Project Number: 50391-001 Loan Number: {LXXXX} September 2019

People’s Republic of China: Demonstration of Guangxi Elderly Care and Health Care Integration and Public–Private Partnership Project

Project Administration Manual

ABBREVIATIONS

ADB – Asian Development Bank EMP – environmental management plan GDOF – Guangxi Department of Finance GGH Guangxi Guidong Hospital GGZAR – Government of Guangxi Zhuang Autonomous Region GPMO – Guangxi project management office GRM – grievance redress mechanism GZAR – Guangxi Zhuang Autonomous Region ha – hectare HMG – Hezhou Municipal Government HPH – Hezhou People’s Hospital IEE – initial environmental examination KPI – key performance indicator LAR – land acquisition and resettlement LIC – loan implementation consultant LTC – long-term care M&E – monitoring and evaluation NMG – Nanning Municipal Government NSWI – Nanning Social Welfare Institute NTCMH – Nanning Traditional Chinese Medicine Hospital OCB – open competitive bidding OPPP – Office of Public–Private Partnership PAM – project administration manual PIE – project implementing entity PMO – project management office PPMS – project performance management system PPP – public–private partnership PRC – People’s Republic of China PSA – poverty and social assessment SDGAP – social development and gender action plan SPS – Safeguard Policy Statement

CONTENTS

I. PROJECT DESCRIPTION 1

II. IMPLEMENTATION PLANS 9 A. Project Readiness Activities 9 B. Overall Project Implementation Plan 10

III. PROJECT MANAGEMENT ARRANGEMENTS 13 A. Project Implementation Organizations: Roles and Responsibilities 13 B. Key Persons Involved in Implementation 16 C. Project Organization Structure 18

IV. COSTS AND FINANCING 19 A. Cost Estimates Preparation and Revisions 19 B. Key Assumptions 19 C. Detailed Cost Estimates by Expenditure Category 20 D. Allocation and Withdrawal of Loan Proceeds 21 E. Detailed Cost Estimates by Financier 22 F. Detailed Cost Estimates by Outputs and/or Components 24 G. Detailed Cost Estimates by Year 25 H. Contract and Disbursement S-Curve 26 I. Fund Flow Diagram 27

V. FINANCIAL MANAGEMENT 28 A. Financial Management Assessment 28 B. Disbursement 29 C. Accounting 30 D. Auditing and Public Disclosure 31

VI. PROCUREMENT AND CONSULTING SERVICES 32 A. Advance Contracting and Retroactive Financing 32 B. Procurement of Goods, Works, and Consulting Services 32 C. Procurement Plan 33 D. Consultant's Terms of Reference 43

VII. SAFEGUARDS 50

VIII. GENDER AND SOCIAL DIMENSIONS 55

IX. PERFORMANCE MONITORING, EVALUATION, REPORTING, AND COMMUNICATION 58 A. Project Design and Monitoring Framework 58 B. Monitoring 61 C. Evaluation 63 D. Reporting 64 E. Stakeholder Communication Strategy 64

X. ANTICORRUPTION POLICY 64

XI. ACCOUNTABILITY MECHANISM 64

XII. RECORD OF CHANGES TO THE PROJECT ADMINISTRATION MANUAL 65

APPENDIX 1: TEMPLATE FOR QUARTERLY PROGRESS REPORT 66

TABLES Table 1: List of Facilities ............................................................................................................. 4 Table 2: Summary of Subprojects .............................................................................................. 7 Table 3: Project Readiness Activities ......................................................................................... 9 Table 4: Implementation Plan ....................................................................................................10 Table 5: Project Implementation and Roles and Responsibilities ..............................................13 Figure 1: Project Organization Structure ...................................................................................18 Table 6: Escalation Rates for Price Contingency Calculation ....................................................19 Table 7: Detailed Cost Estimates by Expenditure Category ......................................................20 Table 8: Allocation and Withdrawal of Loan Proceedsa .............................................................21 Table 9: Detailed Allocation and Withdrawal of Loan Proceeds .................................................21 Table 10: Detailed Cost Estimates by Financier ........................................................................22 Table 11: Detailed Cost Estimates by Outputs ..........................................................................24 Table 12: Detailed Cost Estimates by Year ...............................................................................25 Figure 2: Contract and Disbursement S-Curve ..........................................................................26 Figure 3: Fund Flow Diagram ....................................................................................................27 Table 14: Financial Management Action Plan ...........................................................................28 Table 15: Basic Data .................................................................................................................33 Table 16: Estimated Costs for Implementing the Environmental Management Plan ..................53 Table 17: Social Development and Gender Action Plan ............................................................55

FIGURES Figure 1: Project Organization Structure 18 Figure 2: Contract and Disbursement S-Curve 26 Figure 3: Fund Flow Diagram 27

Project Administration Manual Purpose and Process

The project administration manual (PAM) describes the essential administrative and management requirements to implement the project on time, within budget, and in accordance with the policies and procedures of the government and Asian Development Bank (ADB). The PAM should include references to all available templates and instructions either through linkages to relevant URLs or directly incorporated in the PAM.

The Government of Guangxi Zhuang Autonomous Region (GGZAR), the executing agency; and the two implementing agencies, Nanning Municipal Government (NMG) and Hezhou Municipal Government (HMG) are wholly responsible for the implementation of ADB-financed projects, as agreed jointly between the borrower and ADB, and in accordance with the policies and procedures of the government and ADB. ADB staff is responsible for supporting implementation including compliance by GGZAR, NMG, and HMG of their obligations and responsibilities for project implementation in accordance with ADB’s policies and procedures.

At loan negotiations, the borrower and ADB shall agree to the PAM and ensure consistency with the loan agreement and the project agreement. Such agreements shall be reflected in the minutes of the loan negotiations. In the event of any discrepancy or contradiction between the PAM and the loan agreement or the project agreement, the provisions of the loan agreement and the project agreement shall prevail.

After ADB Board approval of the project's report and recommendations of the President (RRP),

changes in implementation arrangements are subject to agreement and approval pursuant to relevant government and ADB administrative procedures (including the Project Administration Instructions) and upon such approval, they will be subsequently incorporated in the PAM.

I. PROJECT DESCRIPTION

A. Rationale 1. The People’s Republic of China (PRC) is facing a serious change in its demographic structure. In 2017, 158 million people—11.4% of the population—were aged 65 years and above. The aging rate is expected to reach 14% in 2025 and 21% in 2035.1 The aging population increases incidence of age-related diseases. Elderly people typically have chronic diseases and experience multiple morbidities. The primary cause of their care dependence is the loss of physical function resulting from chronic diseases and age-associated impairments. 2 Further, many elderly people have complex cases of multiple chronic diseases and physical and/or cognitive disabilities which require a continuity of services for both elderly care and health care. Coordination of care between the health sector and the elderly care sector is necessary to provide seamless care services for elderly people in need and to reduce avoidable hospitalization. 2. In an aging society, elderly people tend to be readmitted to hospital because of lack of appropriate elderly care institutions that allow them to transition back to their homes.3 However, it would be difficult for families to provide adequate care for elderly people who are discharged from hospitals and still require medical and elderly care services. Inadequate care at home can cause further health problems, which may require readmission to hospital. Frequent transitions between hospitals and homes or long stays in hospitals further reduce the functional abilities of the elderly. 3. In the PRC, more than 100 million elderly people had at least one chronic disease in 2013 (footnote 2). The burden of chronic disease is expected to increase by 40% by 2030 from the status of 2013. The number of elderly people with multiple chronic conditions is also increasing significantly in the PRC. Those elderly people would require post-acute care and rehabilitation to restore or stabilize their functionality after discharge from hospital as well as elderly care (long-term care) to maintain their daily living.4 A coordination system, linking the acute phase care, post-acute phase care, rehabilitation, and elderly care in an effective and efficient way, is at the core of integrated health and elderly care. Such a system needs to ensure smooth linkage of care services across the elderly care and health care sectors. 4. To create a coordination system, a functional hospital discharge management system needs to be established. The discharge management system will (i) clarify care needs after hospitalization, including needs for medical care, medication, rehabilitation, and elderly care; and (ii) identify where and how an elderly person can access his or her needed care. Such individualized care plans should be prepared based on discussions with the elderly people, their families, medical experts, therapists, social workers, and elderly care experts. Further, it is necessary to strengthen the elderly care service capacity of to meet a range of care needs. The

1 The aging rate is the ratio of population aged 65 years and above to the total population. United Nations Development

Programme. 2016. Asia–Pacific Human Development Report: Shaping the Future—How Changing Demographics Can Power Human Development. New York; and Government of Japan, Cabinet Office. 2017. Kourei Syakai Hakusho (White Paper on Aging Society). Tokyo.

2 World Health Organization. 2015. China Country Assessment Report on Ageing and Health. Geneva. 3 Such readmission of the elderly cost about $10 billion in unnecessary medical expenditures in Japan in 2002.

T. Hatano. 2004. Shakaiteki Nyuin no Ryoteki Haaku to Hiyo Keisan (Costs of Hospitalization for Non-Medical Reasons). Iryo Keizai Kenkyu (Journal of Health Economics and Policy). Tokyo.

4 Activities of daily living are defined as basic self-care tasks such as eating; toileting, or actions associated with personal hygiene; bathing; and transferring or the ability to sit, stand, and walk independently.

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integration of health and elderly care will provide seamless care services across the two sectors based on needs, and avoid using medical resources for the elderly care service provision.5 5. Enhanced private sector involvement is vital to fill the gap in supplying coordinated elderly care and health care services. Quantity of private providers varies greatly across localities, and no scheme has been established to ensure their quality. Considering substantial increase in care needs due to rapid aging of the population, it would not be realistic for the public sector to be the main provider of care services. Meanwhile, the public sector needs to take responsibility for establishing standardized care needs assessment and service quality monitoring systems. The private sector could bring its knowledge and experience to better design facilities, engage skilled staff, and provide efficient services under the guidelines and regulations set by the public sector. Such alignment of responsibilities is not yet clearly established in the PRC elderly care sector. 6. The Government of the PRC has recognized the importance of integrated elderly care and health care services to respond to its rapidly aging population, and issued a related policy in 2015.6 In line with the central policy, the Government of Guangxi Zhuang Autonomous Region GZAR (GGZAR) in 2016 issued policies on the implementation of elderly care and health care integration, and for enhancing the involvement of the private sector in care service provision for elderly people.7 While the GGZAR issued those policies, it has limited experience and capacity in promoting the integration of elderly care and health care, and private sector involvement in the coordinated care provision.

