1. Answer to Questions FHR RFP 72012124R0001 Amendment 1.pdf

Issuance Date: April 24, 2024

Subject: Amendment 01 to Request for Proposal (RFP) No. 72012124R00008

Reference: Furthering Health Reform and Recovery Activity, USAID/Ukraine

Dear Offerors, The purpose of Amendment 01 is to answer the questions received in response to the subject solicitation and, as a result, revise the RFP. All changes made to the RFP are highlighted in yellow for ease of reference. I strongly advise offerors to carefully review the entire document for any potential adjustments. All other terms of the RFP remain unchanged.

Thank you again for your interest in the USAID/Ukraine Furthering Health Reform activity. We appreciate the thoughtful questions submitted. Your engagement is instrumental in ensuring a comprehensive understanding of the requirements by all potential offerors.

Sincerely, Jessica R. Faber Contracting Officer USAID/Ukraine

RFP No. 72012124R00008, FHR Activity Amendment 1, Answer to Questions

1. The following attachment in Section J.6 is not available at the provided link: Economic determinants of gender equality priorities in the health area in Ukraine (November, 2021) Could USAID provide access to this document?

Answer: The RFP is revised to update the following link in J.6.:

https://drive.google.com/file/d/1_yUe1RPugK1c1bYo4VY8SXUW8awQ7NYO/view?usp=sharing

2. Could USAID please make accessible to offerors the draft GOU Health Sector Recovery Plan?

Answer: The draft GOU Health Sector Recovery Plan does not exist any more as a separate document and has been incorporated into the Draft National Health Strategy 2030 with Action Plan for 2024-2030.

This document exists only in Ukrainian language and is placed by the Ministry of Health for public discussion at their site:

https://moz.gov.ua/article/public-discussions/povidomlennja-pro-opriljudnennja-proektu-rozporjadzhennja-kabinetu-ministriv-ukraini-pro-shvalennja-strategii-rozvitku-sistemi-ohoroni-zdorov%e2%80%99ja-do-2030-roku-ta-zatverdzhennja-operacijnogo-planu-ii-realizacii-u-2024-2026-rokah

Please use the following link to access the unofficial English version of Draft National Health Strategy 2030 with 2024-2026 Operation Plan:

https://docs.google.com/document/d/1cmC9gAg2AqP6_SVCKNn2_mRu5ZKVadrb/edit?usp=drive_link& ouid=118259989925892417035&rtpof=true&sd=true

3. Could USAID please share the USAID Health Reform Support Annual Report for the period October 2022-September 2023?

Answer: Please see the link to the HRS FY 2023 Annual Report.

4. L.7.2, page 104: “Résumés, references and statements are not included in the 35-page limit and should be submitted as an Annex.” This annex is not included on the list in L.7, page 102. Could USAID please add this annex to the list and confirm in the list that the annex is not included in the 35-page limit?

Answer: Yes, as per the last paragraph of L.7.2, we confirm that Résumés, references, and statements are not subject to the 40-page limit and should be submitted as an Annex. The page limit for the technical proposal is adjusted to 40 pages from the previous 35 pages. Section L.7 is updated to clarify this.

https://drive.google.com/file/d/1_yUe1RPugK1c1bYo4VY8SXUW8awQ7NYO/view?usp=sharing https://drive.google.com/file/d/1_yUe1RPugK1c1bYo4VY8SXUW8awQ7NYO/view?usp=sharing https://moz.gov.ua/article/public-discussions/povidomlennja-pro-opriljudnennja-proektu-rozporjadzhennja-kabinetu-ministriv-ukraini-pro-shvalennja-strategii-rozvitku-sistemi-ohoroni-zdorov%e2%80%99ja-do-2030-roku-ta-zatverdzhennja-operacijnogo-planu-ii-realizacii-u-2024-2026-rokah https://moz.gov.ua/article/public-discussions/povidomlennja-pro-opriljudnennja-proektu-rozporjadzhennja-kabinetu-ministriv-ukraini-pro-shvalennja-strategii-rozvitku-sistemi-ohoroni-zdorov%e2%80%99ja-do-2030-roku-ta-zatverdzhennja-operacijnogo-planu-ii-realizacii-u-2024-2026-rokah https://moz.gov.ua/article/public-discussions/povidomlennja-pro-opriljudnennja-proektu-rozporjadzhennja-kabinetu-ministriv-ukraini-pro-shvalennja-strategii-rozvitku-sistemi-ohoroni-zdorov%e2%80%99ja-do-2030-roku-ta-zatverdzhennja-operacijnogo-planu-ii-realizacii-u-2024-2026-rokah https://moz.gov.ua/article/public-discussions/povidomlennja-pro-opriljudnennja-proektu-rozporjadzhennja-kabinetu-ministriv-ukraini-pro-shvalennja-strategii-rozvitku-sistemi-ohoroni-zdorov%e2%80%99ja-do-2030-roku-ta-zatverdzhennja-operacijnogo-planu-ii-realizacii-u-2024-2026-rokah https://docs.google.com/document/d/1cmC9gAg2AqP6_SVCKNn2_mRu5ZKVadrb/edit?usp=drive_link&ouid=118259989925892417035&rtpof=true&sd=true https://docs.google.com/document/d/1cmC9gAg2AqP6_SVCKNn2_mRu5ZKVadrb/edit?usp=drive_link&ouid=118259989925892417035&rtpof=true&sd=true https://docs.google.com/document/d/1cmC9gAg2AqP6_SVCKNn2_mRu5ZKVadrb/edit?usp=drive_link&ouid=118259989925892417035&rtpof=true&sd=true https://drive.google.com/file/d/1ke2p2kOiLsCWvC5BJWj-p33aeO3lDcpy/view?usp=sharing https://drive.google.com/file/d/1ke2p2kOiLsCWvC5BJWj-p33aeO3lDcpy/view?usp=drive_link

5. May Offerors provide an organizational chart in an additional annex, rather than included in the 35-page limit?

Answer: The page limit for the technical proposal is adjusted to 40 pages from the previous 35 pages.

