Inside:Changing India’s investment landscape — EY advising seven states on Ease of Doing Business.......................2

Implementation of diagnostic services on PPP: A case of Jharkhand.........6

Providing critical support to Housing and Urban Development Department (H&UDD), Government of Odisha (GoO), in effective implementation of Deendayal Antyodaya Yojana National Urban Livelihood Mission (DAY-NULM).......................8

Partnering with Nagpur Municipal Corporation and Government of Maharashtra for “Nagpur Smart & Safe City”...................4

Dear readers,

The ninth edition of Signpost highlights EY’s support and interventions across four engagements leading to the realization of economic and social development goals.

EY has been assisting seven state governments in the implementation of business reforms spreading across 10 different areas. Six out of these seven client states ranked among the top 10 in the 2016 “Ease of Doing Business” rankings conducted by the World Bank and the Department of Industrial Policy & Promotion (DIPP), Government of India (GoI). Telangana was ranked number 1, while the other five states featured in the rankings were Chhattisgarh, Madhya Pradesh, Jharkhand, Rajasthan and Uttarakhand, with a remarkable average implementation rate of 97.11%. The rankings are a testimony to our efforts to work with State Governments in the areas of investment promotion and private sector development.

Our second featured assignment details our work with the Nagpur Municipal Corporation (NMC). The vision is to transform Nagpur into a smart eco-friendly city where people are connected to the Government through an inclusive, digital ecosystem. EY was appointed to advise NMC on technology-led interventions. It makes for a unique case of comprehensive transformation by translating vision into an implementation roadmap across key city functions.

The third case talks about the Government of Jharkhand’s endeavor to transform its health infrastructure for diagnostic services, making such facilities available to a larger segment of citizens. The “state-wide pathology and state-wide radiology & imaging network” project was conceptualized on a public-private partnership (PPP) model. The International Finance Corporation engaged EY as technical advisors for defining the project contours, including developing a viable “hub-spoke” model, which can be considered for replication across other states in the country.

The last project featured in this edition highlights our engagement with the Government of Odisha. The goal is eradication of urban poverty and empowerment of the poor by promoting sustainable livelihoods. EY has been engaged for the establishment and operationalization of State Mission Management Unit (SMMU) and City Mission Management Unit (CMMU) for 26 Urban Local Bodies (ULBs). It has been a year and a half into the project, and it has already led to noteworthy outcomes under six components of livelihood creation.

Please continue to share your feedback and ideas with me at gaurav.taneja@in.ey.com.I look forward to hearing from you.

Kind regards Gaurav Taneja India Government and Public Sector Leader

SignpostEY Newsletter for Government and Public Sector

June 2017

2Signpost, EY newsletter for the Government and Public Sector

Overview and challengesIndia has immense investment opportunities among emerging markets and consistently ranks among the top investment destinations. Yet, the realization of the committed investments requires improvement. This challenge has also been reflected in the “Doing Business” ranking by the World Bank.

In order to encourage states to undertake reforms for attracting new investors and supporting the existing investors, the Department of Industrial Policy & Promotion (DIPP), Government of India (GoI), in consultation with The World Bank, designed the EoDB ranking mechanism. In 2014 each state was ranked on a 98-Point Action Plan for improving the regulatory framework for business in the country. Subsequently, an assessment of states’ implementation of business reforms was released in September 2015. Further to which, in 2016, a 340-Point comprehensive Action Plan was initiated to undertake reform processes and assess states and Union Territories (UTs) on EoDB.

States have used this assessment to reinvigorate reforms aimed at implementation and grounding of investments. To achieve compliance on these agenda points, EY team worked with over 50 officers across 20 departments in seven states on improving the regulatory framework for doing business. Our mandate comprised suggesting changes in legislation, policies and approval processes to ensure minimal governance but maximum compliance with regulatory requirements. Critical approvals such as labor, pollution, tax, property registration, industrial land allotment and access to electricity required significant change in the existing processes and compliance mechanism.

Support and interventionEY’s broad scope of work with each state entailed identifying approvals through a business’s lifecycle — before establishment, at the time of commencement of operations, during operations and at the time of winding up. EY teams defined improved processes and developed checklists that assist in EoDB and obtaining timely approvals by simplifying processes and integrating a “single window” approval system.