7. In order to build this institutional capacity and system, the municipalities of Nanning and Hezhou were selected as pilot cities for elderly care and health care integration in 2017.8 In the same year, people aged 65 years and above were 0.8 million and 0.2 million in Nanning and Hezhou municipalities which account for 11.4% and 10.1 % of the population, respectively. More than 85% of those elderly people have at least one chronic disease and about 60% have multimorbidity. The integration of elderly care and health care is necessary to provide needed care services for those elderly people. However, most elderly patients directly return home after discharge from tertiary level hospitals. A functional coordination system is not established between hospitals and elderly care facilities in those municipalities. The inter-sectoral coordination among bureaus, such as the civil affairs bureaus and the health commission, needs to be established. 8. In 2014, the Asian Development Bank (ADB) began to support the PRC’s local governments in promoting elderly care service development, including support to develop a public–private partnership (PPP) model in the elderly care sector. Lessons from those initial experiences suggested a strong need for strengthening the governments’ knowledge and capacities in elderly care and PPP. 9 ADB has extended its support for the central government to

5 The PRC’s social security system includes medical insurance, which helps finance medical care services. The PRC

has not yet established a long-term care insurance system. Most local governments provide some capital and operational subsidies for elderly care institutions.

6 Government of the PRC, State Council. 2015. Notice [84] on the Integration of Elderly Care and Health Care. Beijing. 7 GGZAR. 2016. Opinion [82] on Implementation of Elderly Care and Health Care Integration Promotion. Nanning; and

GGZAR, Department of Civil Affairs. 2016. Promote Involvement of Private Sector in the Elderly Care Sector. Nanning.

8 Hezhou Municipal People’s Government. 2017. Notice [90] on Pilot of Promoting Elderly Care and Health Care in Hezhou City. Hezhou; and People’s Government of Nanning Municipality. 2017. Notice [235] on Implementation of Elderly Care and Health Care Integration Promotion. Nanning.

9 ADB. People’s Republic of China: Strategic Elderly Care Services Development in Yichang; ADB. People’s Republic of China: Development of Geriatric Nursing Policy Principles and Training Program in Liaoning Province; ADB. People’s Republic of China: Public–Private Partnerships Demonstration Program to Transform Delivery of Elderly

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establish an overall policy framework for the PRC’s elderly care system. 10 Previous ADB interventions focused on the three-tiered elderly care system and indicated that coordination of health care and elderly care services is a challenge in the PRC, which requires urgent policy action. Building on ADB’s experiences and knowledge in the elderly care sector, the project will further support GZAR to achieve its policy target of elderly care and health care integration to better adapt to the needs of its aging population (footnote 7). 9. The project also supports Healthy China 2030, highlighting the optimization of health services as a critical development challenge in the PRC.11 It is in line with ADB’s (i) country partnership strategy for the PRC, 2016–2020, focusing on inclusive growth; (ii) Operational Plan for Health, 2015–2020, which has elderly care as a focus area; and (iii) Strategy 2030, as it (a) demonstrates the “One ADB” approach with the Office of Public–Private Partnership’s support for catalyzing investments through PPP and delivering integrated solutions, and (b) supports operational priorities 1 (addressing remaining poverty and reducing inequality) and 2 (accelerating progress in gender equality).12 The project addresses issues of upper middle-income countries, as in ADB’s Strategy 2030, through strengthening institutions, developing a demonstrative project, expanding PPPs, and responding to critical social issues, i.e., the aging population. The project’s demonstrative and innovative experiences in the areas of elderly care and PPP will have an essential knowledge transfer impact not only on other provinces in the PRC but also on other developing member countries facing challenges regarding their aging populations.

B. Impact and Outcome

10. The project is aligned with the following impact: integrated elderly care and health care services in GZAR established (footnote 7). The project will have the following outcome: utilization of coordinated health care and elderly care services in GZAR increased.13 C. Outputs

11. Output 1: Coordinated care services and facilities improved. This output will include strengthening the coordination between elderly care and health care services provision by (i) improving the hospital discharge management systems in the target hospitals (project implementing entities [PIEs]); 14 (ii) building four elderly care facilities in the municipalities of Hezhou and Nanning and a medical facility in Nanning, with age-friendly design and gender-sensitive facility use; (iii) establishing elderly care institutions to operate the elderly care facilities; 15 (iv) strengthening the capacity of PIEs to provide rehabilitation (physical and occupational therapy) appropriately; (v) strengthening the capacity of PIE-operated elderly care

Care Services in Yichang, Hubei; ADB. People’s Republic of China: Hebei Elderly Care Development Project; and ADB. People’s Republic of China: Hubei Yichang Comprehensive Elderly Care Demonstration Project.

10 ADB. People’s Republic of China: Policy and Capacity Development for Elderly Care. 11 Government of the PRC, State Council. 2016. The Healthy China 2030. Beijing. 12 ADB. 2016. Country Partnership Strategy: People's Republic of China, 2016–2020—Transforming Partnership:

People's Republic of China and Asian Development Bank. Manila; ADB. 2015. Health in Asia and the Pacific: Operational Plan for Health, 2015–2020. Manila; and ADB. 2018. Strategy 2030: Achieving a Prosperous, Inclusive, Resilient, and Sustainable Asia and the Pacific. Manila.

13 The design and monitoring framework is in Section IX. 14 The PIEs are (i) Nanning Traditional Chinese Medicine Hospital, (ii) Hezhou People’s Hospital, (iii) Guangxi Guidong

Hospital (GGH), and (iv) Nanning Social Welfare Institute (NSWI). The first three PIEs are public hospitals while NSWI is a public entity, providing long-term care.

15 Details of elderly care institutions are described in paragraph 14 of this PAM. Nanning social Welfare Institute will continue to operate its expanded facility.

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institutions to adequately provide care services, such as care for activities of daily living, dementia care, and terminal care; and (vi) developing a capacity-building plan for PIEs to strengthen their capacity to ensure proper and sustainable provision of care services. 12. Output 2: Public–private partnership project for integrated elderly care and health care services provision developed. The output will help build and operate an elderly care facility in Hezhou municipality under a PPP modality (the Hezhou PPP subproject). It will include: (i) an implementation arrangement for the construction, operation, and maintenance of an elderly care institution through a PPP model which will be set up; and (ii) an elderly care institution using a PPP model which will be created.16 The PPP structure will define a risk allocation between the public and private sectors based on internationally accepted PPP norms and principles for bankability and sustainability in PPP implementation.17 The elderly care facility operation will also be coordinated with the health care services provided by the PIE. 13. Output 3: Management and policy development capacities in promoting integrated elderly care and health care services developed. This will (i) support the executing agency, implementing agencies, and PIEs in implementing the project; and (ii) ensure that the elderly care-related functions, facilities, and services to be delivered under each elderly care institution is technically appropriate. It will support domestic and international study visits of local governments, including female officials and staff, to strengthen their knowledge on elderly care development, integrated elderly and health care, rehabilitation, and dementia care. Through its Office of Public–Private Partnership, ADB will assist the GGZAR in structuring the Hezhou PPP subproject; and implementing the development, financing, and tendering of the Hezhou PPP subproject.

Table 1: List of Facilities Facility

No. Municipality Project Implementing

Entities Location Institution/Facility 1

Nanning

Nanning Social Welfare Institute

No. 16 Xinjiangbei, No.3 Road, Nanning City

Social welfare institute

2

Nanning Nanning Traditional Chinese Medicine Hospital

No. 3, Shizhuling, No. 2 Road, Nanning City

Elderly care institution (not a nursing home)

3

Medical facility

4 Hezhou Hezhou People’s Hospital

Chengdong District, Hezhou City (within future Chengdong subsidiary)

Elderly care institution (not a nursing home)

5 Jiangnan East District, Hezhou City

Elderly care institution (not a nursing home)

6 Hezhou

Guangxi Guidong Hospital

Hezhou Ecological Industrial Park, Hezhou City

Elderly care institution (not a nursing home), to be developed through public–private partnership

Source: Asian Development Bank. 14. Elderly care institution. An elderly care institution means an elderly care organization that satisfies applicable laws and regulations to operate one or more elderly care facilities in the respective municipalities and has functionalities, provides services, and meets the standards. Considering rapid changes in the elderly care-related regulatory conditions in the PRC, with the project consultants’ support, GPMO, the implementing agencies, PIEs and ADB will reassess the 16 The operating period of the concession could be about 10–15 years. The PPP structure could also be design–build–

finance–operate, depending on the private sector’s appetite. 17 The private sector includes nonprofit and for-profit organizations and enterprises.

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applicable laws and regulations, prior to the commencement of operation of each elderly care facility which will be created under the project. Each elderly care facility should be operated by an organization which satisfies the applicable laws and regulations upon the time of operation. The basic functionalities and services targeted by each of the elderly care institutions in Table 1 are summarized in Table 2. Considering rapid changes in the demographic structure in each locality and operational conditions of elderly care services, with the project consultants’ support, GPMO, the implementing agencies, PIEs and ADB will also reassess the target care services, target elderly people, and needed staffing, indicated in Table 2, prior to the commencement of operation of each elderly care facility to well reflect the actual needs upon the time of operation. 15. Summary of public–private partnership subproject. Output 2 will deliver, (i) an implementation arrangement for the construction, operation, and maintenance of an elderly care institution through a PPP model will be set up, and (ii) an elderly care institution using a PPP model will be created. An elderly care facility of the elderly care institution will be designed, constructed, operated and maintained by a private partner (i.e., the concessionaire) (footnote18). The private partner will be procured through a PPP model, likely using the design-build-operate contract.18 The payment for the PPP concessionaire will be likely made based on the availability of the facility and the provision of services that meets the minimum performance service standards or key performance indicators. During the PPP implementation period, the HMG and Guangxi Guidong Hospital (GGH) will monitor the performance of the PPP concessionaire. Through a PPP expert engaged under the project, the output will (iii) support HMG and GGH to set up an institutional arrangement to properly monitor the PPP concessionaire’s performance; (iv) help HMG and GGH conduct the performance monitoring and verification during the project implementation period; and (v) provide training on the performance monitoring and verification to the relevant staff of HMG and GGH, including both overall guidance and on-the-job training (OJT). Upon the completion of the project, HMG and GGH will take full responsibility to monitor and verify the concessionaire’s performance under the PPP agreement. OPPP’s involvement in the implementation of the financing and structuring PPP component is expected to enhance the private sector’s involvement in the elderly care service provision by successfully tendering the concession to a private partner (footnote 18) that would undertake the design, build, finance, and operations and maintenance of the Hezhou PPP subproject. 16. ADB, through OPPP, will also assist GGZAR in (i) structuring the Hezhou PPP subproject and (ii) implementing the development, financing, and tendering of the Hezhou PPP subproject (collectively known as the “financing and structuring PPP component”). The financing and structuring PPP component to be implemented by OPPP will include the following functions and activities: (i) preparation of PPP pre-feasibility study, PPP options and business case analyses; (ii) development of a bankable transaction structure; and (iii) assistance with drafting and negotiating tender documents, concession agreement, and other project-related.19

17. To deliver the assist in structuring the PPP subproject (para. 16), OPPP will set up a PPP advisory team, comprising PPP specialists of OPPP and a team of external experts, who will provide technical, domestic PPP and legal expertise. The PPP specialist of OPPP will lead the team and be responsible for the financing and structuring PPP component. The team of external experts will comprise: (i) elderly care technical expert; (ii) domestic PPP expert; (iii) PPP project manager; and (iv) financial modelling specialist. The scope of works for the external experts will broadly include: (a) support conducting of due diligence and project preparation, encompassing;

18 The operating period of the concession could be about 10-15 years. 19 ADB and GGZAR will agree to the scope of the Financing and Structuring PPP Component and reflect the terms and

conditions for the implementation of that component in the project agreement.

