BAA-388-17-000002_Amendment_1_UHC.pdf

Amendment 1: BAA-388-17-000002 Advancing Universal Health Coverage (UHC) In Bangladesh

1. The Solicitation is amended as follows:

1. Cover Page: Please replace the language, “This Broad Agency Announcement (BAA) seeks opportunities to co-create, co-design, co-invest, and collaborate in the development of a grant-making challenge fund mechanism focused in the area of climate resilience innovation and enterprise in Bangladesh” with “This Broad Agency Announcement (BAA) seeks opportunities to co-create, co-design, co-invest, and collaborate in the area of significantly expanding access to safe, affordable and quality health services in Bangladesh”

2. Cover Page: Extensions of EoI submission date to November 12, 2016

3. Please delete section “V.E. Criteria to be applied to all Expressions of Interest” in its entirety (page 9).

4. Please delete the sentence “F. Expressions of Interest may be accepted on a rolling basis for 20 days after the release of this BAA.” in its entirety under section “VIII. F Expression of Interest Information” of the BAA (page 12)

4. Add the following paragraph under section “IX. F. Review of Submission”

Cost Share/Leverage: Ability to provide a financial, in-kind, or leveraged match at various stages of the process. Cost Share/Leverage proposals are encouraged as they increase the competitiveness and the sustainability of a proposed activity.

2. Answers to all Questions received are provided below:

Technical Questions:

1) The BAA cover page mentions climate solutions, which seems inconsistent with the overall proposed statement of work. Would USAID kindly clarify this?

USAID Response: This is in error; the BAA will not address climate solutions.

2) Does this BAA separate out the NHSDP project into two parts? One more specifically focusing on the financial aspects of the network whereas another portion of the current project that is not addressed in this BAA is the health service delivery aspects of the network including WASH, HIV, TB, medical waste, etc.

USAID Response: USAID does not have a pre-determined number of awards to be made as per the BAA.

The co-creation process will guide and determine how many “parts/awards” will be made, if any.

3) Will the Government of Bangladesh be contributing any funds to offset the out of pocket expenses

(OOPE)? Historically, this has not been the case and the GOB have been declining health expenditures.

USAID Response: GOB funding is one of several sources of funding in the overall scheme of Universal

Health Coverage.

4) Is there a USAID approved definition or criteria on what constitutes the different levels of ability to pay for health services? What are the established definitions within economic stratification? I.e. What is the definition of poorest of the poor within the context of urban and rural Bangladesh?

USAID Response: USAID follows the Government of Bangladesh's definition of poverty. Our intent in the

BAA is to focus on the bottom two wealth quintiles.

5) What required financial or supply mechanisms will be put in place or already in place that will have to be used for this particular project?

USAID Response: This will be determined as part of the co-creation design process.

6) Will this project also have any resources to carry out the implementation of the developed structures, mechanisms, and schemes?

USAID Response: Yes. Specifics will be determined during the co-creation process.

7) Can USAID clarify if the award(s) will be to manage a "grant making mechanism" or "fund innovative approaches and enterprising solutions on game changing solutions to advance Universal Health

Coverage"? The cover letter states that the BAA is to select collaborators to "co-design a grant making mechanism;" however, the document later discusses how collaborators could turn co-designs into funded awards.

USAID Response: This is a co-creation process to potentially fund award(s) to implement creative and innovative solutions to advance universal health coverage in Bangladesh. Managing a grant making mechanism is not the objective of this award.

8) Will the implementing partner provide grants to the Smiling Sun clinics while also developing innovative financing mechanisms?

USAID Response: This will be determined as part of the co-creation process.

9) Is USAID open to differentiated models depending on environment, i.e. urban vs rural settings?

USAID Response: Yes

10) Role of research: Page 6 notes that "OPHNE seeks innovative, practical, cost effective solutions to these constraints through basic and applied research and development." Are research results on innovative approaches intended to be a primary outcome of any interventions?

USAID Response: No. This is not the primary outcome.

11) Please confirm that the references to climate in the cover letter to the announcement should be replaced with references to health and/or population.

USAID Response: Correct. This BAA will not address issues related to climate. The corrections are made through the amendment 1 of the BAA.