Changing India’s investment landscape —EY advising seven states on Ease of Doing BusinessThe “Doing Business Survey” by the World Bank ranks countries on a number of parameters related to Ease of Doing Business (EoDB). With India’s ranking at 142 in 2014, the Department of Industrial Policy and Promotion of the Central Government initiated efforts to promote EoDB across states to promote investments. Today, state governments are actively focusing on improving ease of doing business to attract investments and generate employment.

EY has been assisting seven state governments in the implementation of business reforms across 10 different areas that impact the EoDB ranking. Six of these states were ranked among the top 10 states in India by the World Bank in the 2016 edition of the EoDB survey.

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EY teams assisted multiple departments in each state in benchmarking with leading practices with insights from other countries. The teams provided hands-on support for the implementation of EoDB reforms and established a program management rigor for follow-up on agreed actions.

Our teams worked with software development teams, which were engaged by various departments/agencies of the State Governments to modify the online systems by improving processes and integrating multiple state departments into a “single window system.”

The reforms required simplification of procedures for more than 150 approvals, classified in 10 different action areas. The outcome was measured using objective criteria by evaluating 340 questions. The EY team worked with the State Governments of Chhattisgarh, Jharkhand, Madhya Pradesh, Rajasthan and Uttar Pradesh in 2015 and additionally with Telangana and Uttarakhand in 2016. We worked closely with these Governments in implementing these reforms and compile submissions to DIPP for the evaluation, leading to high ranking of these states on ease of doing business.

Result and ImpactSimplification of regulatory approval process, improvement in transparency and reduction in delays across departments helped in the improvement of the overall investment climate of the states. The single window system/one-stop-shop e-platform for the investors was appreciated by the industry as well.

The efforts by the EY teams working with these state governments have been outstanding as 6 out of the top 10 states, as per DIPP/World Bank ranking, are being advised by EY, with an average implementation rate of 97.11%. Another remarkable feat was Uttarakhand’s progress in terms of compliance percentage from 13.36% in 2015 to 96.13% in 2016, which is the maximum compliance increase by any state in India so far. Additionally, Telangana graduated from the 13th position in 2015 to the top of the chart in 2016 with EY’s support.

EY’s deep domain expertise, and ability to coordinate with multiple stakeholders, helped the clients achieve an average increase in implementation rate by 45%.

“The Jharkhand State Pollution Control Board (JSPCB) is the first Pollution Control Board in the country to implement the online full-fledged inspection module, which has been developed by NIC, Delhi, with the help of the EY team. This has been recommended for consideration as a reference model by other pollution control boards.”

Dr. D D Sharma Chairman Jharkhand State Pollution Control Board

“The insights offered by the EY team as well as the coordination done with more than 20 state

departments enabled the state to improve its compliance to the agenda from 13% to 96%.”

Dr. Rajesh Kumar, IAS, Director of Industries,Government of Uttarakhand

EY’s Economic Development Advisory (EDA) services focus on policy and regulatory advisory, investment and trade promotion, sector and regional promotion and program management for clients. EDA advises governments on EoDB initiatives and reforms, simplification of approvals and procedures, investor-facilitation mechanisms and lead monitoring. EDA helps design long-term roadmaps for infrastructure development encompassing development of economic cities, clusters and investment region through private sector participation.

For more details contact:

Adil Zaidi Partner- Economic Development Advisory (EDA), Transaction Advisory Services, EY Tel: +91 11 6623 3230 Email: adil.zaidi@in.ey.com

4Signpost, EY newsletter for the Government and Public Sector

Overview and challengesNagpur, the third largest city of Maharashtra, is a fast-growing city with a robust health and education infrastructure. However, the city faces challenges of unplanned urbanization, leading to 36% of its population residing in slums and the riverfront. Waste management and inadequacy in public transport systems also require attention.

EY has been mandated by the Government of Maharashtra for developing an integrated technology roadmap for a transformation led by information and communication technologies (ICT), providing assistance in the procurement of technology solutions and on-boarding of implementing agencies. We have also helped the state in end-to-end implementation of ICT solutions in various city functions.

Support and interventionEY conducted a diagnostic study to assess current initiatives and implementation mechanisms. We developed the smart city vision and integration plan for the city after extensive stakeholder consultations. Further, citizen feedback was incorporated as an important input for prioritization of smart services.