The organizational chart is included in the body of the technical proposal and counts towards the 40-page limit.

6. May Offerors include a 2-page Executive Summary, excluded from the 35-page limit?

Answer: The page limit for the technical proposal is adjusted to 40 pages from the previous 35 pages.

The cover page/executive summary is included in the body of the technical proposal and counts towards the 40-page limit.

7. Can USAID please clarify if the number of PPPs noted in indicator 2.4 could be the same PPPs noted in indicator 5.3, and thus the minimum total PPPs required for FHR is three (3)?

Answer: The number of PPPs noted in indicator 2.4 could be the same PPPs noted in indicator 5.3, and thus the minimum total PPPs required for FHR is three. However, cumulatively they should encompass both the healthcare workforce capacity modernization and continuous healthcare quality improvement AND restoration or expansion of healthcare services (preferably, in rehabilitation, mental health or emergency care).

8. Under Objective 5, page 128 USAID describes its potential construction-related activities as “minor renovation of critical healthcare facilities, as well as procurement and installing essential equipment for selected targeted HCFs”. It may be difficult to identify and retain an Infrastructure Manager at the qualifications required for these limited scope activities. Would USAID consider limiting infrastructure activities to “non-structural work” which would negate the need for an Infrastructure manager and engineering firms to oversee the work per USAID’s Construction policy (USAID Implementation of Construction Activities - A Mandatory Reference for ADS Chapters 303).

Alternatively, can all costs associated with the Infrastructure requirements, including the Infrastructure Manager be applied to the Construction line item amount?

Answer: No. USAID allocates $20,000,000 for Infrastructure activities. Additionally, as per ADS 303maw, the definition of construction work includes, without limitation, improvements, renovation, alteration and refurbishment. The costs associated with the Key Personnel Position of the Infrastructure Manager should not be included into the Construction/ Infrastructure line item amount.

9. Does USAID have a preferred QASP template that they would like offerors to use?

Answer: The Offeror is required to adhere to the instructions outlined in L.7.3 to furnish a qualitative QASP. Attachment J.7 serves as a sample for QASP; however, Offerors have the flexibility to utilize alternative templates, provided they encompass all the necessary information.

10. Under indicator 2.1, could USAID please expand on “healthcare workforce development and management system” - is the “system” referring to a specific system/platform?

Answer: No, concerning indicator 2.1, which mentions 'healthcare workforce development and management system,' USAID is not referring to any specific system or platform.

11. Under Section C.8, the RFP states a maximum value for construction activities as $20,000,000; in attachment J.1, the amount is listed as $25,000,000. Please confirm that $20,000,000 is the correct amount.

Answer: Attachment J.1/SOO has been revised to correct the figure to $20,000,000, aligning with Section L.7.3 Infrastructure. The plug figure for infrastructure activities, encompassing construction and potential medical or power equipment, is set at $20,000,000.

12. Can USAID please confirm if the following understanding of the fee payment is correct? Per Section L.8, page 105: “It's important to note that 50% of this 60% must be linked to the minimum results explicitly already stated in the Statement of Objectives.” Meaning that 30% of fee is based on achievement of the minimum indicator results established by USAID in Section J: Statement of Objectives, and that the other 30% of the fee (the other 50% of the 60%) will be linked to the deliverables under Section F.6 (as described on page 105 of the RFP)? And finally, that the remaining 40% of fixed-fee that is not tied to results will be made upon receipt of a proper invoice (as described on

pg. 11 of the RFP)?

Answer: USAID confirms that 60% of the total fee is linked to achieving the Minimum Required Results outlined in Section F.7, while 40% will be made upon receipt of a proper invoice. Within the 60% allocated for F.7, 75% of the fee amount must be associated with already provided minimum results, with the remaining 25% potentially tied to additional indicators with targets that may be proposed by the offeror.

Please note that Offerors, as per J.3.3, may propose up to a maximum of five additional indicators cumulatively in their proposal, provided they enhance the probability of successfully attaining the required outcomes. Section L.7 and L.8 was updated to reflect this.

13. Assuming the above interpretation is correct, could USAID update the discrepancy related to both the percentage of fee and source of results noted in Section L.7, page 102 (“Please note that 75% of the 60% must be tied to the results already explicitly stated in the SOO.”) to match section L.8, page 105, and address any other changes to support the clarity of this interpretation?

Answer: Please refer to the response provided for question 12.

14. Page 2: “Pursuant to Block 12 of Standard Form 33 of this RFP, USAID requires that offers remain valid for 180 calendar days from the RFP closing date.” However, Block 12 of Standard Form 33, as well as L.8, page 104, asks for proposals to remain valid for 120 days. Can USAID please confirm if the proposal offer must be valid for 120 or 180 days?

Answer: The RFP is revised to accurately state the number of days as 180 in Section L.8 and Standard Form 33.

15. In the requirements in F.5.2 Key Personnel requirements for the Infrastructure Manager, it is indicated that the candidate must possess both a degree in civil engineering and be a US licensed PE or other national equivalent. Given that the requirements of this contract include primarily design and construction for vertical structures, would qualifications in related disciplines such as Bachelors in Architecture or Structural Engineering, and certifications such as Registered Architect or Certified Construction Quality Management also be acceptable to USAID?