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(b) assistance in the preparation of bid documents; and (c) assistance in the conduct and management of the tender process, including assistance in bid evaluation and contract negotiations. In addition, OPPP, though Office of the General Counsel (OGC) will also procure international and legal experts to conduct a legal due diligence, assist in preparation of bid documents including the relevant contracts, and assist in bid evaluation and contract negotiations.

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Table 2: Summary of Subprojectsa

Project Implementing Entity

Estimated Scale and Facilities Planned Target Elderly Planned Target Care Services

Staffing (for 750 estimated beds)

Capacity Development

Nanning Social Welfare Institute

500 beds (750 in total including own expansion) 9F+7F+3F Underground 2F 19,760.42+B10,376.54= 30,136.96 m2 (building area)

• Target elderly: those who could not go back home and will stay in the facility until the end of life

• 50%–70%: full-disabled

• About 60 beds: Dementia elderly

• Long-term care (including care for activities for daily living)

• Dementia care • Rehabilitation (non-intensive rehabilitation) • Terminal care (counseling and pain

management) • Counseling (for families and elderly to

adapt to becoming resident of the facility, while retaining family relationships with the resident elderly)

• Training on caregivers (from other institutions)

Doctor Nurse (including team leaders) Caregivers Therapist Nutritionist Social workers

25 60 200 10 3 10

• Rehabilitation (rehabilitation care and support for procurement)

• Dementia care • Terminal care • Counseling • Trainers’ training

Nanning Traditional Chinese Medicine Hospital (NTCMH)

Medical facility (Component 1) 150 beds 13F 12,731 m2 (building area) Elderly care institution (Component 2) 200 beds 7F + Underground 2F 9,277+B7,592=16,869 m2 (building area)

• Target elderly: those

who could not go back home and will stay in the facility until the end of life

• 30%: full-disabled

• Long-term care (including care for activities

for daily living) • Rehabilitation (non-intensive rehabilitation) • Terminal care (counseling and pain

management) • Activities/recreation (to retain remaining

physical and cognitive capability and for quality of life)

Doctor Nurse (including 4 team leaders) Caregivers Therapist Nutritionist Social workers

1 12 47 3 1 2

• Discharge management

• Rehabilitation (intensive and non-intensive rehabilitation for NTCMH staff and elderly care staff)

• Terminal care • On-the-job

training for caregivers

Hezhou People’s Hospital (HPH) (site 1)

400 beds 12F + Underground 2F 18,903.06+B3,560.66 = 22,463.72 m2 (building area)

• Target elderly: those who could not go back home and will stay in the facility until the end of life

• 30%: full-disabled • 40 beds for elderly with

dementia (one floor for dementia)

• Long-term care (including care for activities for daily living)

• Rehabilitation (intensive and non-intensive rehabilitation)

• Dementia • Terminal care (counseling and pain

management) • Activities/recreation (to retain remaining

physical and cognitive capability and for quality of life)

Doctor Nurse (including 7 team leaders) Caregivers Therapist Nutritionist Social workers

3–4 25 95 6 2 4

• Discharge management

• Rehabilitation (intensive and non-intensive rehabilitation for HPH staff and elderly care staff)

• Dementia • On-the-job

training for caregivers

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Project Implementing Entity

Estimated Scale and Facilities Planned Target Elderly Planned Target Care Services

Staffing (for 750 estimated beds)

Capacity Development

• Support to design the activities/ recreation programs

Hezhou People’s Hospital (HPH) (site 2)

400 beds 3F+6F+Underground 1F 19,188.30+B5,914.08= 25,102.38 m2 (building area)

• Target elderly: semi-disabled

• Dementia (one floor with 52 beds)

• Light physical needs (independent) with high social needs 5%

• Long-term care (including care for activities for daily living)

• Rehabilitation (intensive and non-intensive rehabilitation)

• Dementia • Activities/recreation (to retain remaining

physical and cognitive capability and for quality of life)

Doctor Nurse (including 7 team leaders) Caregivers Therapist Nutritionist Social workers

1–2 32 88 6 2 4

• Discharge management

• Rehabilitation (intensive and non-intensive rehabilitation for HPH staff and elderly care staff)

• Dementia • On-the-job

training for caregivers

• Support to design the activities/ recreation programs

Guangxi Guidong Hospital (GGH)b

450 beds 9F+7F+Underground 1F 22,096.76+B7,200 = 29,296.76 m2 (building area)

• Target elderly: semi-disabled 20%

• Full-disabled 70% • Dementia 5% (one

floor) • Light physical needs

with high social needs 5%

• Long-term care (including care for activities for daily living)

• Rehabilitation (intensive and non-intensive rehabilitation)

• Dementia • Terminal care • Activities/recreation (to retain remaining

physical and cognitive capability and for quality of life)

Doctor Nurse (including team leaders) Caregivers Therapist Nutritionist Social workers

1–2 19 128 4 2 4

• Discharge management for GGH and the new hospital

• Rehabilitation (intensive and non-intensive rehabilitation) for GGH and the new hospital

• Terminal care a Target elderly people, target care services, and needed staffing will be reassessed before each elderly care institution will begin its operation, to consider the actual needs.

Capacity development will be provided under the project to the relevant staff of the respective PIEs and/or each elderly care institution which will be created under the project. b This is the public–private partnership (PPP) subproject. The PPP concessionaire would design, build, and operate the facility as an elderly care institution. Therefore, details of

the facility and target elderly and target care services will be further assessed and specified under the financing and structuring of the PPP subproject. The capacity development under this subproject will be provided to Guangxi Guidong Hospital.

Source: Asian Development Bank.

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II. IMPLEMENTATION PLANS

B. Project Readiness Activities

Table 3: Project Readiness Activities

Indicative Activities 2019 2020 Responsible Individual/

Unit/Agency/Government 5 6 7 8 9 10 11 12 1 2 3

Establish project implementation arrangements GPMO, implementing agencies, and PIEs

Advance contracting actions (hiring of procurement agency and project implementation support firm)

GPMO, implementing agencies, and PIEs

SRM ADB

FSR approval GDRC

FCUP submission GDRC

FCUP approval NDRC

Loan negotiations ADB, MOF, and GGZAR

ADB Board approval ADB

Loan signing ADB, MOF, and GGZAR

Government legal opinion provided MOF, MOFA, and GGZAR

Loan effectiveness ADB and MOF

ADB = Asian Development Bank, FCUP = foreign capital utilization plan, FSR = feasibility study report, GDRC = Guangxi Development and Reform Commission, GGZAR = Government of Guangxi Zhuang Autonomous Region, GPMO = Guangxi project management office, MOF = Ministry of Finance, MOFA = Ministry of Foreign Affairs, NDRC = National Development and Reform Commission, PIE = project implementing entity, SRM = staff review meeting. Source: ADB.

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C. Overall Project Implementation Plan

Table 4: Implementation Plan

Indicative Activities 2019 2020 2021 2022 2023 2024 2025 2026 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2

A. Design and monitoring framework Output 1: Coordinated care services and facilities improved Nanning Municipality: Nanning Social Welfare Institute (demolition and expansion for residential care) Detailed design Bidding process Building works and outfitting Capacity building plan Occupational and physical therapy training

Training of elderly care related staff

Nanning Municipality: Nanning Traditional Chinese Medicine Hospital (construction of an elderly care facility) Detailed design Bidding process Building works and outfitting Discharge management reform Capacity building plan Occupational and physical therapy training

Training of elderly care related staff

Nanning Municipality: Nanning Traditional Chinese Medicine Hospital (construction of a medical facility) Detailed design Bidding process Building works and outfitting Discharge management reform Capacity building plan Occupational and physical therapy training

Training of elderly care related staff

Hezhou Municipality: Hezhou People’s Hospital (site 1: construction of an elderly care facility) Detailed design Bidding process Building works and outfitting Discharge management reform Capacity building plan

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Indicative Activities 2019 2020 2021 2022 2023 2024 2025 2026 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2

Occupational and physical therapy training

Training of elderly care related staff

Hezhou Municipality: Hezhou People’s Hospital (site 2: construction of an elderly care facility) Detailed design Procurement Building works and outfitting Discharge management reform Capacity building plan Occupational and physical therapy training

Training of elderly care related staff

Output 2: Public–private partnership (PPP) project for integrated elderly care and health care services provision developed Hezhou Municipality: Guangxi Guidong Hospital (Indicative plan to be confirmed upon award of the PPP subproject) Launch tender Construction Operate elderly care facility Output 3: Management and policy development capacities in promoting integrated elderly care and health care services developed Incorporate and finalize designs for elderly care facilities

Prepare and implement PPP model for Hezhou subproject

Identify a feasible PPP modality for integrated elderly care and health care services provision

Finance and structure a PPP model for Hezhou PPP subproject

Support PPP implementation Provide elderly care technical

support

Provide training on elderly care services support

Provide training on care and rehabilitation

Provide training on discharge management

Prepare and conduct domestic and international trainings

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Indicative Activities 2019 2020 2021 2022 2023 2024 2025 2026 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2

Finalize training agenda Complete domestic and international training

B. Management activities Selection of project implementation consultants completed

Engage construction supervision Annual/midterm review Loan closing procedures

Source: Asian Development Bank.

