized monitoring of the operations.

2.5.6 The Agency will establish a system for daily on-line reporting of thework done.

2.5.7 The vehicles will be assigned to the cities mentioned and will not beshifted from one city to another without the written permission from the StateGovernment.

2.5.8 The vehicle(s) assigned to a city shall be headquartered in the DistrictHospital or at a place to be identified by the concerned Civil Surgeon.

2.5.9 The Agency will have to develop a system for daily on-line reporting ofthe work done; the State Programme Management Unit (MMSSK) will providethe framework for establishing this system.

2.5.10 Providing insurance cover to the vehicles and MMU staff etc. will be theresponsibility of the Agency.

3. Commitments of the Directorate

3.1 The State Government is establishing a State Programme ManagementUnits (MMSSK) at Raipur and City Programme Management Units at the Citylevel. While the state PMU will coordinate with the State office of the Agency,day-do-day coordination of operations will be looked after by the city level PMUs.

3.2 The medicines, vaccines (in a cold box), family planning supplies andlaboratory re-agents required for the camps will be arranged by the concernedCivil Surgeon. The supplies will be made against a requisition slip to the doctorin-charge of the vehicle.

3.3 The city PMU or the office of Civil Surgeon may also provide IEC materialto the doctor in-charge of the MMU. The IEC material will be used / distributedat the camp sites. A Q

a y e

3.4 In addition to the above, the State PMU will facilitate the work of theAgency through :

• Arranging orientation training of the MMU staff in national healthprogrammes, state health system and its major initiatives,

Ensuring participation of the ANMs and other field staff recruited for theimplementation of MMSSK.

4. Effective Date, Commencement Month, Duration of the project andNumber of MMUs

4.1 The effective date of the inception of the project will be the date of signingof this Agreement by the Directorate.

4.2 The first MMU must be rolled out within 15 days of execution of theAgreement and all 12 MMUs must be rolled out within 45 days of execution ofthe Agreement. The month in which the first MMU is operationalized shall bedeemed as the "Commencement Month".

4.3 The duration of the project will be 5 years counted from thecommencement month.

4.4 The Directorate may offer an extension of the duration of the projectbeyond 5 years as specified above provided the agency is willing to provide theservices on the same terms and conditions as mentioned in the scope of work andpayments terms specified in this Agreement.

4.5 The Directorate may offer to the Agency to take up additional cities forlaunching MMU services and / or additional number of MMUs within the 11cities, provided that such additional cities and /or additional MMUs shall besubject to the same terms and conditions as applicable for the original cities /MMUs covered under this Agreement.

5. Payment terms and Performance Guarantee

5.1 Mobilization advance

5.1.1 The Agency has committed to operationalize 12 MMUs within 45 days ofexecution of the Agreement. Accordingly, the Directorate shall pay amobilization advance of Rs 46.62 lakh {-Quoted rate of Rs 1,29,500 x!2x3} tothe agency within 30 days of execution of the Agreement. This advance will begiven against a bank guarantee of equal amount and upon submission ofevidence that orders for vehicle and equipment have been placed by the Agency.The advance will be deducted in 3 equal installments from the amount payableagainst the quarterly bills raise after service delivery has started.

5.1.3 The Agency shall have the freedom to furnish a combined bank guaranteeassuming as if all 30 vehicles may get operationalized within 60 day

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Community Action ThM* Motivationamme'CA»IP'Rew3(M.P.)

5.1.4 The bank guarantee will be released within 30 days of liquidation of themobilization advance.

5.2 Payment for services rendered

5.2.1 The amount payable for services rendered shall be calculated at the rate ofRupees 1,29,5007- (One lakh twenty nine thousand five hundred rupees) perMMU per month. In the event where a mobile Medical unit has not beenoperated for 20 days in a calendar month, the amount payable shall becalculated at the rate of Rs 6,475 (Six thousand four hundred seventy five ) perMMU per day. This pro-rate calculation of amount payable is, however,applicable only during the first month of the launch of a vehicle. Amountspayable in other cases will be dealt as bonus and penalty clauses given in para5.4 below.

5.2.2 The Agency shall submit a consolidated bill /invoice on a quarterly basis,the first quarter being counted from the commencement month.

5.2.3 The Directorate shall arrange to pay 85% of the payable amount, afterdeduction of one third of the mobilization advance, within 30 days ofpresentation of the bill/ invoice by the Agency.