EY’s mandate also includes identification of gaps in existing technology interventions to roll out the smart city ICT vision. Our team has helped in designing and developing a comprehensive implementation strategy.

We have created an “implementation roadmap” One of the key features of this assignment has been architecting the design of a city operations center and an emergency response center for civic and law-enforcement agencies, respectively. The design also included inputs for city Wi-Fi network and service kiosks for citizens and city-wide smart-city surveillance, including advanced video analytics.

Nagpur Municipal Corporation (NMC) envisions to “transform Nagpur into the most liveable, eco-friendly, edu-city, which electronically connects people with the government to co-create an inclusive ecosystem.” In order to assist NMC in realizing its vision, EY has been appointed by the Government of Maharashtra to provide advisory services for “Nagpur Smart & Safe City” through technology-led transformation. This transformation is based on inputs from the city’s development plans, administrative priorities and extensive citizen engagement.

Partnering with Nagpur Municipal Corporation and Government of Maharashtra for “Nagpur Smart & Safe City”

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The EY project team played a pivotal role, in developing Nagpur’s “Smart Strip” — a stretch of approximately 5.8 kilometers, spanning from Japanese Garden Square to Orange City Hospital Square, wherein smart transport, smart parking, smart traffic, solid waste management, environment sensors and smart lighting are being implemented to showcase smart solutions. This Smart Strip will become a benchmark user case for other cities in the country to follow.

Result and ImpactEY has facilitated the successful selection of a system integrator and developed a robust business model for the implementation of smart city initiatives. Once the project is implemented, it would improve the living standards of citizens as well as enhance the internal functioning of urban management, which includes city administrators, law enforcement agencies and businesses.

Our core teams’ expertise and ability to provide in-depth project management and smart city domain expertise, manage ICT-led initiatives and co-ordinate with multiple stakeholders has brought EY recognition as a partner in success for the implementation of Nagpur Smart & Safe City.

“The team led by Vikas Aggarwal has been right on the ground from day one, completed interactions with the key stakeholders, prepared the first blueprint of the road ahead, and we are in a very advanced stage of not only establishing the SPV on the models and the recommendations given by EY but also in the process of taking out our first RFP for the implementation of the Smart & Safe Nagpur City.

The EY team has shown not only a very high caliber of competency levels but at the same time communication skills as well to connect with all kind of stakeholders both in Nagpur city as well as in DIT. With their support, I think we will be able to establish a state-of-the-art model for a smart and safe city to be followed by other cities in the country.”

Shri Vijay Kumar Gautam, IAS Principal Secretary, Directorate of Information Technology (DIT), Government of Maharashtra

EY’s Smart City IT Transformation Advisory Services team has been playing an increasingly significant role by partnering with cities to assist with the definition of their Smart City vision and transforming that into an implementation roadmap. As part of this endeavor, the team has developed the ability to advise city administrators looking to harness technological innovations to improve the quality of life of citizens and future-proof cities from the vagaries of unplanned development. In a short time, the team has already showcased their prowess by establishing Nagpur as one of the pioneers of Smart Cities in India. Apart from government and public sector clients, the team has also been assisting private sector players in addressing the smart city market canvass and in capacity building. For more details contact:

Vikas Aggarwal Executive Director, IT Advisory Services — Government — Performance Improvement Business Advisory Services, EY Tel: +91 124 612 1180 Email: vikas.aggarwal@in.ey.com

6Signpost, EY newsletter for the Government and Public Sector

Overview and challengesOut-of-pocket (OOP) spending on healthcare in India is 69% — one of the highest in the world. A large part of the OOP spending is toward outpatient consultation and diagnostic services in the outpatient department (OPD). OOP spending can be particularly harsh on the low-income group and BPL patients.

In the context of Jharkhand, where the BPL population is around 39%, expenditure on health care facilities, particularly diagnostics, becomes a bottleneck to healthcare for all. With this perspective, the Government of Jharkhand conceived the diagnostics project (state-wide pathology, and radiology and imaging network) on the PPP model to make diagnostic facilities available to citizens.

The International Finance Corporation (IFC) — a member of the World Bank Group — was engaged by the Government of Jharkhand as the Lead Transaction Advisor, which further engaged EY and Hemant Sahai Associates as its technical and legal consultants respectively for defining the project contours including the development of a viable project model and selection of private sector partners.