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III. PROJECT MANAGEMENT ARRANGEMENTS

A. Project Implementation Organizations: Roles and Responsibilities

18. The GGZAR through Guangxi project management office (GPMO) is the executing agency. It is responsible for overall planning and implementation of the project, and has substantial experience in the preparation, implementation, and management of projects funded by ADB. The project leading group, chaired by the vice governor of GGZAR, has also been set up to facilitate the cross-sectoral coordination. 19. Nanning Municipal Government (NMG) and HMG are the implementing agencies and are responsible to oversee the implementation for the subprojects in their respective municipalities. 20. The project covers six facilities: three are located in Nanning and the other three are in Hezhou. One of the six facilities, the Hezhou PPP subproject, will be pursued under a PPP modality. The following four PIEs will be responsible for respective facilities: (i) Nanning Social Welfare Institute (NSWI), (ii) Nanning Traditional Chinese Medicine Hospital (NTCMH), (iii) Hezhou People’s Hospital (HPH), and (iv) GGH. The NTCMH will be responsible for an elderly care facility and a medical facility. HPH will be responsible for two project sites while all other for one. The first three PIEs (NSWI, NTCMH, HPH) will be responsible for day-to-day project administration of their subprojects. GGH will be responsible for the implementation of the Hezhou PPP subproject, following the PPP concession agreement. Each PIE will manage their own financial accounts; and retain all project-related documents and statements of respective subprojects for project administration, auditing, and evaluation. 21. Project management roles and responsibilities of the key agencies involved in the project are summarized in Table 5. The project organization diagram is in Figure 1.

Table 5: Project Implementation and Roles and Responsibilities Project Implementation Organizations Management Roles and Responsibilities Guangxi project leading group (GPLG)

The GPLG, led by the vice governor of Guangxi Zhuang Autonomous Region (GZAR), includes high-level officials from Guangxi Development and Reform Commission, Guangxi Department of Finance (GDOF), Guangxi Health Commission, Guangxi Department of Civil Affairs, and other key stakeholders, including the vice mayors of Nanning and Hezhou municipalities. (i) Provide strategic and policy guidance. (ii) Facilitate interagency coordination and cooperation, and support cross-

agency policy dialogue to ensure smooth and successful project implementation and coordination across departments, bureaus, and agencies to attain elderly and health care integration.

Executing agency: Government of GZAR (GGZAR)

(i) Supervise implementing agency activities and provide guidance and support, as needed.

(ii) Coordinate project preparation and implementation activities, including financial and procurement planning.

(iii) Supervise the grievance redress mechanism (GRM) at the implementing agency level during construction and operations.

(iv) Recruit and sign contracts for the procurement agency and Asian Development Bank (ADB)-financed consulting services.

(v) Oversee project procurement. (vi) Monitor and report project progress and performance, including

environment, resettlement, and social and gender safeguards and action plans to ADB.

14

Project Implementation Organizations Management Roles and Responsibilities

(vii) Ensure the project financial statements are audited in accordance with International Standards on Auditing, by an independent auditor acceptable to ADB based on the terms of reference acceptable to ADB.

(viii) Prepare and submit reports on project activities as required. (ix) Coordinate project evaluation and dissemination activities. (x) Engage external safeguards monitoring experts to ensure compliance with

environmental management plan (EMP) and resettlement plan. (xi) With project technical consultants, implement relevant capacity building

activities for the related staff and officials. (xii) Communicate and coordinate with ADB.

Guangxi Department of Finance (GDOF)

(i) Open and manage the project advance account, and liquidate and replenish advances made.

(ii) Keep financial records. (iii) Make loan proceeds available for use of GPMO and implementing

agencies and manage the loan disbursement process. (iv) Oversee project financial management. (v) Consolidate and submit withdrawal applications to ADB. (vi) Process repayment of ADB loan. (vii) Liaise with the Ministry of Finance.

Nanning and Hezhou municipal finance bureaus

(i) Manage the project account. (ii) Keep financial records. (iii) Make loan proceeds available for use by municipal project implementing

entity (PIEs), as set forth in the loan and project agreements and in accordance with agreed procedures.

(iv) Create separate budgets for monitoring environment and involuntary resettlement safeguards implementation, GRM, and fund remedial measures required as per EMP and resettlement plan.

(v) Oversee project financial management and provide financial management support to municipal project management office (PMOs) and PIEs.

Implementing agencies: Nanning Municipal Government (NMG) through Nanning PMO Hezhou Municipal Government (HMG) through Hezhou PMO

(i) Oversee the implementation of each subproject within its jurisdiction. (ii) Facilitate audit of project account. (iii) Facilitate interagency coordination and cooperation at municipal level. (iv) Review, consolidate, and submit withdrawal applications to GPMO and

GDOF. (v) Supervise the GRM implementation and remedial measures as per EMP

and resettlement plan at PIE level. (vi) Monitor and report project progress and performance, including

environmental, resettlement, and social and gender safeguards action plans.

(vii) Maintain the project financial accounts. (viii) Prepare and submit reports on project activities, as required. (ix) Coordinate project evaluation and dissemination activities. (x) With project technical consultants, implement relevant capacity building

activities for the related staff and officials. Project implementing entities: Nanning Social Welfare Institute (NSWI) Nanning Traditional Chinese Medicine Hospital (NTCMH)

(i) Manage specific project bank account to channel for reimbursement and counterpart funding.

(ii) Receive and utilize ADB loan proceeds to finance project investments under arrangements established by the municipal finance bureau.

(iii) Timely provide necessary counterpart funding. (iv) Maintain project financial accounts and related financial statements. (v) Prepare withdrawal applications for submission to respective municipal

finance bureau and municipal PMOs.

15

Project Implementation Organizations Management Roles and Responsibilities Hezhou People’s Hospital (HPH) Guangxi Guidong Hospital (GGH)

(vi) With project technical consultants, implement capacity building activities for the relevant staff of PIEs and/or the relevant staff of elderly care institutions which will be created under the project.

(vii) Ensure quality in project activities necessary to meet objectives. (viii) Create separate budgets for environment and involuntary resettlement

safeguards monitoring, grievance redress, and fund remedial measures as required in the EMP and for compensation and assistance payments as required in the resettlement plan.

(ix) Report project progress and performance, including environmental, resettlement, and social and gender safeguards action plans, and take action, as needed, to implement relevant plans.

For subprojects of NSWI, NTCMH, and HPH (x) Day-to-day administration and implementation of each subproject. (xi) Procure and sign contracts for works and goods (with support of

procurement agent). (xii) Review the implementation of EMP by the contractors and ensure

compliance, conduct public consultations, and redress grievance during construction and operations.

(xiii) Review the resettlement plan implementation including timely payment of compensation to the affected persons by HPH and ensure consistency with resettlement plan provisions, conduct consultations with affected persons, and ensure functioning of GRM.

For subproject of GGH: Hezhou public–private partnership subproject (xiv) Provide support in financing and structuring the public–private partnership

(PPP) subproject, with HMG, procure a PPP concessionaire and sign a PPP concession agreement based on a design-build-operate contract.

(xv) Under the PPP concession agreement, monitor administration and implementation of the PPP subproject by the PPP concessionaire.

(xvi) Review the implementation of EMP and resettlement plan by the PPP concessionaire and ensure compliance, conduct public consultations, and redress grievance during construction and operations.

ADB (i) Monitor compliance with loan covenants including safeguards requirements.

(ii) Conduct periodic loan, midterm, and project completion review missions. (iii) Disburse the loan in accordance with agreed procedures upon receipt of

duly authorized withdrawal applications and necessary supporting documentation.

(iv) Provide guidance to GPMO, implementing agencies, and PIEs to help resolve any implementation issues that arise.

(v) Review project progress reports and monitor implementation of resettlement plans, EMP, social development and gender action plan, and other key project activities.

(vi) As PPP implementing organization of the financing and structuring PPP component, (a) conduct financial and legal due diligence; (b) prepare project; (c) develop PPP transaction structure; (d) prepare necessary documents to meet People’s Republic of China’s

domestic PPP procedures and requirements; (e) prepare tendering documents; and (f) manage tendering process.

Source: Asian Development Bank.

16

B. Key Persons Involved in Implementation

Executing Agency Government of Guangxi Zhuang Autonomous Region

Yan Yan Director, Guangxi Project Management Office Telephone No.: +86 771 232 8850 Email address: gxecpmo2018@gxi.gov.cn;

449768496@qq.com Office Address: No. 111-1 Minzu Avenue, Nanning, Guangxi Zhuang Autonomous Region (GZAR), People’s Republic of China (PRC)

Implementing Agencies Nanning Municipal Government Gan Xianghe

Deputy Secretary of Party Committee, Nanning Civil Affairs Bureau Telephone No.: +86 771 550 5961 Email address: xmz5521613@163.com Office Address: No. 38 Jinzhou Road, Nanning, GZAR, PRC

Hezhou Municipal Government Li Hui

Member of the Party Group and Director, Hezhou Major Projects Construction Service Center Telephone No.: +86 188 7849 878 Email address: hzsfgwxmb@163.com Office Address No. 221 Jiangbei Road Middle, Babu District, Hezhou, GZAR, PRC

Project Implementing Entities Nanning Social Welfare Institute Chen Jihong

Vice President, Nanning Social Welfare Institute Telephone No.: +86 771 553 6920; +86 136 1771 2658 Email address: xmz5521613@163.com Office Address: No. 38 Jinzhou Road, Nanning, GZAR, PRC

Nanning Traditional Chinese Medicine Hospital

Chen Yuan Vice President, Nanning Traditional Chinese Medicine Hospital Telephone No.: +86 181 0771 3118 Email address: 2503852815@qq.com Office Address: No. 45 Beihu Road North, Nanning, GZAR, PRC

Hezhou People’s Hospital Xie Ruibin

Vice President, Hezhou People’s Hospital Telephone No.: +86 133 8774 5350 Email address: hzsrmyy5282358@sina.com

17

Office Address: No. 150 Xiyue Street, Babu District, Hezhou, GZAR, PRC

Cheng Wendong

Guangxi Guidong Hospital Vice President, Guangxi Guidong Hospital Telephone No.: +86 138 0774 0082 Email address: gxgdyy@163.com Office Address: No.1 Jinjichong, 4 Xijiang Road, Wuzhou, GZAR, PRC

Asian Development Bank

Urban and Social Sectors Division, East Asia Department

Sangay Penjor Director, EASS Telephone No.: +63 632 6148 Email address: spenjor@adb.org

Mission Leader Hiroko Uchimura-Shiroishi Senior Social Sector Specialist, EASS Telephone No.: +63 632 6996 Email address: huchimura@adb.org

18

C. Project Organization Structure

Figure 1: Project Organization Structure

EA = executing agency, IA = implementing agency, PIE = project implementing entity. Source: Asian Development Bank.