Answer: No, USAID requires a degree in civil engineering and to be a US licensed PE or other national equivalent, for the Key Personnel position for the Infrastructure Manager as stated in the F.5.2.

Structural engineering falls under the broader category of civil engineering and is an acceptable degree.

16. Are there any restrictions on the type of subcontracts (CPFF, T&M, FFP) that can be used under the prime contract?

Answer: No, there are no anticipated restrictions on the type of subcontracts that can be utilized under the prime contract.

17. Considering the highly dynamic operating context in Ukraine, would USAID please add the following to Section B.6, Payment of Fixed Fee (p. 11)? “Any unpaid fee resulting from the contractor not achieving a certain result beyond its manageable control can be reallocated among other or new deliverables in the work plan for the current or upcoming year. The Fee Payment Schedule may be adjusted during annual work planning to reprogram any unpaid fees from partially completed or non-accepted deliverables from the past year into other or additional deliverables, as mutually agreed to between the contracting officer’s representative and the contractor, ensuring the fee remains fixed.”

Allowing this flexibility with the fee schedule will enable the contractor to reallocate effort and resources as needed to achieve the greatest attainable results within the total estimated cost, seizing windows of opportunity as possible.

Answer: USAID will discuss any deviations from achieving results with a selected contractor during the implementation phase as necessary, based on the circumstances. RFP Section B.6 is revised to reflect this update. Additionally, please review Attachment J.1 for updated targets.

18. Section B.6 (p.11) indicates that 60% of the payment of the fixed fee is tied to deliverables described in F.7, while the remaining 40% may be made “upon receipt of a proper invoice” and “shall be allocated based on the proportion of the invoiced amount in the period covered by the invoice.”

However, in Section L.8, Part 3, (1) (i) (p. 105), the RFP notes that while 60% of the fee is dependent on achievement of the deliverables outlined in section F.7, the remaining 40% is “linked to deliverables under Section F.6.” Would USAID please clarify whether the 40% of the fee is paid proportionately to invoices or is tied to deliverables?

Answer: Please refer to the response provided for question 12.

19. Would USAID include the anticipated period of performance start date in Section F.2 (p. 24) to allow offerors to correctly delineate the base and option period in their cost proposals?

Answer: USAID is unable to provide an exact forecast for the start date. However, for reference purposes, please consider October 2025 as the tentative start date.

20. Would USAID please confirm that when it mentions “deliverables outlined in Section F.7” (such as in Section L.8 Part 3, (1) (i) and Section B.6), it references the “minimum quantifiable results” in section F.7 (p. 44) rather than the deliverables in Section F.6 (p. 28)?

Answer: Yes - we confirm.

21. Would USAID confirm if offerors should include the “Completion of the ‘Representations, Certifications, and Other Statements of Offerors’ in Section K” (p. 100) in the Cost Volume along with Part 6 – Portions of Section K not Available Online (p. 110)?

Answer: Yes – that is correct. We confirm.

22. To facilitate USAID’s review of proposals, may offerors include an executive summary between the Acronym List and the Performance Work Statement in the required order of the technical proposal in Section L.7 (p.102), while remaining within the overall page limit?

Answer: Yes - the Offeror may include an Executive Summary. It counts towards the 40 page limit.

23. L.7.1 Performance Work Statement (p. 102) states, “Please note that 75% of the 60% must be tied to the results already explicitly stated in the SOO. Other results/indicators may be added but not tied to the fee.” L.8 Part 3 – Proposed Costs (1) General (i) (p. 105) states, “It’s important to note that 50% of this 60% must be linked to the minimum results explicitly already stated in the Statement of Objectives (SOO). While other results may be proposed, they will not be tied to the fee.” Attachment J.1, Section J.3.3 also notes that “75% of this 60% must be linked to the minimum results already explicitly stated in the Statement of Objectives (SOO).” Would USAID please confirm which percentage of the 60% of fee dependent on achievement of the results in Section F.7 must be linked to the minimum results explicitly stated in the SOO? And regarding the remaining portion of the 60%, what should it be tied to if not the results proposed by the offeror?

24. The RFP references inclusion of personnel statements/letters of commitment in both the technical volume annex (Section L.7/p. 104) and the cost volume (Section L.8 Part 7/p. 111). Would USAID please confirm that offerors may include letters of commitment as part of the technical volume annex only, exempt from the 35-page limit?

Answer: Yes - as per L.7.2 - offerors may include letters of commitment as part of the technical volume annex only. These are exempt from the 40-page limit.

25. Section L.8, Part 3 (ii) (p. 105) states that “Labor costs for CCNs must not exceed the thresholds in the U.S. Embassy’s local employee compensation plan (LCP) at $93,646/year. Positions comparable to USAID positions that exceed the U.S. Embassy’s local employee compensation plan (LCP) at $93,646/year require approval by USAID.” Would USAID please remove this language from the RFP, as it appears to be inconsistent with AIDAR 752.7007 Personnel Compensation, which is incorporated in the contract under Section H.1 (p. 51) and stipulates that personnel compensation must be in accordance with the contractor’s established policies, procedures, and practices, with reimbursement subject only to the USAID Contractor Salary Threshold. The above-cited language in L.8, Part 3 (ii) may preclude contractors from following their established policies, procedures, and practices, as required by AIDAR 752.7007.