Support and interventionEY served as the transaction advisor to IFC and the Government of Jharkhand to select private operator(s) under the PPP model to develop and operate a state-wide network of modern and advanced pathology and radiology centers. EY’s involvement included detailed techno-commercial due diligence, transaction structuring, bid process management and assistance in contract signing.

The project was conceived on a hub-spoke model for both pathology and radiology centers. In the case of radiology, spokes were equipped to handle fewer categories of tests as equipment such as for CT and MRI was only planned at the hub level. In the case of pathology, while samples were collected for all tests, only few tests were performed locally at the spoke level from economies of scale consideration. Additionally, pathology centers were expected to have collection centers for wider reach.

The Government of Jharkhand, in its endeavor to improve health infrastructure in the state, embarked on a transformation project of making diagnostic facilities available (through PPP) across the state. The diagnostic facilities were conceived on a hub-spoke model and the private sector has been involved on equip, finance, operate and transfer basis.

The proposed model ensures financial viability and at the same time provides for subsidy to below-poverty-line (BPL) patients for the services. Payment security mechanisms for private operators have been ensured by creating a provision for escrow mechanism and a well-defined identification process for BPL patients. At the same time, to ensure efficiency, incentive-based payments to the private partner have been defined in the contract.

Implementation of diagnostic services on PPP: A case of Jharkhand

7 Signpost, EY newsletter for the Government and Public Sector

The state was divided into two clusters, each having 12 districts with similar profiles. The “two-cluster approach” was designed to share the implementation risk, while ensuring that the projects were of sufficient size to ensure a balance between provision and affordability of services.

Through this project, vital health services have been started at district levels, improving both access and quality, and supporting future improvements in state-wide health infrastructure.

Under the Concession Agreement, incentives have been mandated for all pathology labs and radiology centers accredited by the National Accreditation Board for Testing and Calibration Laboratories (NABL) and the National Accreditation Board for Hospitals (NABH) respectively for ensuring quality.

Each cluster was bid out and private operators for the radiology and pathology clusters were separately selected through transparent, competitive bidding processes. The built-up space for the project in the district hospitals was provided by the State Government.

Result and ImpactThe Concession Agreement for the pathology clusters was signed in August 2015 with SRL Limited and in August 2015 with Medall Healthcare Private Limited. For the radiology clusters, the Concession Agreements were signed in November 2015 with a consortium of Manipal Health & Philips.

It is expected that the pathology and radiology projects will lead to private sector investment of US$2 million and US$10 million and generate annual concession fee of US$360,000 and US$50,000, respectively, for the State Government. This transaction will improve access to better diagnostics services to 3.5 million people, of which nearly 40% would be BPL.

EY’s Public Private Partnership (PPP) services focus on the development of infrastructure and provisioning of related services through the participation of the private sector. It aims to facilitate the development of efficient assets and effective service delivery systems by leveraging the potential of the private sector. As part of our service offerings, we advise government bodies on designing relevant projects, performing technical and financial viability studies, structuring and implementing optimal risk-sharing mechanisms, and putting in place bid process management systems to select private players. For more details contact:

Abhaya Krishna Agarwal Partner- Public Private Partnership (PPP), Transaction Advisory Services, EY Tel: +91 11 43633060 Email: abhaya.agarwal@in.ey.com

8Signpost, EY newsletter for the Government and Public Sector

Overview and challengesDAY-NULM, the flagship program of the Ministry of Housing and Urban Poverty Alleviation (M/o HUPA), GoI, lays emphasis on strategies for livelihood creation for the urban poor. The strategies mostly relate to building skills to access market-based job opportunities, providing training and support for the establishment of micro enterprises, building strong grassroots institutions of urban poor, identifying and ensuring availability of appropriate infrastructure for the urban homeless, and facilitating planned relocation and rehabilitation of urban street vendors without affecting their livelihood.

DAY-NULM has a three-tier interdependent structure at the national, state and city levels for implementation of the program. In every state/UT, a State Urban Livelihoods Mission (SULM) has been established for effective coordination and implementation of the program.

EY has been selected by H&UDD, GoO, to provide critical and need-based support for effective implementation of the components of DAY–NULM.

EY is also involved in designing and implementing innovative solutions such as participatory urban appraisal, dashboard, and data analysis as a tool for stock taking with focus on improving the effectiveness of the program.