19

IV. COSTS AND FINANCING

22. The PRC Government has requested a regular loan of $100 million from ADB’s ordinary capital resources to help finance the project. The loan will have a 25-year term, including a grace period of 6 years; an annual interest rate determined in accordance with ADB’s London interbank offered rate (LIBOR)-based lending facility; a commitment charge of 0.15% per year (the interest and other charges during construction will not be capitalized in the loan) and such other terms and conditions set forth in the draft loan and project agreements. Based on the straight-line method, the average maturity is 15.75 years, and the maturity premium payable to ADB is 0.10% per year. The PRC is the borrower of the loan and will make the loan available to the GGZAR on the same terms and conditions as those of the ADB loan. GGZAR will make the loan proceeds available, through the implementing agencies, to the PIEs. A. Cost Estimates Preparation and Revisions

23. Preparation. The cost estimates were prepared jointly by GPMO, NMG, HMG, PIEs, and ADB. The sources and bases for cost estimates were reviewed during project preparation and had been confirmed by related parties. 24. Revisions. Revision of the cost estimates will be conducted when deemed necessary during implementation. The GGZAR, through GPMO, will be responsible in proposing and drafting the revision which will be subject to ADB’s approval. B. Key Assumptions

25. The following key assumptions underpin the cost estimates and financing plan:

(i) Exchange rate: CNY 6.71 = $1.00 (April 2019). (ii) Price contingencies based on expected cumulative inflation over the

implementation period are as follows:

Table 6: Escalation Rates for Price Contingency Calculation Item 2019 2020 2021 2022 2023 Average Foreign rate of price inflation 1.5% 1.5% 1.6% 1.6% 1.6% 1.6% Domestic rate of price inflation 2.2% 1.8% 2.0% 2.0% 2.0% 2.0% Source: Asian Development Bank.

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C. Detailed Cost Estimates by Expenditure Category

Table 7: Detailed Cost Estimates by Expenditure Category

CNY million $ million

Item Foreign

Exchange Local

Currency Total Cost

Foreign Exchange

Local Currency

Total Cost

% of Total Base Cost

A. Investment Costs 1. Works 0.00 473.66 473.66 0.00 70.59 70.59 44.08% 2. Goods 1.08 129.27 130.35 0.16 19.27 19.43 12.13% 3. Public–private partnership 13.69 225.95 239.65 2.04 33.67 35.71 22.30% 4. Land acquisition and resettlement 0.00 48.10 48.10 0.00 7.17 7.17 4.48% 5. Project management 26.55 35.03 61.57 3.96 5.22 9.18 5.73% 6. Capacity development 17.41 17.41 34.82 2.59 2.59 5.19 3.24% 7. Financing and structuring cost 6.71 0.00 6.71 1.00 0.00 1.00 0.62%

Subtotal (A) 65.44 929.42 994.86 9.75 138.51 148.26 92.58% B. Taxes and Duties 0.00 79.74 79.74 0.00 11.88 11.88 7.42%

Total Base Cost (A+B) 65.44 1,009.16 1,074.59 9.75 150.40 160.14 100.00% C. Contingencies

1. Physical 4.99 80.44 85.43 0.74 11.99 12.73 7.95% 2. Price 4.17 67.42 71.58 0.62 10.05 10.67 6.66%

Subtotal (C) 9.15 147.86 157.01 1.36 22.04 23.40 14.61% D. Financial Charges During Implementation 0.00 66.95 66.95 0.00 9.98 9.98 6.23%

Total Project Cost (A+B+C+D) 74.59 1,223.96 1,298.55 11.12 182.41 193.52 120.84% Note: Numbers may not sum precisely due to rounding. Source: Asian Development Bank estimates.

21

D. Allocation and Withdrawal of Loan Proceeds

Table 8: Allocation and Withdrawal of Loan Proceedsa

No. Category Total Amount Allocated for Asian Development Bank Financing ($)

Percentage and Basis for Withdrawal from the Loan Account

1 Works, goods, services, and capacity buildingb 100,000,000 Up to100% of total expenditures claimed

Total 100,000,000 a Detailed categories and disbursement percentages to be used during disbursement are in Table 9. b Includes financing for a public–private partnership subproject, and the financing and structuring cost which is intended to cover the costs and expenses to ADB for

implementing the financing and structuring component under the project agreement. Source: Asian Development Bank.

Table 9: Detailed Allocation and Withdrawal of Loan Proceeds

Item

Total Amount Allocated for Asian Development Bank

Financing ($) Percentage and Basis for Withdrawal from the

Loan Account

1 Works 64,730,000 1.1 Nanning Social Welfare Institute (SWI-CW1) 14,946,000 91.5% of total expenditures claimed 1.2 Nanning Traditional Chinese Medicine Hospital Elderly Care (CTM1-CW1)

7,891,000 91.2% of total expenditures claimed

1.3 Nanning Traditional Chinese Medicine Hospital Medical (CTM2-CW1)

8,661,000 93.7% of total expenditures claimed

1.4 Hezhou People’s Hospital site 1 (HZ1-CW1; HZ1-CW2) 15,487,000 94.1% of total expenditures claimed 1.5 Hezhou People’s Hospital site 2 (HZ2-CW1; HZ2-CW2) 17,745,000 94.7% of total expenditures claimed

2 Goods 9,840,000 100.0% of total expenditures claimed 3 Public–Private Partnership 18,930,000 50.0% of total expenditures claimed 4 Capacity Development 5,500,000 100.0% of total expenditures claimed 5 Financing and Structuring Costa 1,000,000 100.0% of total expenditures claimed

Total 100,000,000 a The financing and structuring cost is intended to cover the costs and expenses to ADB for implementing the financing and structuring component under the

Project Agreement. Source: Asian Development Bank.

22

E. Detailed Cost Estimates by Financier

Table 10: Detailed Cost Estimates by Financier ($ million)

ADB Government Total Cost Item Amount

Taxes and Duties Total

% of Cost Category Amount

Taxes and Duties Total

% of Cost Category

A. Investment Cost 1. Works 59.39 5.34 64.73 83.77% 11.51 1.01 12.54 16.23% 77.27 1.1 Nanning Social Welfare Institute With ADB support (SWI-CW1) 13.71 1.23 14.95 91.53% 1.27 0.11 1.38 8.47% 16.33 Government-financed 0.00 0.00 0.00 0.0% 4.04 0.36 4.40 100.00% 4.40 1.2 Nanning Traditional Chinese Medicine Elderly

Care With ADB support (CTM1-CW1) 7.24 0.65 7.89 91.23% 0.70 0.06 0.76 8.77% 8.65 Government-financed 0.00 0.00 0.00 0.0% 1.41 0.13 1.54 100.00% 1.54 1.3 Nanning Traditional Chinese Medicine Hospital With ADB support (CTM2-CW1) 7.95 0.72 8.66 93.72% 0.53 0.05 0.58 6.28% 9.24 Government-financed 0.00 0.00 0.00 0.0% 1.76 0.16 1.92 100.00% 1.92 1.4 Hezhou People's Hospital 1 With ADB support (HZ1-CW1; HZ1-CW2) 14.21 1.28 15.49 94.13% 0.89 0.08 0.97 5.87% 16.45 Government-financed 0.00 0.00 0.00 0.0% 0.00 0.00 0.00 0.00% 0.00 1.5 Hezhou People's Hospital 2 With ADB support (HZ2-CW1; HZ2-CW2) 16.28 1.47 17.75 94.66% 0.92 0.08 1.00 5.34% 18.75 Government-financed 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00% 0.00 2. Goods 8.72 1.13 9.85 44.86% 10.71 1.40 12.10 55.14% 21.95 2.1 Nanning Social Welfare Institute With ADB support (SWI-G1) 0.86 0.11 0.97 100.00% 0.00 0.00 0.00 0.00% 0.97 Government-financed 0.00 0.00 0.00 0.00% 1.18 0.15 1.34 100.00% 1.34 2.2 Nanning Traditional Chinese Medicine Elderly

Care With ADB support (CTM1-G1; CTM1-G2) 2.68 0.35 3.03 100.00% 0.00 0.00 0.00 0.00% 3.03 Government-financed 0.00 0.00 0.00 0.00% 0.75 0.10 0.85 100.00% 0.85 2.3 Nanning Traditional Chinese Medicine Hospital With ADB support (CTM2-G2) 2.29 0.30 2.58 100.00% 0.00 0.00 0.00 0.00% 2.58 Government-financed 0.00 0.00 0.00 0.00% 1.99 0.26 2.25 100.00% 2.25 2.4 Hezhou People's Hospital 1 With ADB support (HZ1-G1) 0.79 0.10 0.89 100.00% 0.00 0.00 0.00 0.00% 0.89 Government-financed 0.00 0.00 0.00 0.00% 3.98 0.52 4.50 100.00% 4.50 2.5 Hezhou People's Hospital 2 With ADB support (HZ2-G1) 2.10 0.27 2.37 100.00% 0.00 0.00 0.00 0.0.0% 2.37 Government-financed 0.00 0.00 0.00 0.00% 2.80 0.36 3.17 100.0% 3.17 3. Public–private partnership 17.86 1.07 18.93 50.00% 17.86 1.07 18.93 50.00% 37.86 4. Land acquisition and resettlement 0.00 0.00 0.00 0.00% 7.17 0.00 7.17 100.00% 7.17

23

ADB Government Total Cost Item Amount

Taxes and Duties Total

% of Cost Category Amount

Taxes and Duties Total

% of Cost Category

5. Project management 0.00 0.00 0.00 0.00% 9.18 0.55 9.73 100.00% 9.73 6. Capacity development 5.19 0.31 5.50 100.00% 0.00 0.00 0.00 0.00% 5.50 7. Financing and structuring cost 1.00 0.00 1.00 100.00% 0.00 0.00 0.00 0.00% 1.00

Total Base Cost (A) 92.15 7.86 100.00 62.55% 56.42 4.03 60.47 37.45% 160.48 B. Contingencies

1. Physical 0.00 0.00 0.00 0.00% 12.73 0.00 12.73 100.00% 12.73 2. Price 0.00 0.00 0.00 0.00% 10.67 0.00 10.67 100.00% 10.67

Subtotal (B) 0.00 0.00 0.00 0.00% 23.40 0.00 23.40 100.00% 23.40 C. Financial Charges During Implementation 0.00 0.00 0.00 0.00% 9.98 0.00 9.98 100.00% 9.98 Total Project Cost (A+B+C) 92.15 7.86 100.00 51.59% 89.80 4.03 93.85 48.41% 193.86 % of Total Project Cost 51.59% 48.41% 100.00% ADB = Asian Development Bank. Note: Numbers may not sum precisely due to rounding. Source: ADB estimates.