Answer: Our market research indicates that a significant majority of the anticipated FHR activity positions will be within the current LCP. As per AIDAR 722.170(c), stipulated in Section H.1- Compensation, including merit or promotion increases paid to TCNs and CCNs may not, without the approval of the Mission Director having program responsibility for the project, exceed the prevailing compensation paid to personnel performing comparable work in the cooperating country as determined by the USAID Mission. Requests for waivers will only be considered on a case by case basis and must be accompanied with sufficient justification.

26. Would USAID please confirm that the infrastructure plug is $20,000,000 (as indicated in Sections L.8/p. 106, B.4/p. 10, and C.8/p. 16) and not $25,000,000 (as indicated in Section J.3.2/p. 128)?

Answer: Yes - that is correct. Please refer to the response provided for question 11.

27. In Section L.8, Part 4 (p. 110), USAID requests that offerors complete Attachment 2 for any contracts/agreements for which CPARs are not available. The referenced attachment includes a column labeled “Is there a CPARS report available? Y/N.” Would USAID please confirm that the offerors can include all projects selected for past performance in the Attachment 2 matrix?

Answer: Yes, offerors must include information for relevant projects selected for past performance in the Attachment 2 matrix, if CPARS reports are not available. Additionally, if desired, offerors may include information for projects for which CPARS reports are available.

28. In the final paragraph of Section L.8, Part 4, USAID instructs offerors to submit final CPARs for the three selected relevant contracts and/or assistance agreements presented as part of the Past Performance. Would USAID please confirm that offerors can submit interim CPARs if a final CPAR is not yet available?

Answer: Yes, Offerors may submit the latest interim CPARs if a final CPAR is not available. USAID requires only the most relevant contracts and/or assistance agreements in terms of size, scope and complexity performed over the past three (3) years.

29. Section M.3 (p. 114) refers to “the operating constraints and principles referenced in the Section J.4 and Section C.” Section J.4 (p. 130) of attachment J.1 includes “activity constraints, contract parameters, and operating/management principles,” but Section C (p. 13) does not include a section with a similar heading. Would USAID please specify which parts of Section C it considers the “operating constraints and principles”?

Answer: Offerors are encouraged to integrate any relevant operating constraints and principles from Section J.4 into their proposal/PWS within the 40-page limit, ensuring alignment with the requirements outlined in the RFP. The specific method of integration is at the discretion of the Offeror.

30. In Attachment J.1, Section J.6 (p. 133), “Other References,” the following links are broken.

Would USAID please correct them? a. USAID Vision for Action in Digital Health, 2020-2024 b. Economic determinants of gender equality priorities in the health area in Ukraine, November 2021

Answer: a) https://www.usaid.gov/policy/digital-health-vision

b) Please refer to the response provided for question 1.

31. We appreciate USAID providing links in Attachment J.1, Section J.6, to the USAID Health Reform Support (HRS) program annual reports through September 2022 and monitoring, evaluation, and learning plans (MELPs).

a. Would USAID please also disseminate the Year 5 annual report, covering the period through September 2023, so that offerors can build their approach on USAID’s latest work in the sector?

b. Would USAID please also disseminate the annexes to the MELPs, in particular the HRS M&E performance indicators framework and performance indicator reference sheets?

Answer: a) Please refer to the response provided for question 3.

b) Annexes with HRS M&E Performance Indicators Framework and redacted PIRS (Performance Indicators Reference Sheets) are included into the DEC Folder with HRS reports, in the sub-folder "MEL Plan":

32. Can USAID please clarify if the value of the set-aside figure for Infrastructure activities is $20M or $25M? (p.10, B.4, (a) and p.128, J.3.2, Objective 5

Answer: Please refer to the response provided for question 11

33. Section L.8.Part 3(2) ‘Indirect Cost Information’ requires offerors to propose ceiling rates; and in Section B.4 ‘Indirect Costs and Advanced Understanding on Ceilings,’ states that “the Government must not be obligated to pay any additional amount associated with indirect costs above the ceiling rates established in the contract. This advance understanding must not change any monetary ceiling, cost limitation, or obligation established in the contract.”

Under FAR 52.216-7(b) and (d) a contractor is to be reimbursed its indirect costs in accordance with the final indirect cost rates approved by the contractor’s cognizant federal agency official. Requirement for indirect ceiling rates is inconsistent with this approach and would lock Offeror’s into indirect cost rates that do not reflect actual costs. As such, Offerors will either need to propose artificially inflated proposed indirect cost rates or risk utilizing a proposed indirect cost rate that is lower than their actual costs and government approved indirect rates.

Contractors’ indirect rates, as approved by cognizant USG agencies, do change periodically, and indirect ceilings may prohibit companies from recuperating legitimate approved indirect costs. We respectfully request to remove the requirement for ceiling indirect rates from Section B.4 and L.8.Part 3 and allow https://www.usaid.gov/policy/digital-health-vision https://drive.google.com/drive/folders/1MGzQcJHCHXG_Oc1hx9ZgsWUyVsXJ-OQT?usp=drive_link https://drive.google.com/drive/folders/1InH-acshv-Qnu_eOWs_4Bq5zJB0IAqGD?usp=drive_link the successful offeror to utilize actual indirects during implementation, providing justification to USAID should they need adjustment periodically. (p.10, B.4; p.107, L.8, Part 3, (2))

Answer: FAR 52.216-7 does not prohibit the use of ceiling rates. During contract implementation, USAID will compensate the contractor based on its current Negotiated Indirect Cost Rate Agreement (NICRA), if available. However, during negotiations, before award, notional ceiling rates are to be established, as per the RFP requirements. It's important to note that the Government will not be obligated to pay any additional amount should the final indirect cost rates exceed the negotiated ceiling rates.