12) Please confirm that USAID requests EOIs that propose innovative approaches to financing only the

Smiling Sun network of clinics.

USAID Response: Yes, but specifics will be determined during the co-creation process.

13) On page 4, the BAA references the network entering into “third party payer arrangement on a capitation basis” but defines this as a fixed amount per service delivered. Could USAID clarify how it is defining capitation?

USAID Response: In this regard, capitation payment is a fixed rate paid to a service provider for each patient registered regardless of the service required by or rendered to the patient during a select period of time. The decision on the specific approach and payment mechanism will be discussed and finalized during the co-creation workshop.

14) OPHNE calls for “innovative, practical cost effective solutions to these constraints through basic and applied research and development”. Could USAID please expand on the anticipated scope of basic and applied research and development?

USAID Response: Basic and applied research and development is not the primary outcome.

15) A majority of the BAA references the Smiling Sun network, however in a couple of places (page 5 and

6) there is mention of linking with the non NGO run private sector. Could USAID expand on whether these linkages would be driven by the interested candidates or does USAID have particular parties identified? If so, will they be engaged in the co-creation process?

USAID Response: USAID identified partnership(s) will be discussed/identified during co-creation.

16) The BAA refers in multiple locations (including page 3 and page 5) to USAID’s desire to include

“payments linked to credit” as part of a wider financing approach. Can USAID clarify what they mean in this context by “credit”?

USAID Response: Credit is used broadly in lieu of payment at the site.

17) When the BAA refers to increasing knowledge and awareness of universal health coverage, what is

USAID’s envisioned target population for these efforts (e.g., clients, providers, private sector partners, etc.)?

USAID Response: It may include, but not limited to the above populations and will be determined during the co-creation process.

18) The BAA mechanism affords an interesting process jointly developing solutions to critical problems, but the demands on participants is unclear and often varies from BAA to BAA. Can USAID give some clarity on the level of effort expected compared to a traditional mechanism? What’s the timeline from

Expression of Interest to award? How long is the design workshop expected to last?

USAID Response: Co-creation is an iterative group process involving multiple stakeholders to design the best approach for the development issue identified in the BAA. The design workshop will be approximately 10 days, however, there may need to be follow-up meetings/discussion depending on the outcome of the initial co-creation workshop. Depending on the availability of apparently successful applicant(s) who submit a successful Expression of Interest, we expect apparently successful applicant(s) to be invited to the co-creation workshop in the next 1-2 months. Award date will be determined during the co-creation process.

19) Such a mechanism will bring together organizations that may not have worked together before. How would USAID envision the management of key decision points? Would USAID chose a prime upfront and ensure the budgetary process is transparent (so a sub doesn’t make serious contributions and investment and end up with a limited role)?

USAID Response: This will be determined during the co-creation process.

20) Planning for innovation on this scale requires some lead time in order to bring the best and brightest to the table during co-creation. This will require sufficient advance notice and understanding of organizational scope and role in order to select appropriate technical and leadership representatives. In addition, costing is a time consuming and complex exercise that requires staff in HQ and country offices as well as a review and approval by the sub and prime organizations, commonly taking at least 4 weeks.

We suggest that USAID set a clear and realistic timeline for the co-creation process that accounts for necessary internal organizational supporting processes and procedures that will need to be coordinated among multiple organizations.

USAID Response: The estimated timeframe for the co-creation stage is approximately 10 days. USAID anticipates that the co-creation stage will take place between December 2016 and January 2017.

Successful applicants will be invited to attend the co-creation workshop well in advance once reviews of the EoIs are completed.

21) The composition of the Peer and Scientific Review Board is unclear. The BAA refers to this Board as

“comprised of experts from USAID, partners, and/or outside parties”. Would USAID please clarify whether the ‘partners’ mentioned in the BAA include ‘representatives from applicant organizations?'

USAID Response: The Peer and Scientific Review Board will not include representatives from apparently successful applicant organizations.