24

F. Detailed Cost Estimates by Outputs and/or Components

Table 11: Detailed Cost Estimates by Outputs ($ million)

Total Cost

Coordinated care services and facilities improved

Public–private partnership project for integrated elderly care and health care services

provision developed

Management and policy development capacities in

promoting integrated elderly care and health

care services developed

Item Amount % of Cost Category Amount

% of Cost Category Amount

% of Cost Category

A. Investment Cost 1. Works 70.59 70.59 100.0% 0.00 0.00% 0.00 0.00% 2. Goods 19.43 19.43 100.0% 0.00 0.00% 0.00 0.00% 3. Public–private partnership 35.71 0.00 0.0% 35.71 100.01% 0.00 0.00% 4. Land acquisition and

resettlement 7.17 7.17 100.0% 0.00 0.00%

0.00 0.00%

5. Project management 9.18 9.18 100.0% 0.00 0.00% 0.00 0.00% 6. Capacity development 5.19 0.00 0.0% 0.00 0.00% 5.19 100.00% 7. Financing and structuring cost 1.00 0.00 0.0% 0.00 0.00% 1.00 100.0.%

Subtotal (A) 148.26 106.36 71.74% 35.71 24.09% 6.19 4.17% B. Taxes and Duties 11.88 8.53 71.74% 2.86 24.09% 0.50 4.17%

Total Base Cost (A+B) 160.14 114.89 71.74% 38.58 24.09% 6.68 4.17% C. Contingencies

1. Physical 12.73 9.26 72.76% 3.03 23.79% 0.44 3.46% 2. Price 10.67 7.67 71.86% 2.64 24.72% 0.36 3.42%

Subtotal (C) 23.40 16.93 72.35% 5.67 24.21% 0.80 3.44% D. Financial Charges During

Implementation 9.98 7.77 77.92% 1.36 13.64% 0.84 8.44% Total Project Cost (A+B+C+D) 193.52 139.59 72.13% 45.60 23.57% 8.33 4.30% Note: Numbers may not sum precisely due to rounding. Source: Asian Development Bank estimates.

25

G. Detailed Cost Estimates by Year

Table 12: Detailed Cost Estimates by Year ($ million)

Item Total Cost 2020 2021 2022 2023 2024 2025 2026 A. Investment Cost

1. Works 70.59 0.00 3.23 10.34 18.06 23.50 15.45 0.00 2. Goods 19.43 0.00 0.00 0.00 0.67 7.69 11.07 0.00 3. Public–private partnership 35.71 0.00 0.00 0.00 0.00 13.49 22.23 0.00 4. Land acquisition and resettlement 7.17 0.00 3.30 3.87 0.00 0.00 0.00 0.00 5. Project management 9.18 0.00 1.51 1.82 2.65 2.01 1.18 0.00 6. Capacity development 5.19 0.00 0.49 1.28 1.27 1.03 1.12 0.00 7. Financing and structuring cost 1.00 0.00 1.00 0.00 0.00 0.00 0.00 0.00

Subtotal (A) 148.26 0.00 9.54 17.31 22.65 47.72 51.05 0.00 B. Taxes and Duties 11.88 0.00 0.76 1.39 1.82 3.82 4.09 0.00

Total Base Cost (A+B) 160.14 0.00 10.30 18.69 24.47 51.55 55.14 0.00 C. Contingencies

1. Physical 12.73 0.00 0.72 1.47 1.97 4.15 4.43 0.00 2. Price 10.67 0.00 0.38 1.09 1.84 3.67 3.68 0.00

Subtotal (C) 23.40 0.00 1.10 2.56 3.81 7.82 8.11 0.00 D. Financial Charges During Implementation 9.98 0.15 0.23 0.50 0.99 1.81 2.88 3.42

Total Project Cost (A+B+C+D) 193.52 0.15 11.63 21.75 29.27 61.17 66.13 3.42 % Total Project Cost 100.0% 0.1% 6.0% 11.2% 15.1% 31.6% 34.2% 1.8%

Note: Numbers may not sum precisely due to rounding. Source: Asian Development Bank estimates.

26

H. Contract and Disbursement S-Curve

Table 13: Contract Awards and Disbursements ($ million, by quarter)

Year Projected Contract Awards Projected Disbursement

Q1 Q2 Q3 Q4 Total Q1 Q2 Q3 Q4 Total 2020 0.00 0.00 0.00 2.44 2.44 0.00 0.00 0.00 0.00 0.00 2021 35.56 0.00 0.00 19.40 54.96 0.00 0.72 0.72 3.41 4.85 2022 0.00 8.63 0.00 12.16 20.79 2.99 2.99 2.99 2.76 11.73 2023 5.98 0.00 4.55 0.00 10.53 3.85 3.68 4.89 5.92 18.34 2024 0.00 0.00 0.00 10.28 10.28 8.26 8.69 9.81 5.11 31.87 2025 0.00 0.00 0.00 0.00 0.00 8.20 7.30 8.77 8.94 33.21 2026 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total 41.54 8.63 4.55 44.28 99.00 23.29 23.39 27.18 26.14 100.00

Figure 2: Contract and Disbursement S-Curve

0.00

20.00

40.00

60.00

80.00

100.00

120.00

1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q 3Q 4Q 1Q 2Q

2020 2021 2022 2023 2024 2025 2026

Quarterly Disbursement Quarterly Contracting

27

I. Fund Flow Diagram

Figure 3: Fund Flow Diagram

ADB = Asian Development Bank, GDOF = Guangxi Department of Finance, GPMO = Guangxi project management office, PMO = project management office, PRC = People’s Republic of China, SWI = social welfare institute. Note: The advance account, administered by the GDOF, will be used to pay contractors, suppliers, and other third parties. ADB’s share of eligible project expenditures incurred by the executing agency, implementing agencies, and project implementing entities will be reimbursed. Source: ADB.

28

V. FINANCIAL MANAGEMENT

A. Financial Management Assessment

26. The financial management assessment was conducted in December 2018 in accordance with ADB’s Guidelines for the Financial Management and Analysis of Projects and the Financial Due Diligence: A Methodology Note.20 The financial management assessment considered the capacity of the implementing agencies and PIEs, including funds flow arrangements, staffing, accounting and financial reporting systems, financial information systems, and internal and external auditing arrangements. GGZAR, as the executing agency of the project, was not included in this assessment as it has implemented a number of foreign-funded projects, including ADB projects, in recent years and has been assessed as capable of undertaking the required financial supervision. 27. Based on the assessment of the implementing agencies and PIEs, the key financial management risks identified are (i) implementation risk, due to PIE’s lack of familiarity with ADB disbursement procedures and requirements which could delay project implementation; (ii) compliance risk, due to PIE’s lack of familiarity with ADB financial management requirements, particularly relating to accounting, reporting, and auditing, which may delay project reporting and the identification of issues on the use of loan proceeds; (iii) financing risk, due to delays in provision of, or inadequate counterpart funding from NMG, NTCMH, HPH, and GGH; and (iv) operational risk, due to limited experience in elderly care operations and management, which will impact on the adequacy of the services to be provided. 28. The existing financial management arrangements for both executing and implementing agencies indicate that they have adequate capacity to administer the proposed project having previously demonstrated the capacity to administer the statement of expenditure (SOE) procedure. Guangxi Department of Finance (GDOF) will be accountable and responsible for proper use of advances to the advance account. The PIEs shall maintain a special bank account where ADB loan and counterpart funds will be channeled. The PIEs will enhance their capabilities by undertaking training on ADB disbursement policies and procedures. It is concluded that the overall financial management risk rating of the project before considering mitigating measures is moderate and after mitigation is low. With the identified financial management risks, implementation of agreed mitigation measures will need to be closely monitored. The executing and implementing agencies, and PIEs have agreed to implement an action plan as key measures to address the deficiencies. The financial management action plan is provided in Table 14.

Table 14: Financial Management Action Plan

20 ADB. 2005. Financial Management and Analysis of Projects. Manila; and ADB. 2009. Financial Due Diligence: A

Methodology Note. Manila.

Weakness Mitigation Action Responsibility Timeframe Inadequate or delay in provision of counterpart fundsa

Covenants to be included in the legal agreements to ensure provision of adequate counterpart funds.

ADB and GGZAR Loan negotiations

Close monitoring to quickly identify potential issues in counterpart funding.

GPMO, and Nanning and Hezhou finance bureaus

At least quarterly during project implementation

PIE’s lack of familiarity in ADB loan policies

Training on ADB disbursement procedures and requirements.

GPMO with project consulting support

After loan effectiveness

29

ADB = Asian Development Bank, GPMO = Guangxi project management office, GGZAR = Government of Guangxi Zhuang Autonomous Region, HPMO = Hezhou project management office, NPMO = Nanning project management office, PIE = project implementing entity. a Counterpart funding will come from a combination of government budgetary resources (for Nanning Social Welfare

Institute) and local resources (for other PIEs). In all cases, counterpart funding should be budgeted in advance based on agreed project implementation plans, which should be reviewed and updated on a regular basis.

b Transaction-based process focuses on individual activity or transaction as against system-based which looks into the whole financial operation.

Source: Asian Development Bank.