34. RFP Section B.6, Payment of fixed fee states 60% of the fixed fee amount will be tied to achievement of deliverables/results. We believe 60% is excessive given the fluid environment and the security situation in Ukraine. As stipulated in the RFP, the Activity needs to demonstrate continuous flexibility and resilience to rapidly shifting priorities and wartime challenges. Accordingly, the contractor may need to rely on iterative implementation planning in coordination with USAID to meet shifting priorities and program demands. Additionally, FHR results will be largely dependent upon GOU commitment to reforms and the impact of the war.

This places some of the results outside of the contractor’s direct control and emphasizes the importance of adaptive management. In this environment a rigid fee schedule developed prior to contract execution may reduce USAID’s and the Contractor’s ability to adapt to changing circumstances and priorities.

Accordingly, we respectfully request USAID to either remove the requirement or consider reducing the portion of fixed fee to a level of 30% being linked to performance outcomes/results. (p.11, B.6. p.102, Section L.7)

Answer: Please refer to the response provided for question 17.

35. Would USAID consider revising the fee table to be based on targets that are not time bound (a.k.a. remove references to Year 3 and EoC in the indicators), as some indicators are achieved on different timelines than others? (p.11, B.6; p.102, Section L.7; and p. 123, J.3.2)

Answer: No. USAID will discuss any deviations from achieving results with the contractor during the implementation phase. Our intention is to make two payments rather than a single payment at the end of the project, thereby linking the fee to the achievement of minimum interim required targets and results.

36. Section L.7.1 requires that 75% of the 60% of proposed fixed must be tied to the results already explicitly stated in the SOO. Whereas Section L.8 states “that 50% of this 60% must be linked to the minimum results explicitly already stated in the Statement of Objectives (SOO).” Please clarify the correct percentage of the 60% of the proposed fixed fee that needs be tied to results already explicitly stated in the SOO. (p.102, L.7.1; and p.105, L.8, Part 3, (1))

37. Labor costs for CCNs must not exceed the thresholds in the US Embassy’s local employee compensation plan (LCP) at $93,646/year. Can USAID share the full LCP for Ukraine that breaks out salaries for different grade levels? (p.105-106, L.8, Part 3)

Answer: As identified in Section L.8, Part 3, the current LCP threshold for CCNs salaries is $93,646/year.

Offerors are expected to conduct their own market research and use their established policies to propose justified CCN salaries.

38. Would USAID consider lowering the threshold for relevant past performance from $20M to $18M? (p.109, L.8, Part 4)

Answer: No. The Past performance references should reflect activities of similar scale and scope to the FHR activity.

39. Section L.8, Part 3 “Fee” requires that “Fee must not be applied to the fee/profit of subcontracts and grants.” This appears to be inconsistent with FAR 15.404-4 and ADS 302.3.6.8, which state, inter alia, that pre-negotiation fee objectives must be determined according to a clear and structured approach that considers Contractor effort, risk, and other special factors. GUCs and Subcontracts require significant effort to administer and carry implementation risks for the Contractor. Therefore, kindly consider allowing fee application on Grants under contract and Total subcontractor cost including fee.

(p.109, L.8)

Answer: The RFP is updated to eliminate the limitation language regarding fee application to subcontracts and grants.(L.8)

40. Can the Offeror amend the detailed prime budget template to conform with their estimating and accounting practices? In addition, can the detailed subcontractor budget which is currently in a cost-plus format be adjusted for subcontractors that are Time and Material and Firm Fixed Prices?

(Attachment J.3, Budget Template)

Answer: Yes, the Offerors may amend the budget template, provided that the major cost items align with USAID's budget template in terms of order and include a summary for the required USAID categories, as per Section L instructions.

41. Can USAID clarify if subcontractors for infrastructure activities can issue 2nd tier subcontracts to local construction firms? (p.15, C.8)

Answer: Yes. The Offeror should follow both (1) USAID construction/infrastructure policies and regulations and (2) its own internal policies.

42. In reviewing the requirements for the Infrastructure Manager Key Personnel position, would USAID consider one of the following: 1. In the view that Ukraine is an EU candidate country, and will continue to align/implement EU codes/regulatory environments, would USAID consider expanding the requirement for the Infrastructure Manager to hold a Professional engineer license from EU countries?

OR

2. Set key personnel requirements to allow for locally training and locally licensed engineer supported by a non-key, United States/Canada/the United Kingdom/Australia/New Zealand and/or EU licensed advisor? (p.27-28, F.5.2)

Answer: a) This is acceptable, in this case they should be a licensed EUR ING (Europe).

b) No

43. The RFP requires a US-licensed A&E firm to, at a minimum, provide “final design review, development and liability.” However, a Ukrainian A&E firm will still be necessary for the substantial design work to ensure compliance with local building codes or the 2015 International Building Code (see page 69) for these types of services. Further, the construction activities are expected to be small in nature and consist of minor renovation of health clinics and post. Finally, the 6% cap on design costs will make it very difficult for the contractor to procure both local design services as well as a US-licensed A&E firm. Would USAID consider removing the requirement to have a US-licensed A&E firm to provide the final design review, development and liability as based on the size of the anticipated construction efforts and the additional costs, it seems unnecessary? (p.15, C.8)

Answer: No.

44. Can USAID provide more details on the anticipated composition of the $20M plug figure to inform pricing. E.g., can costs for labor associated with infrastructure-related activities (e.g., cost of the Infrastructure Manager and their team) be captured in the $20M infrastructure set-aside? (p.16, C.8 p.106, L.8, Part 3, 1, (v))

Answer: As per Section L.8.Part 3.(v) - The plug figure for construction/infrastructure activities is $20,000,000 and includes construction services and equipment. This includes, and is not limited to, design and minor renovation of health clinics and posts, medical equipment for primary and specialized healthcare facilities, IT products (hardware and software), medical and office furniture, power generators, and solar panels. The cost for the Key personnel/Infrastructure Manager should not be included to the amount of $20,000,000.