22) On page 3, “OPHNE seeks opportunities to partner with companies and or/organizations to develop, test and scale-up health insurance coverage”, We would want to clarify whether US-AID would want to partner with a single agency to design, test and implement the health insurance coverage program. Given that there will be limited skill set in agency to conceptualize, design and implement the program, we would request that as part of this program the partner along with US-AID conceptualize and design the program and also supports in selection of implementation agencies.

It may also be clarified whether all the innovative solutions / approaches need to be designed keeping

Smiling Sun Health Clinics in mind.

USAID Response: Based on the EOIs and the co-creation design workshop, USAID will determine the number of apparently successful applicants under this BAA. Yes, Smiling Sun network of clinics should be considered in your EoI and approach as they will implement the creative solutions proposed/developed, however, other actors/partners/agencies/stakeholders can be proposed.

23) On page 3, “Background: Advanced Universal Healthcare Coverage”, Would US-AID plan to cover Primary, Secondary and Tertiary healthcare as part of this program.

USAID Response: Primary Health Care.

24) Page 6, “Greater Health Insurance Coverage”, Could you please share whether this program will currently cater to limited population (e.g. BPL) or will be open for all residents/strata of residents.

USAID Response: Serving the poor is one of USAID’s main mandates, however, specific populations served will be determined during co-creation.

25) Page 7, “Co-Invest”, We understand that there is a role for the partner to first jointly create and design the program / approach. In reference to co-invest what is the type of investment being looked at from the Partner.

Please validate whether the partner can support in the overall co-invest through Program Management

Support.

USAID Response: Co-invest varies from organization to organization to include but not limited to products, services, financial contributions (in-kind), brand, and or new technology.

26) Page 1, “This Broad Agency Accruement (BAA) seeks opportunity to co-create, co-design, co-invest and collaborate in development of a grant making challenge fund mechanism…”

We would like to clarify whether through this program US-AID would want to make a grant to the selected partner or are they also keen to seek support/collaboration from Consulting agencies who can support in conceptualization and design of such program.

USAID Response: This is a co-creation process to potentially fund award(s) to implement creative and innovative solutions to advance universal health coverage in Bangladesh. Managing a grant making mechanism is not the objective of this award.

27) Page 3, “Background : Advanced Universal Healthcare Coverage”

We would also like to share that conceptualizing sustainable programs will require overall buy-in from the Government and it may also so happen that government will have to anchor the program. We want to understand US-AID’s point of view in this regard.

USAID Response: The initial award(s) will be funded through USAID. However, increased GOB and investor contribution is desired.

28) Page 3, “Expression of Interest: Please submit an Expression of Interest in accordance with Section

IX. Expressions of Interest must indicate the development idea which will work towards discovering potential solutions to the Problem and increasing knowledge and understanding”

Would you please like to share the critical areas US-AID would like to cover/address as part of the initiatives.

USAID Response: The critical areas are covered in the solicitation.

29) Will the BAA be the source of all funding for SS network?

USAID Response: It is not the intent for USAID to provide sole funding over the life of the project.

Timing related Questions:

30) What is the anticipated timeline for stage 2 of the BAA?

USAID Response: USAID expects Stage 2 to be implemented between December 2016 – January 2017, and Stage 3 and Stage 4 will be announced later depending on the progress of the preceding stages.

These timelines are estimates and are subject to change.

31) What is the anticipated period of performance for awards issued under the BAA?

USAID Response: The anticipated period of performance for awards under this BAA will depend on the concepts received and the availability of funds. The funding amount and project execution period will be determined during the project design period, with selected partners. However, it is anticipated that if any award/s will be made, the period of performance would not exceed five years.

32) Pages 9 and 10: The BAA includes four stages, with Stage 1 expressions of interest due by November

5, 2016. Would USAID please provide information on the overall proposed timeline for each stage?

USAID Response: November 12, 2016, 11:59 pm local time is the last date for EoI submission.

33) The BAA doesn't include an implementation period; is there a preferred/maximum length envisaged for proposed intervention(s)?

USAID Response: It is anticipated that if any award/s will be made out of this BAA, the period of performance would not exceed five years. For further details, please see the response to question no.

34) Can USAID share an expected timeline for the full procurement process, to allow for appropriate planning by partners?