B. Disbursement

1. Disbursement Arrangements for Asian Development Bank Funds

29. The loan proceeds will be disbursed in accordance with ADB’s Loan Disbursement Handbook (2017, as amended from time to time),21 and detailed arrangements agreed upon between the government and ADB. Online training for project staff on disbursement policies and procedures is available.22 Project staff are encouraged to avail of this training to help ensure efficient disbursement and fiduciary control. 30. The fund flow is shown in Figure 3. The responsibility for collecting and retaining supporting documents at the subproject level rests with the PIEs. The PIEs will prepare withdrawal applications and submit to Nanning or Hezhou financial bureaus through Nanning or Hezhou PMOs. Each municipal financial bureau will submit the withdrawal applications to GDOF through GPMO. GDOF will review and endorse the withdrawal applications, and submit those to ADB. 31. Advance fund procedure. To facilitate subproject implementation through timely release of loan proceeds, GDOF will establish and maintain a separate advance account for the investment loan promptly after loan effectiveness at a commercial bank. The currency of the advance account is the US dollar. The advance account is to be used exclusively for ADB’s share of eligible expenditures. The GDOF, who administers the advance account, is accountable and responsible for proper use of advances to the advance account. 21 The handbook is available electronically from the ADB website (English version: http://www.adb.org/documents/

loan-disbursement-handbook; Chinese version: https://www.adb.org/zh/documents/loan-disbursement-handbook). 22 Disbursement eLearning. http://wpqr4.adb.org/disbursement_elearning

Weakness Mitigation Action Responsibility Timeframe and procedures Training on ADB financial

management requirements, specifically on accounting reporting and auditing which can be undertaken under the project implementation support. Financial management consultants will be engaged under the loan to support the PIEs and implementing agencies for the project financial management.

NPMO, HPMO, and PIEs

and any other time as needed

Existing audit process is transaction-based rather than system- basedb

Training on international audit standards

GPMO with support of project consultants NPMO HPMO PIEs

Any time as needed

30

32. The total outstanding advance to the advance account should not exceed the estimate of ADB’s share of expenditures to be paid through the advance account for the forthcoming 6 months. The GDOF through GPMO may request for initial and additional advances to the advance account based on an Estimate of Expenditure Sheet 23 setting out the estimated expenditures to be financed through the account for the forthcoming 6 months. Supporting documents should be submitted to ADB or retained by the executing agency in accordance with ADB’s Loan Disbursement Handbook (2017, as amended from time to time) when liquidating or replenishing the advance account. 33. Statement of expenditure procedure. 24 The SOE procedure may be used for reimbursement of eligible expenditures or liquidation of advances to the advance account. Supporting documents and records for the expenditures claimed under the SOE should be maintained and made readily available for review by ADB's disbursement and review missions, upon ADB's request for submission of supporting documents on a sampling basis, and for independent audit.

34. Before the submission of the first withdrawal application, the borrower should submit to ADB sufficient evidence of the authority of the person(s) who will sign the withdrawal applications on behalf of the GGZAR, together with the authenticated specimen signatures of each authorized person. The minimum value per withdrawal application is stipulated in the Loan Disbursement Handbook (2017, as amended from time to time). Individual payments below such amount should be paid (i) by the executing agency and subsequently claimed to ADB through reimbursement, or (ii) through the advance fund procedure, unless otherwise accepted by ADB. The borrower should ensure sufficient category and contract balances before requesting disbursements. Use of ADB’s Client Portal for Disbursements system is encouraged for submission of withdrawal applications to ADB.

2. Disbursement Arrangements for Counterpart Fund

35. For NSWI, it will request budgetary allocations for counterpart funds from Nanning Municipal Finance Bureau and disbursement will flow through the treasury payment system to a special account maintained by NSWI. Other PIEs; that is, NTCMH and HPH, will be responsible for their counterpart funds and will pay their contractors, suppliers, and consultants using their normal payment procedures. The counterpart funds for the Hezhou PPP subproject will be mobilized by the PIE and details will be identified during the PPP structuring. Counterpart funds will be fully segregated from ADB funds. Each PIE will prepare disbursement projections. C. Accounting

36. The GDOF, implementing agencies, and PIEs will maintain separate books and records by funding source for all expenditures incurred on the project following accrual-based accounting system following International Financial Reporting Standards. The GPMO will prepare

23 Estimate of Expenditure sheet is available in Appendix 8A of ADB’s Loan Disbursement Handbook (2017, as

amended from time to time). 24 SOE forms are available in Appendix 7B of ADB’s Loan Disbursement Handbook (2017, as amended from time to

time).

31

consolidated project financial statements in accordance with the government's accounting laws and regulations which are consistent with international accounting principles and practices.

D. Auditing and Public Disclosure 37. The GPMO will cause the detailed consolidated project financial statements to be audited in accordance with International Standards on Auditing, by an independent auditor acceptable to ADB based on the terms of reference acceptable to ADB. The audited project financial statements together with the auditor’s opinion will be presented in the English language to ADB within 6 months from the end of the fiscal year by the GPMO. 38. For PIEs, the audited entity financial statements, together with the auditor’s report and management letter, will be submitted in the English language to ADB, through GPMO, within 1 month after their approval by the relevant authority. If ADB advises GGH that entity financial statements are required from the PPP concessionaire or another entity involved in the Hezhou PPP subproject, GGH will ensure that the entity in question provides audited annual financial statements meeting ADB’s requirements to GGH for provision to ADB. 39. The audit report for the project financial statements will include a management letter and auditor’s opinions, which cover (i) whether the project financial statements present an accurate and fair view or are presented fairly, in all material respects, in accordance with the applicable financial reporting standards; (ii) whether the proceeds of the loan were used only for the purpose(s) of the project; and (iii) whether the borrower or executing agency was in compliance with the financial covenants contained in the legal agreements (where applicable).

40. Compliance with financial reporting and auditing requirements will be monitored by review missions and during normal program supervision, and followed up regularly with all concerned, including the external auditor.

41. The government, executing and implementing agencies, and PIEs have been made aware of ADB’s approach to delayed submission, and the requirements for satisfactory and acceptable quality of the audited project financial statements.25 ADB reserves the right to require a change in the auditor (in a manner consistent with the constitution of the borrower), or for additional support to be provided to the auditor, if the audits required are not conducted in a manner satisfactory to ADB, or if the audits are substantially delayed. ADB reserves the right to verify the project's financial accounts to confirm that the share of ADB’s financing is used in accordance with ADB’s policies and procedures.

25 ADB’s approach and procedures regarding delayed submission of audited project financial statements:

(i) When audited project financial statements are not received by the due date, ADB will write to the executing agency advising that (a) the audit documents are overdue; and (b) if they are not received within the next 6 months, requests for new contract awards and disbursement such as new replenishment of advance accounts, processing of new reimbursement, and issuance of new commitment letters will not be processed.

(ii) When audited project financial statements are not received within 6 months after the due date, ADB will withhold processing of requests for new contract awards and disbursement such as new replenishment of advance accounts, processing of new reimbursement, and issuance of new commitment letters. ADB will (a) inform the executing agency of ADB’s actions; and (b) advise that the loan may be suspended if the audit documents are not received within the next 6 months.

(iii) When audited project financial statements are not received within 12 months after the due date, ADB may suspend the loan.

32

42. Public disclosure of the audited project financial statements, including the auditor’s opinion on the project financial statements, will be guided by ADB’s Access to Information Policy.26 After the review, ADB will disclose the audited project financial statements and the opinion of the auditors on the project financial statements no later than 14 days of ADB’s confirmation of their acceptability by posting them on ADB’s website. The management letter, additional auditor’s opinions, and audited entity financial statements will not be disclosed.27

VI. PROCUREMENT AND CONSULTING SERVICES

A. Advance Contracting and Retroactive Financing

43. All advance contracting and retroactive financing will be undertaken in conformity with ADB’s Procurement Policy (2017, as amended from time to time) and Procurement Regulations for ADB Borrowers (2017, as amended from time to time). The GPMO requested ADB to approve advance contracting for procurement of goods, services, and civil works, including the preparation of bid documents, inviting and receiving bids for project contracts, and retroactive financing under the project. The borrower, executing, and implementing agencies have been advised that approval of advance contracting and retroactive financing does not commit ADB to finance the project. 44. Advance contracting. Advance contracting will include (i) tendering and bid evaluation for goods packages, (ii) awarding of contracts, and (iii) recruitment of consultants. The issuance of invitations to bid under advance contracting will be subject to ADB’s approval. In preparing the bidding documents under the advance contracting arrangement, the GGZAR, through the GPMO, must ensure that the provisions of this PAM are complied with, and all loan assurances agreed at loan negotiations are adhered to. These assurances include monitoring and reporting requirements for contractors, compliance with labor laws and regulations, specific measures in the environmental management plan (EMP) and social development and gender action plan (SDGAP). 45. Retroactive financing. Retroactive financing could only apply up to the equivalent of 20% of the total ADB loan, with respect to eligible expenditures incurred prior to loan effectiveness but not more than 12 months before the signing of the loan agreement. The borrower, executing and implementing agencies, and PIEs have been advised that approval of advance contracting and retroactive financing does not commit ADB to subsequently approve the project or to finance the procurement costs, and ADB will not finance expenditures paid by the borrower prior to loan effectiveness, even if advance contracting is approved, unless retroactive financing has also been approved by ADB. B. Procurement of Goods, Works, and Consulting Services

46. All procurement of goods, works, and consulting services will be undertaken in accordance with ADB’s Procurement Policy (2017, as amended from time to time) and Procurement Regulations for ADB Borrowers (2017, as amended from time to time). 47. Open competitive bidding (OCB) with national advertising will be used for procurement of 7 works contracts with total value of $74.97 million and estimated contract amount between

26 Access to Information Policy: https://www.adb.org/documents/access-information-policy 27 This type of information would generally fall under exceptions to disclosure. ADB. 2018. Access to Information Policy.

Manila.

33

$6.32 million and $17.64 million, OCB with international advertising for 1 contract, under a PPP model, with total value of $38.77 million, and OCB with national advertising for 11 goods contracts with total value of $10.66 million and estimated contract amount between $0.18 and $2.48 million. 48. Before the start of any procurement, ADB and the government will review the public procurement laws of the central and state governments to ensure consistency with ADB’s Procurement Policy (2017, as amended from time to time) and Procurement Regulations for ADB Borrowers (2017, as amended from time to time). 49. An 18-month procurement plan indicating threshold and review procedures, goods, works, and consulting service contract packages and national competitive bidding guidelines is in Section C. 50. All consultants will be recruited according to Procurement Regulations for ADB Borrowers (2017, as amended from time to time). The terms of reference for all consulting services are detailed in Section D.