45. Could USAID provide a specific template, page limit, or additional guidance on the expected level of detail for the QASP? (p.23, E.3 and p.104, L.7,3)

Answer: Attachment J.7 has been included as a sample for the Quality Assurance Surveillance Plan (QASP); however, Offerors are free to use alternative templates, ensuring they cover all necessary information. It should be noted that Attachment J.7 falls within the 40-page limit. During the proposal stage, when drafting the QASP, Offerors should focus on defining performance standards and assessment methods for achieving the five objectives and outcome indicators with minimum targets outlined in RFP Section J - Statement of Objectives (pages 123-129). Section L.7.3 is updated accordingly.

46. Can USAID provide the estimated award date for the purpose of pricing? (p. 24, F.2)

Answer: Please refer to the response provided for question 19.

47. Would USAID consider removing the Cover Page, Table of Contents, and Acronym List from the 35-page limit? (p.102, L.7)

Answer: No, the Cover Page, Table of Contents and Acronym list are included in the body of the technical proposal. They count towards the updated 40-page limit.

48. The instructions for the PWS reference Attachment 3, Budget Template. Should offerors also include the outcome indicators (corresponding to the Budget Template) in the PWS? (p.102, L.7, Factor

1 – PWS)

Answer: Yes, the Performance Work Statement should describe the technical approach for achieving the five objectives, including outcome indicators and minimum targets identified in the RFP Section J - Statement of Objectives.

49. Per the RFP, the outcome indicator quality methods are in the QASP. It seems duplicative to also include measurable quality standards in the PWS, as indicated in the PWS instructions. Would USAID consider removing the requirement for the PWS? If not, can USAID provide more guidance on the measurable quality standards as they relate to the PWS? (p.103, L.7)

Answer: The RFP is revised to remove the "measurable quality standard" component from the PWS, aligning it with the QASP. The Performance Work Statement should describe the technical approach for achieving the five objectives, including outcome indicators and minimum targets identified in the RFP Section J - Statement of Objectives.

50. Can USAID clarify if Key Personnel Letters of Commitment should be included in the Technical Volume or the Cost/Business Volume. (p.104, L.7, Staffing Plan; and p.111, L.8, Part 7)

Answer: Please refer to the response provided for question 24.

51. Offerors must submit their proposed costs/price for award in two formats: An overall summary as presented in Annex 2 tab1 and a detailed budget Annex 2 tab 2. The language above references Annex 2 tab 1 and tab 2. Can USAID provide the location of Annex 2? (p.105, Part 3, Proposed Costs)

Answer: Annex 2 containing the FHR budget template can be accessed via the following link:

https://docs.google.com/spreadsheets/d/1ZU9YZXTVhQU_g2Wxxki8TtFNEASIXsjd/edit#gid=918273819] . The first tab is labeled 'Summary' (Tab 1), and the second tab is labeled 'Detail Prime' (Tab 2). These correspond to the referenced Annex 2 tab 1 and tab 2, respectively.

52. NHSU introduced a PBF mechanism for the PHC package with 2 indicators related to immunization targets and preventive NCD examinations (i.e., hypertension screening). These PBF indicators are automatically included in all PHC contracts offering the 2.5% financial top-ups for achieving these indicators. Therefore, it would not be feasible to increase the number of PHC facilities who sign performance-based funding contracts with NHSU as required in the target for Objective 1.2.

We therefore recommend revising this indicator. For example, the indicator can measure “an increase in % of PHC facilities who implement the PBF-linked indicators and are eligible for receiving the financial top-ups.” (p.124, J.3.2, Objective 1, Indicator 1.2)

Answer: Thank you for your suggestion. USAID is not in a position to revise this indicator at this stage.

USAID will discuss any deviations from achieving results with the contractor during the implementation phase.

53. Given the long-term nature of the war and complexity of international operations, increases in technical assistance are unlikely under Indicator 1.5. Even more challenging is international and domestic private sector investments to commit to restoration and modernization with specific timelines.

Would USAID consider removing or revising this indicator? (p.124, J.3.2. Indicator 1.5)

Answer: The RFP is revised regarding Indicator 1.5. Offerors are encouraged to suggest their own targets for this indicator.

54. In reference to Indicator 2.1, is the metric to retain 75% of their current/baseline staffing levels, or retain 75% of the necessary staffing levels at a given time based on changing demand? We suggest the latter, based on current plans not always being evidence-based. (p.125, J.3.2. Indicator 2.1) https://docs.google.com/spreadsheets/d/1ZU9YZXTVhQU_g2Wxxki8TtFNEASIXsjd/edit#gid=918273819 https://docs.google.com/spreadsheets/d/1ZU9YZXTVhQU_g2Wxxki8TtFNEASIXsjd/edit#gid=918273819

Answer: Thank you for your suggestions regarding Result #2.1. We revised the RFP to adjust the wording of Result #2.1 as follows:

At least 5% of HCFs, that provide services to distant rural and hard-to-reach communities, in one targeted oblast succeed by the end of Year 3 in mobilizing and/or retaining 75% of their staff to recover, sustain and expand essential healthcare for those communities based on changing demand, and at least 15% of such HCFs - in three targeted oblasts by EoC, utilizing the strategic healthcare workforce development and management system developed and/ or adjusted due to the USG support.