USAID Response: There is no set timeline for the potential award process. Multiple awards, or no awards, may be made under this BAA. That said, USAID intends to move expeditiously with regard to co-created concept papers that are successfully reviewed and for which there is funding available. The procurement process timeline will depend upon the award instrument selected.

35) Can USAID provide details on the timing and location of a co-creation workshop?

USAID Response: USAID anticipates the Co-Creation stage of the BAA will take place in Dhaka, Bangladesh between December 2016 and January 2017. These dates are estimates and subject to change. Please note: travel, local transportation and lodging costs for participants will not be reimbursed by USAID.

36) The deadlines for Questions and Expressions of Interest do not list times or time zones. For the EOI, can USAID offer a more exact deadline?

USAID Response: The submission date for the Expressions of Interest is November 12, 2016, 11:59 pm

(Bangladesh local time)

Process related Questions:

37) Are we eligible to submit the EOI

USAID Response: Yes, Public, private, for-profit, and non-profit organizations, as well as institutions of higher education, public international organizations, non-governmental organizations, U.S. and non-U.S.

government organizations, individuals and international donor organizations are eligible to submit an

Expression of Interest under this Announcement. The amount of resources made available under the

BAA will depend on the expressions of interest received and the availability of funds.

38) Can we submit the EOI as an Individual development worker?

USAID Response: Yes. For details, please answer no. 37

39) Could you confirm if Expressions of Interest will be accepted from consortia, or whether they will only be accepted from individual organizations?

USAID Response: Yes. Consortia and associations are welcome to participate in this BAA. The exact nature of collaboration under the BAA does not have to be finalized or pre‐determined at the Expression of Interest phase. A further discussion about partnerships, associations and resources may take place during the Concept Paper “co‐creation” stage of the process which is conducted with

USAID/Bangladesh. There are no particular requirements specific to consortia.

40) Can any organization apply for a particular area of activities? For example, an organization has expertise in strategic communication, raising awareness and creating demand for services. Will you allow that organization to express interest for the particular scope of work – Increase Knowledge and

Awareness of Universal Health Coverage.

USAID Response: An organization can respond to select areas where it best contributes particular expertise and/or value. Expressions of Interest should focus on at least one of the purposes. The BAA procurement process may result in an activity design that leads itself to more than one award and/or more than one type of award, and/or no award. An organization can respond to select areas where it best contributes particular expertise and/or value.

41) Can you clarify when a partner can be brought into the process? If an organization submits an EOI and is invited to join the co-creation stage, can the organization bring a partner into that stage to join the co-creation process if their proposed partner did not submit a EOI? Can an organization bring on a partner in response to the RFA or RFP if the partner has not participated in earlier stages, such as submitting an EOI?

USAID Response: In terms of partnerships, it is USAID’s hope that Expressions of Interest will indicate any formalized partnership or consortia that makes your idea viable. If the Expression of Interest is selected to participate in the co-creation/co-design/co-investment workshop, USAID may request that one or only a small number of representatives from the partnership or consortia attend the workshop for space issues and to enhance dialogue across all the selected Expressions of Interest. It is conceivable that USAID could also recommend new partnerships as a result of the Expressions of Interest received, in order to strengthen similar ideas presented. USAID also welcomes the inclusion of partners who may have unconventional backgrounds and new perspectives.

The Expression of Interest should be prepared by the partners interested in working with USAID to identify solutions to the specific problem(s) outlined in the Announcement. This could be an NGO, or any other type of partner. It will not be prepared with a USAID representative.

All entities must be identified at the co-creation stage; however, the specific named organization(s) or partner (s) can be brought in later as the co-creation process evolves. Caution: We strongly recommend against vague teaming arrangements since USAID will evaluate the merit of the EoI based on the participation of the organizations involved.

42) Is it required that the EOI respond to all of the focus opportunities noted in the BAA, or can the organization respond to select areas where it best contributes particular expertise and/or value?

USAID Response: Yes. Please see the response to question no. 40 for more detailed information.

43) Pages 9 and 12: Page 9, Section E, mentions two criteria that will be applied to all expressions of interest (idea/approach and partnership expectation and value). However, page 12, Section IX, lists five criteria that will be applied. Will USAID please clarify the BAA selection criteria?