Challenges facing the State:

• The state has multiple challenges with regard to the urban poor, specifically:

• High but declining dropout rates among the trainees in skill building

• Growing trend of seeking jobs outside Odisha for want of placement tie-ups with potential employers in the state

• Supply side needs to cater to the projected demand for workers, especially in the construction and textile/apparel sectors

• Need for agencies to cater to the diverse working age population, especially women, tribal youth and other weaker sections of the society

• Difficulty in finding suitable trainers who are experts at building up the skills of the trainees to make them employable

DAY-NULM aims at building grassroots institutions to gain access to resources, and impart demand-driven skills to poor and vulnerable youth. NULM aims at eradication of urban poverty based on promotion of sustainable livelihood through empowerment of urban poor across ULBs.

EY is supporting the State Urban Development Agency (SUDA), Odisha, and all ULBs, providing ideas and insights to address existing and emerging livelihood opportunities in the state through sectoral and program management inputs and coordinating with multiple stakeholders. EY is also playing a critical role in providing support for the creation of appropriate infrastructure with relocation and rehabilitation plan for the urban homeless.

Providing critical support to Housing and Urban Development Department (H&UDD), Government of Odisha (GoO), in effective implementation of Deendayal Antyodaya Yojana National Urban Livelihood Mission (DAY-NULM)

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Support and interventionEY’s 78-member team is working at different levels of the GoO. Of these, 6 experts along with support staff are functioning as the State Mission Management Unit (SMMU) and monitoring the entire 30 districts and 110 ULBs across the entire state. Forty-six experts along with 26 support staff are working as the City Mission Management Unit (CMMU) in 21 ULBs in the state.

The EY team’s support and intervention included feedback to SUDA on the following areas:

• Sharing of critical insights on improving the effectiveness of stakeholders through interface and suggestions based on field observations from time to time

• Design of innovative solutions programs such as Participatory Urban Appraisal, State Level CLC and Dashboard to improvise the Urban Poverty Alleviation Initiative

• Regular compilation and processing of data as a measure to analyze and track the progress of the program

Result and Impact • For Social Mobilization and Institution

Development (SM&ID), Resource Organisations (ROs) have been engaged to organize the urban poor into Self Help Groups (SHGs). These ROs have played an active part in the opening of accounts and training of SHG members to move upward on the path of sustainability. Till date, 13,000 SHGs have been formed, including four SHGs of specially-abled, covering 135,000 beneficiaries in the state. The state is ranked on top of SM&ID rankings across India.

• Under Employment through Skill Training and Placement (EST&P), Skill Training Providers have been selected through a defined process, and subsequently EY CMMU Managers have regularly followed up to ensure regular monitoring of the skill building program.In addition, assessment and certification by assessing bodies is done timely.

EY’s Performance Improvement Advisory Services helps government clients to improve performance across a range of areas, including infrastructural, social and economic, by using technology tools for monitoring and analyzing key performance metrics and recommending appropriate interventions and strategies. For more details contact:

Vineet Chhatwal Partner- Advisory Services, EY Tel: +91 880418897 Email: vineet.chhatwal@in.ey.com

Till date, 28,000 urban poor have been trained and assessed and are currently undergoing placements.

• Active facilitation support and regular follow up with ULBs, banks and other stakeholders by EY CMMU Managers have resulted in disbursement of loan to 3,500 beneficiaries for establishing and/or expanding micro businesses toward improved livelihood in the long run.

• Under Shelter for Urban Homeless (SUH), EY has provided active support in the timely evaluation of DPR and subsequent monitoring for timely construction of shelters for the homeless. Further, CMMU Managers from EY in collaboration with concerned NGOs have mobilized helpless and abandoned people on the street for the active functioning of SUH.

• So far, the vibrant functioning of 22 new shelters has catered to about 42,000 homeless people spread across various ULBs. Of the 45 SUHs in the state, 22 have been fully operationalized and are operating 24*7. Currently, the state is among the top three states in SUH ranking across India.

• Support to Urban Street Vendors (SUSV): EY has provided critical support in the identification of street vendors, issuance of ID cards and subsequent rehabilitation of urban poor for enhanced livelihood.

• Till date, more than 29,000 street vendors have been identified and they are being issued identity cards.

• The Capacity Building & Training (CB&T) component has covered 1,521 representatives of various stakeholders such as representatives of ULBs, ROs, and officers from different departments of the Government.

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