5.2.4 The balance 15% of the payable amount will be made within 90 days of thepresentation of the bill /invoice, after such verification of work as may bedirected by the Directorate in this regard.

5.2.5 All payments will be made through e-payment mode and shall be madeafter deducting taxes as per Rules, The Directorate shall provide a TDScertificate to the Agency by 30th June of the next financial year.

5.2.6 Delay in payment by the Directorate, beyond the dates specified above, willentitle the Agency to receive interest calculated at the rate of 5% per annum forthe period of delay.

5.3 Annual escalation and rates payable in years 2,3,4 and 5

5.3.0 The Directorate shall allow an annual escalation of 10% of the contractamount to the Agency, The enhanced rates will apply after the end of 12th, 24th,36th and 48th month, calculated from the "commencement month" and will be asfollows:

Year 2: Rs.1,42,450/- (One lakh forty two thousand four hundred fiftyrupees only) per MMU per month .

Year 3: Rs. 1,55,400 (One lakh fifty five thousands four hundred rupeesonly) per MMU per Month.

Year 4: Rs 1,68,350 (One lakh sixty eight thousand three hundred fiftyonly) per MMU per month

Year 5: Rs 1,81,300 ( One lakh eighty one thousand three hundred rupeesonly ) per MMU per month

_ ;cn 'i-aoy 7 JCommunity Action Thrown Motivation

CAMP1 Rewa (M.P.)

5.4 Bonus and Penalties

5.4.1 Every MMU is expected to operate for at least 20 days in a calendar month,except the month when it is launched, From second month onward. A bonus willbe paid for additional days beyond the stipulated 20 days.Similarly any shortfallin the days operated will be penalized. The bonus and penalty rates will be asgiven in the rate will be as given in the table below.

Normal per day rateAmount payable forevery additional daybeyond 20, subject to amaximum of 5 days in amonthAmount deduct able forevery shortfall of 1 day,up to 5 days in acalendar monthAmount deduct able forevery shortfall of 6 daysor more in a month

Year 164757000

8000

Year 271237500

9000

Year 377708000

10000

Year 484188500

11000

Year 590659000

12000

50% of applicable monthly rate

5.4.2 The Agency will maintain vehicle wise data on the number of actual tripsand prepare a monthly invoice as per the format given at Schedule -4. Thepayment shall, however, be made on a quarterly basis after deducting themobilization advance as applicable.

5.5 Performance Guarantee

5.4.1 In addition to the bank guarantee against the mobilization advance, theAgency will furnish a "Performance Bank Guarantee" for 'an amount ofRs.46,62,0007- (Forty Six lakh sixty two thousand rupees only).

i

5.4.2 The performance bank guarantee will be released one quarter before theend of the contract period.

6. Reporting & Monitoring Mechanism

6.1 The CS of the concerned district will monitor the mobile units operationalin hisTher city and the Agency shall cause its programme managers to ensurethat the route planning for the MMUs is done in consultation with the concernedCS. The Directorate shall cause the CS to ensure that necessary arrangementare ma'de to publicize the date, time and location for the MMU services.

6.2 The medicines and other supplies required for the camp will be providedby the Directorate through the concerned CS. The Agency will seek the issue ofthese supplies in writing, to cover the requirements anticipated for a 3 monthperiod. The indent may be submitted at least 15 days prior to the beginning ofthe period for which the supplies are required and may be made in the formatgiven at Schedule- 5.

8 i ' aecretumi* Action I hrowjri Motivation

.[Time 'CAMP" Rewa (M.P.)

6.3 For every camp organized, the Agency will obtain a certificate from theANM / Ward Parshad I Mitanin Trainer of the concerned area. The Certificatemay be obtained in the format given at Schedule -3.

6.4 During the camp, it may become necessary to refer certain cases whichcan not be treated at the camp site, Such cases will be referred through a printedreferral card. The sample of the referral card is given at Schedule -2.

6.5 The Agency will submit the following documents/ reports to the office ofCS by the 7th of the following month (or the next working day in case 7th is apublic holiday):

<• Monthly performance report for each vehicle deployed in the district asper the format given at Schedule -1.

<• Copies of certificates obtained from the concerned ANM/ WardParshad/ Mitanin Trainer of concerned area.