USAID Response: Criteria listed on page 12 apply to the BAA selection criteria selection.

44) We noticed that the criteria to be applied to all EOI listed in section V. E on page 9 of the procurement document is different from the criteria listed in section IX. on page 12. Can USAID please confirm which criteria would be applied for this BAA?

USAID Response: Please see answer no. 43.

45) Are organizations encouraged to submit EOIs as formal consortia (submitting one EOI together) or as individual organizations that refer to their capacity/experience working with others? Is one approach preferred? We are working together on a specific intervention that may be of interest to

USAID/Bangladesh but also have broader organizational competencies that could be of interest.

USAID Response: Either. Please see response to question no. 39 and 40 for details.

46) Being an evaluation organization, do we need to necessarily partner with an implementing organization (that will presumably carry out the bulk of the implementing activities) or can we submit an

Expression of Interest by ourselves.

USAID Response: You can submit an EOI on your own. Please see response to question no. 41 for details.

47) Will USAID bring different partners to the table (including evaluation partners) at which we time we can explore possible collaborations with other implementing organizations?

USAID Response: Yes. Please see response to question no. 41 for additional information.

48) Could USAID confirm that the response to the BAA (EOI) should be from an individual organization versus a consortium of partners?

USAID Response: Either. Please see response to question no. 39 regarding consortium.

49) Could USAID provide any more detail as to when in the process applicants would be expected to identify any key personnel for the bid?

USAID Responses: USAID’s intention at this time is to hold a co-creation with all selected applicants to further explain the process. This convening will be held in Dhaka, Bangladesh between December 2016 and January 2017. (These dates are estimates and are subject to change). USAID may ask for key personnel information once the co-creation stage is completed. Therefore, one or two key experienced individuals from the submitting organization, as identified in the Expression of Interest, must be available to participate in person in the co-creation event.

However, it is expected that staff be identified at later stage/s, as key personnel will be a criteria for any potential award(s).

50) Does USAID expect organizations to identify partner/consortium arrangements in their expressions of interest?

USAID Response: It is at the discretion of interested submitters whether to include partner/s’ name/s.

Please read response to question no. 39 and 41 for further detail information.

51) When organizations are selected, USAID may want to suggest which organizations might prime but with subsequent final selection by partners early during co-creation (by Day 2) and through an externally facilitated process. Sub organizations would need to be assured that the prime has the management and financial systems to prime a large award.

USAID Response: USAID will not suggest which organizations should be the prime. For additional information please see our response to question no. 41

52) Some organizations have a long history of working with each other which provides the lessons learned to create a strong atmosphere of collaboration, mutual trust, and understanding. This relationship is often documented and protected through a nondisclosure agreement. Will USAID set up a process that ensures a respectful and collaborative environment during co-creation with established guiding principles and parameters for areas of mutual concern that all organizations endorse?

USAID Response: Yes. Nondisclosure agreements will be signed during the co-creation process.

Expressions of Interest should be free of any intellectual property that the submitter wishes to protect.

However, once submitters have been invited to engage in further discussions, submitters will work with

USAID to identify proprietary information that requires protection. We understand that part of the co-creation process means working with others to pull together elements of ideas, expertise, and technologies to create something new, where the whole is greater than the sum of the parts. In doing so, you may determine that it is not possible to preserve the integrity of your intellectual property to the degree you wish, and you are welcome to leave the process. USAID/Bangladesh may decide to pursue a partnership with your organization, if USAID determines that your intellectual property has the ability to accelerate positive development outcomes on a major scale.

Standard Terms and Conditions: Organizations making submissions under the BAA hereby grant USAID a royalty-free, nonexclusive, and irrevocable right to use, disclose, reproduce, and prepare derivative works, and to have or permit others to do so to any information contained in the expressions of interest submitted under the BAA. Organizations must ensure that any submissions under the Announcement are free of any third party proprietary data rights that would impact the license granted to USAID herein.

53) May an applicant submit an expression of interest jointly with another agency? If so, may an applicant be on more than one expression of interest?