55. Given the PPP regulatory constraints in Ukraine, would USAID consider revising Indicators 2.4 and 5.3 to fit under broader cases of public and private sector collaboration, rather than only a PPP arrangement? (p.126, J.3.2. Indicator 2.4 and p.129, Indicator 5.3)

Answer: Thank you for your suggestion. While we are unable to revise the indicators outlined in the RFP, we appreciate your input. During the implementation phase, USAID will engage in discussions with the selected contractor regarding any deviations from achieving results, taking into account the specific circumstances at that time.

56. Would USAID please confirm that Indicators 2.4 and 5.3 refer to the same target of total 3 PPPs by the end of contract. (p.126, J.3.2. Indicator 2.4 and p.129, Indicator 5.3)

Answer: Yes, we confirm that Indicators 2.4 and 5.3 refer to the same minimum target of total 3 PPPs by the end of contract.

57. This seems to be a two-part indicator. The factors that lead to unnecessary hospitalizations extend beyond hospital optimization and unnecessary hospitalizations will be difficult to measure due to the lack of standardized definitions and data requirements. Therefore, would USAID consider removing this second part of the indicator? (p.129, J.3.2. Indicator 5.4)

Answer: Thank you for your suggestions regarding Result #2.1. We revised the RFP to adjust the wording of Result #2.1 as follows:

"At least 5% of HCFs in one targeted oblast complete optimization (e.g., downsizing, merge, reprofiling) by the end of Year 3 based on the Hospital District Development Plan developed and/ or revised due to the USG support. By the EoC - 20% of HCFs in the same or another oblast complete optimization.

Baselines to be established in Year 1."

58. Ukraine’s 2030 National Health Strategy envisions further implementation of complex cybersecurity measures and information and data protection in the healthcare information systems. Can

USAID please clarify whether the cyber security activities will be included in the scope, as this is an integral part of the expanding capacities and ensuring reliability of digital health platforms and tools?

(p.132, J.4.4)

Answer: The Offeror is responsible for proposing all necessary interventions in their technical approach to best achieve the Activity objectives in a cost-effective and efficient manner.

59. General. Could USAID please provide the starting date of the project for budgeting purposes?

Answer: Please refer to the response provided for question 19.

60. General. General. Sections B.6 (page 11), L7.1 (page 102), and J.3.3 (page 129) appear to have consistent requirements regarding the fee. However, Section L.8, Part 3 (page 105), presents conflicting requirements compared to other sections:

- Section B.6 states that "payment of fixed fee shall be allocated based upon the proportion of the invoiced amount in the period covered by the invoice to the total estimated cost of the periods of the contract not including fixed fee."

- Section L.8, Part 3, states that "remainder of up to 40% of fixed fee linked to deliverables under Section F.6."

- Additionally, on page 105, the solicitation states that "50% of this 60% must be linked to the minimum results explicitly already stated in the Statement of Objectives (SOO)." However, other sections of the RFP mention 75% of the 60%.

Could USAID confirm whether L.8, Part 3, should align with the consistency of other sections of the RFP?

Answer: Please refer to the response provided for question 12.

61. Section E.2.1, pg. 22. In the solicitation, USAID Ukraine specified the requirement for a US-licensed A&E firm. Could USAID confirm whether the Contractor will need to adhere to Ukrainian regulations, considering that construction will take place in Ukraine?

Answer: Yes, we confirm that the Contractor will need to adhere to Ukrainian regulations on construction.

62. Section L.7, pg. 102. Would USAID consider using Calibri font point 11 size instead of Times New Roman point 12 size? If not for the main application, could it be considered for graphics, tables, and charts?

Answer: The Offeror can use Calibri font for Technical Application, size 12. Additionally, as per instructions in L.7 “The offerors may use smaller font size for text in graphs, charts, tables, and text boxes, so long as the text is legible.”

63. Section L.7, pg. 102. Given that the Contractor must submit the full QASP to USAID within 60 calendar days after the effective date of award, could USAID please consider excluding the draft QASP from the 35-page limit, as drafts of such documents are typically lengthy?

Answer: Please refer to the response provided for question 45.

64. Section L.6, page 102. Can USAID please elaborate on the statement found on page 102, which reads, "Description of all requirements to be performed in terms of outcomes to be achieved (not in terms of ‘how to’ accomplish)"? Please clarify if by "Description of all requirements to be performed," USAID means the description of technical approaches and illustrative activities, including immediate results (inputs) that will lead to the achievement of outcomes, and the application of these activities in context.

Answer: Yes, USAID confirms that your understanding is correct.

65. Section L.7, pg. 103. Could USAID clarify whether the applicant is required to use the terminology "the contractor must" instead of "the contractor will"? Please consider the stated need to remain iterative and adaptive in language usage in the PWS, noting that "will" and "will consider" are more flexible words than "must."

Answer: Yes, the Offeror is expected to adhere to the terminology as specified in the RFP.

66. Section L.7, pg. 103. Could USAID clarify whether the applicant is required to use the terminology "the contractor must" instead of "the contractor will"? Please consider the stated need to remain iterative and adaptive in language usage in the PWS, noting that "will" and "will consider" are more flexible words than "must."

Answer: Yes, that is correct. The Management Plan should be included with the Staffing Plan.

67. Section L.6, pg. 104. Could USAID please confirm whether the statements mentioned on page 104 regarding the Key Personnel (KP) are equivalent to the letters of commitment signed by each proposed KP outlined on page 111? If they are the same, could USAID please clarify where these letters should be included – in the annex mentioned on page 104 or in the Cost Proposal, as suggested on page 111?

Answer: Please refer to the response provided for question 24.