7. Insurance

7.0 The Agency shall obtain suitable insurance for the Mobile Medical Units.This will cover the vehicle, medical equipment and staff deployed including thedriver. The insurance shall cover accidents, riots, arson, loot, fire and accidentfor loss of wages and other beneficiary compensation as per the policy of theinsurance company for the duration of the contract. The Agency shall providephoto copies of the insurance papers to the Directorate for its record / assurance.

8. Force Majeure:

8.0 No penalty will be imposed in case the Agency is unable to operate avehicle due to fire, strike, natural calamity, (flood, rain, hailstorm), Bandh, riots,communal violence etc. Payment in such cases shall be made on the basis ofactual number of camps, without imposing any penalty.

9 Written Articles/ correspondence and Divulging of Information

9.0 Both the parties will ensure that any article/ correspondence/ technicalliterature / service program / reports etc written regarding the activity of theproject during the course of the project shall be the sole property of theDirectorate and both parties will not share the information with any otherperson or organizations. However, for the documents presented by the Agency tothe Directorate during the currency of the project such as progress reports, theDirectorate shall have the right to reproduce, publish, or otherwise use all thematerial produced by the Agency under this project.

10 Property:

10.0 The Mobile clinics and all its equipment will be the sole property of theAgency. The clinic and its deliverables will be operated on behalf of theDirectorate and the Agency shall have the right to withdraw its MMUs at theend of the term of project.

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Communiiv Action ThrogjJMotivaticp.

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11 Conflict Resolution

11.0 Disputes, if any, shall be settled amicably between the parties. In casethe parties fail to settle the dispute amicably, the same shall be referred to thePrincipal Secretary / Secretary (Health), Govt. of Chhattisgarh who will act as anArbitrator and will settle the dispute under the provisions of the Arbitration &Concelliation Act, 1996. Decision of the Arbitrator shall be final and binding onboth the parties. Jurisdiction will be Chhattisgarh for any further resolution ofdispute.

12 Termination for Default/Exit from the Project by either party

12.1 The CSs of the concerned districts shall scrutinize theperformance of the Agency every month and forward a report to theDirectorate, who shall consider whether the contract shall continueor be terminated.

12.2 The Directorate may terminate the contract at any point oftime where there is a breach of agreement on any ground. A breach ofagreement shall be deemed to have occurred when the Agency fails toimprove its performance despite three consecutive notices of warningfrom the Directorate based on physical verification of deficiency inservice by a five member state level inspection committee.

12.3 In case of the failure of the Agency to operationalize the projectwithin the stipulated timeframe, the offer may be withdrawn at thediscretion of the Directorate and the security money through bankguarantee shall be forfeited.

12.4 If for any sufficient reason, the Agency decides to terminate thecontract prior to satisfactory completion of the project, it may do soby giving a notice of not less than 60 days to the Directorate.

12.5 Both the- parties agree to the above-mentioned terms andconditions of the contract and two copies of this Agreement have been

prepared for each of the party.

For Directorate of Health Services,Chhattisgarh,

For CAMP, Rewa (MP}

Authorized S i g n a t o r S J e a lDateAddressWitness:(Name)AddressDate

2-

(

Au

Date

AddressWitness:(Name). , ,AddressDate

ecretaCommunity Aclion Tfiroug h Jdolivalion

Seal

10 | P

Schedule -1

Monthly Performance Report : Month Year-

District: Vehicle Number

CampNo.

12

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

Camp Location

/

Date Number ofANC/PNCCases

Number ofpatientstreated

Number ofpatientsreferred

•

Number ofdiagnostictests done

Name and Signature of the MMU in -charge

Date :

- '

Schedule -2

MMU Vehicle No.

/

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Community Action Through MotivationProgramme 'CAKFRewafM.P.)

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Schedule -3

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Community Action Thrown MotivationProgramme "CAMP" Rewa(M.P.)

Schedule -4

Invoice for the Month

SI. No.

12

3

4

5

6

7

8

9

10

11

12

Vehicle Number Number ofcampsorganized

Amount payable In RupeesAgreedMonthlyRate

BonusAmount

Penalty

Total amount payable account of camps organized

Net payable

Signature

Name of authorized signature of Agency-

Programme

Schedule -5

Indent for supplies

S.No. Item Name/description

'

,

Name & signature of Agency Repre

Name, Signature, and seal of distric

QuantityDemandde

„

Quantity issuedreceived

Remark

—

-/V^fey/Sffcreiofy/Community Action Thrajpolivato

Programme 'CAMP' RfiwafM.P.,