USAID Response: Yes. USAID will accept multiple expressions of interest from a single applicant. Please clearly mark the theme of your expression of interest in accordance with the Announcement. However, to make the process easier for interested parties, we suggest describing multiple ideas in one Expression of Interest.

54) Will the implementing consortium be entirely chosen by USAID or are organizations encouraged to suggest consortiums? If chosen by USAID, how will the prime be selected?

USAID Response: The implementing consortium will not be entirely chosen by USAID. Please see response to question no. 39 and 41 for details.

55) Developing partnerships successful at implementing USAID programs requires more than technical compatibility. Management, administrative, and contracting processes as well as lessons learned weigh heavily in partnership decisions on traditional RFA applications and RFP solicitations. Will USAID allow partners to consider these when deciding on consortiums?

USAID Response: All submitted expressions of interest will be evaluated based on the criteria specified in the BAA Announcement. For details regarding consortium and evaluation, please see responses to questions no. 39 and 43.

Other Questions:

56) Cooperative Agreements and Contracts offer very different advantages for USAID and potential implementing partners. Are there any limits or expectations on the kind of mechanisms available after

BAA board approval?

USAID Response: The goal of this process is to bring together bright minds to develop new solutions to difficult problems. If USAID determines that the co-created solution should be funded, it will be – whether by USAID or other participants in the co-creation process. While it is possible that one participant’s idea will be funded, it is more likely that the most successful ideas will be those involving a range of actors who have collaboratively co-designed an idea.

Instrument types include but are not limited to contracts, grants, cooperative agreements, Global

Development Alliance agreements, Development Innovation Agreements, Inter-Agency Agreements, Government to Government Agreements, Donor to Donor Agreements, and Memorandums of

Understanding. In addition, the United States Government may craft a new instrument type to meet the needs of a specific relationship. Also it is to be noted that USAID may not fund any activities resulting from this co-creation process.

57) Does USAID anticipate a grants component through this program?

USAID Response: This will depend on the nature of the design developed collaboratively. Please see response to question no. 56 for further information.

58) Will participation in this BAA preclude us from bidding on any projects related to the NHSDP/Smiling

Sun Network?

USAID Response: No.

59) In the previous project, there has been notes on the delays of being able to release funds to the

NGOs to the point of the NGOs not being able to pay staff wages. How is this being addressed and what protections are being set up for this project?

USAID Response: The question is irrelevant to the requirement of the BAA.

60) Are small business partners allowed to join on these EOI’s?

USAID Response: Yes

61) Is this a follow-on requirement? If so, could you please provide the incumbent contract number for this opportunity? If not, is this a new requirement?

USAID Response: This is a new requirement in advancing the provision of health care by USAID in Bangladesh. This Broad Agency Announcement (BAA) seeks Expressions of Interest for innovative and collaborative solutions to advance Universal Health Coverage in Bangladesh. For detail requirements please see the announcement.

62) Please confirm that this BAA replaces the NGO Health Service Delivery Project (NHSDP) rebid solicitation that has been listed in the Mission Forecast for December 2016.

USAID Response: Yes. The Business Forecast is to updated in quarter 1 of Fiscal Year 2017. The activity will be forecasted as “ADVANCING UNIVERSAL HEALTH COVERAGE (UHC) IN BANGLADESH”

63) Is this the same opportunity that is listed on the USAID Business Forecast (July 2016) — NGO Health

Service Delivery Activity (NHSDP) Next Iteration, which will provide "direct service provision under the new health sector program” and support "the Government of Bangladesh's goal to obtain Universal

Health Coverage by 2035"? If these are separate procurements, can USAID provide more detail on how these two procurements would interact?

USAID Response: Yes. Please see response to question no. 62

64) Can USAID please share any evaluations of the current NHSDP project with applicants to this BAA?

USAID Response: No, the question is irrelevant to the requirement of the BAA.

65) Does this solicitation replace the NGO Health Service Delivery Activity (NHSDP) Next Iteration listed in the most recent USAID forecast?

USAID Response: Yes. Please see response to question no. 62 for more details

66) Is this a follow-on to current NHSDP?

USAID Response: Yes. Please see response to question no. 62 for more details

[End of Amendment #1]