68. Section L.6, pg. 104. Could USAID please confirm if resumes and references can indeed be included in an annex, as stated on page 104, despite the statement on page 102 that "Nothing is excluded from the 35-page limitation"?

Answer: Please refer to the response provided for question 4.

69. Section L.6, pg. 104. Could USAID please clarify the specific documents or attachments that are permitted or expected to be included in the Annexes?

Answer: As per instruction provided in L.7, Résumés, references and statements are not included in the 40-page limit and should be submitted as an Annex.

70. Section L.8, pg. 104. Could USAID clarify which validity period should be followed for the proposal submission: the 120 days mentioned in the SF-33 and section L.8, or the 180 days stated on the cover page?

Answer: Please refer to the response provided for question 14.

71. Section L.8, pg. 105. Could USAID please clarify the allocation of fixed fee payments outlined in Section L.8? Specifically, is it accurate that 60% of the fixed fee payment is contingent upon the successful achievement of deliverables in Section F.7, with the remaining 40% based on the proportion of the monthly invoiced amount? Additionally, is it correct that 75% of the 60% tied to Section F.7 deliverables must align with the minimum results stated in the Statement of Objectives (SOO)?

Answer: Please refer to the response provided for question 12.

72. Section L.8, pg. 109. Could USAID please confirm whether Evidence of Responsibility should be Part 4 instead of Part 3 of the cost proposal, with Past Performance being part 5, and so on for the remaining sections of Section L.8?

Answer: The RFP is revised to correct the numbering of the sections. We confirm that Evidence of Responsibility should indeed be Part 4 of the cost proposal, with Past Performance being Part 5, and so on for the remaining sections of Section L.8. The Cost Proposal includes a total of 10 Parts, numbered sequentially.

73. Section L.8, pg. 109. In Section L.8 Part 3 (1) of the solicitation, only the budget and budget narrative for prime and major subcontractors are required. However, Section L.8 Part 3 (2)(iii) necessitates a "description of the composition of proposed Subcontractor indirect rates and application thereof, including a discussion of the pools and bases" specifically for non-major subcontractors under flexibly-priced subcontracts. Could USAID please confirm the following:

a) Whether the budget (both summary and detailed) and budget narrative for non-major subcontractors are not required.

b) Whether the requirement stated in L.8 Part 3 (2)(iii) (page 107) of the RFP does not apply to non-major subcontractors.

Answer: a) USAID confirms that both the summary and detailed budget for non-major subcontractors are not required. However, the information in the narrative should be in sufficient detail to allow a complete analysis. b) The requirement stated in L.8 Part 3 (2)(iii) (page 107) of the RFP does apply to non-major subcontractors.

74. Section L.8, pg. 110. Could USAID please confirm that Letters of Commitment are only required for major subcontractors?

Answer: Yes, USAID confirms that Letters of Commitment are only required for major subcontractors.

75. Section M.3, pg. 114. Could USAID please confirm if the bullet for PWS, the bullet for Staffing Plan, and #6 for QASP are intended to be Factor 1, Factor 2, and Factor 3 respectively, in that order as mentioned on page 114?

Answer: USAID confirms that the bullet for PWS, the bullet for Staffing Plan, and for QASP are intended to be Factor 1, Factor 2, and Factor 3, respectively, as mentioned in Section M.3 on page 114. RFP is revised to clarify this.

76. Section M.3, pg. 114. Could USAID please clarify where the evaluation criteria regarding "the ambitiousness and appropriateness of the offeror’s proposed fixed fee percentage" should be addressed, considering the note in Section L on page 102 stating that the Offeror must not incorporate this table in their technical proposal?

Answer: In addressing the evaluation criteria regarding the ambitiousness and appropriateness of the proposed fixed fee percentage, Offerors should describe their technical approach in the proposed Performance Work Statement (PWS). This should outline how they intend to achieve the Contract Objectives, outcomes, and meet all minimum quantifiable expected results with targets as stated in Section J, Statement of Objectives (pages 123-129). The Technical Evaluation Committee will use the information provided in the budget table. It's important to note that Offerors must not include this table in their technical proposal.

Additionally, Offerors may propose additional quantifiable results beyond those already stated under the outcomes in Section J, provided they enhance the likelihood of successfully achieving the required outcomes and objectives. However, this should not exceed a total of five additional results/indicators cumulatively in their proposal. Offerors can also propose to exceed the required minimum targets already stated in the RFP/SOO, provided that achieving these exceeded targets is realistic in terms of time, resources, and country context.

77. Section J.3.2, pg. 123. Could USAID clarify the timing for establishing baselines as outlined in Sections J.3.2 and J.3.3 of the solicitation? Section J.3.2 mentions that minimum required indicators all require baselines to be established in Year 1. However, Section J.3.3 states that offerors should provide targets, including suggested baselines, for all indicators identified in the proposal. Could USAID specify when baselines should be provided based on these sections?

Answer: The Offeror is expected to provide suggested baselines and/or ways to establish baselines by the end of Year 1 in their proposal.

78. Section J.3.2. pg. 128. The solicitation states, "FHR may support minor renovation... having a separate budget line under the contract with a maximum amount of up to $25,000,000 USD." However, in another section, the solicitation states a maximum amount of $20,000,000. Could USAID please clarify this discrepancy?

Answer: Please refer to the response provided for question 11.

79. Attachment J.3. In the Attachment J.3 Budget Template Fixed Fee Completion Tab, there are only 2 results/outcomes listed under each of the objectives. Could USAID clarify if this is intentional, or if offerors can add additional results/outcomes based on the SOO?

Answer: All of the required minimum results…