C. Procurement Plan

Table 15: Basic Data Project Name: Demonstration of Guangxi Elderly Care and Health Care Integration and Public–Private Partnership Project Project Number: 50391-001 Approval Number: xxx Country: People’s Republic of China Executing Agency: Government of Guangxi

Zhuang Autonomous Region Project Procurement Classification: A Implementing Agencies: Nanning Municipal

Government and Hezhou Municipal Government Procurement Risk: Medium Project Financing Amount: $193,520,000 ADB Financing: $100,000,000 Non-ADB Financing: $93,520,000

Project Closing Date: 30 April 2026

Date of First Procurement Plan: 16 August 2019 Date of this Procurement Plan: 16 August 2019 Procurement Plan Duration (in months): 18 Advance Contracting:

Yes E-procurement: No

1. Methods, Review and Procurement Plan

51. Except as the Asian Development Bank (ADB) may otherwise agree, the following process thresholds shall apply to procurement of goods, works, and consulting services.

Procurement of Goods, Works, and Non-consulting Services

Method Comments Open competitive bidding (OCB) – National advertising

National suppliers and contractors are available and the market is competitive

Consulting Services

Method Comments Quality- and cost-based selection (QCBS) Quality- cost ratio = 80:20 Consultants’ qualifications selection (CQS) Individual consultants selection (ICS)

34

2. List of Active Procurement Packages (Contracts)

52. The following table lists goods, works, and consulting services contracts for which the procurement activity is either ongoing or expected to commence within the procurement plan duration.

Goods and Works

Package Number General Description

Estimated Valuea

($ million) Procurement

Method Review Bidding

Procedure Advertisement

Date (quarter/ year) Comments

SWI-CW1 Nanning Social Welfare Institute–Construction of an elderly care facility with 500 beds–Main building and external works

17.64 OCB Prior 1S1E Q4 2020 Advertising type: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Works

TCM1-CW1

Nanning Traditional Chinese Medicine Hospital–Elderly Care Institution–Construction of an elderly care facility with 200 beds–Main building and external works

9.34 OCB Post (Sampling)

1S1E Q4 2020 Advertising type: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Works

TCM2-CW1

Nanning Traditional Chinese Medicine Hospital–Medical facility–Construction of a hospital with 150 beds–Main building and external works

9.98 OCB Post (Sampling)

1S1E Q4 2020 Advertising type: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Works

HZ1-CW1 Hezhou People’s Hospital (site 1)–Construction of an elderly care facility with 400 beds–Main building and external works

11.06 OCB Prior 1S1E Q4 2020 Advertising type: National Number of contracts: 2 Prequalification of bidders: No Advance contracting: No Bidding document: Works

OCB = open competitive bidding, Q = quarter. a Estimated value includes Asian Development Bank financing, counterpart financing, and physical contingencies. Source: Asian Development Bank.

35

Consulting Services

Package Number General Description

Estimated Valuea

($ million) Selection Method Review

Type of Proposal

Advertisement Date (quarter/

year) Comments

CS1 Project management and capacity development

1.22 QCBS Prior FTP Q1 2020 Type: Firm Assignment: National Quality/cost ratio: 80:20

CS2 Construction supervision

2.00 QCBS Prior FTP Q2 2020 Type: Firm Assignment: National Quality/cost ratio: 80:20

CS3 External safeguards monitoring

0.18 CQS Prior STP Q2 2020 Type: Firm Assignment: National Quality/cost ratio: 80:20 Number of contracts: 2

CS4 Technical capacity development in elderly care sector

1.73 QCBS Prior FTP Q2 2020 Type: Firm Assignment: International Quality/cost ratio: 80:20

CS5 Technical experts in Elderly care and Private sector enhancement

0.37 ICS Prior N/A Q1 2020 Type: Individual Assignment: International; National

CQS = consultants’ qualifications selection, ICS = individual consultants selection, FTP = full technical proposal, N/A = not applicable, Q = quarter, QCBS = quality- and cost-based selection. a Estimated value includes Asian Development Bank financing, counterpart financing, and physical contingencies. Source: Asian Development Bank.

3. List of Indicative Packages (Contracts) Required Under the Project

53. The following table lists goods, works, and consulting services contracts for which procurement activity is expected to commence beyond the procurement plan duration and over the life of the project (i.e., those expected beyond the current procurement plan duration).

Goods and Works

Package Number General Description

Estimated Valuea

($ million) Procurement

Method Review Bidding

Procedure Advertisement

Date (quarter/year) Comments

SWI-G1 Nanning Social Welfare Institute–Intelligent

0.73 OCB Prior 1S1E Q1 2022 Advertising: National Number of contracts: 1 Prequalification of bidders: No

36

Goods and Works

Package Number General Description

Estimated Valuea

($ million) Procurement

Method Review Bidding

Procedure Advertisement

Date (quarter/year) Comments

engineering and information systems

Advance contracting: No Bidding document: Goods

SWI-G2 Nanning Social Welfare Institute–Physical therapy, rehabilitation facilities, and medical equipment

0.32 OCB Post (sampling)

1S1E Q3 2022 Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Goods

TCM1-G1 Nanning Traditional Chinese Medicine Hospital–Elderly care institution–Intelligent engineering and information systems

0.79 OCB Post (sampling)

1S1E Q1 2022 Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Goods

TCM1-G2 Nanning Traditional Chinese Medicine Hospital–Elderly care institution–Physical therapy, rehabilitation facilities

1.93 OCB Post (sampling)

1S1E Q3 2022 Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Goods

TCM1-G3 Nanning Traditional Chinese Medicine Hospital–Elderly care institution– Central oxygen supply and suction system

0.38 OCB Post (sampling)

1S1E Q3 2022 Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Goods

TCM1-G4

Nanning Traditional Chinese Medicine Hospital–Elderly care institution–Elevators

0.18 OCB Post (sampling)

1S1E Q1 2022

Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Goods

TCM2-G2 Nanning Traditional Chinese Medicine Hospital–Medical facility– Medical equipment

2.48 OCB Post (sampling)

1S1E Q3 2022 Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Goods

37

Goods and Works

Package Number General Description

Estimated Valuea

($ million) Procurement

Method Review Bidding

Procedure Advertisement

Date (quarter/year) Comments

TCM2-G3 Nanning Traditional Chinese Medicine Hospital–Medical facility– Central oxygen supply and suction system

0.31 OCB Post (sampling)

1S1E Q4 2022

Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Goods

HZ1-CW2 Hezhou People’s Hospital (site 1)–Interior decoration

6.70 OCB Post (sampling)

1S1E Q1 2022 Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Works

HZ1-G1 Hezhou People’s Hospital (site 1)–Intelligent waste recycling system

0.97 OCB Post (sampling)

1S1E Q1 2022 Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Goods

HZ2-CW1 Hezhou People’s Hospital (site 2)–Construction of an elderly care facility with 450 beds, main building, and external works

13.93 OCB Prior 1S1E Q2 2022 Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Works

HZ2-CW2 Hezhou People’s Hospital (site 2)–Interior decoration

6.32 OCB Post (sampling)

1S1E Q1 2024 Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Works

HZ2-G1 Hezhou People’s Hospital (site 2)–Intelligent waste recycling system

1.29 OCB Post (sampling)

1S1E Q1 2024 Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Goods

HZ2-G2

Hezhou People’s Hospital (site 2)– Information systems

1.28 OCB Post (sampling)

1S1E Q1 2024

Advertising: National Number of contracts: 1 Prequalification of bidders: No Advance contracting: No Bidding document: Goods

38

Goods and Works

Package Number General Description

Estimated Valuea

($ million) Procurement

Method Review Bidding

Procedure Advertisement

Date (quarter/year) Comments

HZ3-CW1 (PPP subproject)

Hezhou–Guangxi Guidong Hospital (PPP)–(Design-build-operate)

38.77 OCB Prior 1S1E/ 2S1E

Q4 2020 Managed under the structuring and development of PPP subproject

OCB = open competitive bidding, PPP = public–private partnership. a Estimated value includes Asian Development Bank financing, counterpart financing, and physical contingencies. Source: Asian Development Bank.

Consulting Services

Package Number

General Description

Estimated Value ($)

Selection Method Review

Type of Proposal

Advertisement Date (quarter, year) Comments

4. List of Awarded and Completed Contracts

54. The following table lists the awarded and completed contracts for goods, works, non-consulting, and consulting services.

Goods, Works, and Non-Consulting Services

Package Number General Description Contract Value

Date of ADB Approval of

Contract Award Date of Completion Comments

Consulting Services

Package Number General Description Contract Value

Date of ADB Approval of

Contract Award Date of Completion Comments

5. Non-ADB Financing

55. The following table lists goods, works, non-consulting, and consulting services contracts over the life of the project, financed by non-ADB sources.

39

Goods and Works

Package Number General Description

Estimated Value ($ million)

Estimated Number of Contracts

Procurement Method Comments

SWI-CW2 Nanning Social Welfare Institute–Secondary interior decoration

4.04 1 OCB

Counterpart financing

SWI-CW3 Nanning Social Welfare Institute–Ventilation and air conditioning

0.35 1 OCB

SWI-CW4 Nanning Social Welfare Institute–Elevators 0.37 1 OCB SWI-G3 Nanning Social Welfare Institute–Furniture, firing

equipment 1.08 1 OCB

TCM1-CW2 Nanning Traditional Chinese Medicine Hospital–Elderly care institution–Interior decoration

1.66 1 OCB

TCM1-CW3 Nanning Traditional Chinese Medicine Hospital–Elderly care institution–Ventilation and air conditioning

0.71 1 OCB

OCB = open competitive bidding. Source: Asian Development Bank.

Goods and Works

Package Number General Description

Estimated Value ($ million)

Estimated Number of Contracts

Procurement Method Comments

TCM1-CW5 Nanning Traditional Chinese Medicine Hospital–Elderly care institution–Power distribution system

0.13 1 OCB

TCM1-G5 Nanning Traditional Chinese Medicine Hospital–Elderly care institution–Office equipment

0.06 1 OCB

TCM1-G6 Nanning Traditional Chinese Medicine Hospital–Elderly care institution–Kitchen equipment

0.01 1 OCB

TCM2-CW2 Nanning Traditional Chinese Medicine Hospital–Elderly care institution–Interior decoration

2.07 1 OCB

TCM2-CW3 Nanning Traditional Chinese Medicine Hospital–Medical facility–Ventilation and air conditioning

0.90 1 OCB

TCM2-CW4 Nanning Traditional Chinese Medicine Hospital–Medical facility–Elevators

0.23 1 OCB

TCM2-CW5 Nanning Traditional Chinese Medicine Hospital–Medical facility–Power distribution system

0.21 1 OCB

TCM2-G1 Nanning Traditional Chinese Medicine Hospital–Medical facility–Intelligent engineering and information systems

0.99 1 OCB

40

Goods and Works

Package Number General Description

Estimated Value ($ million)

Estimated Number of Contracts

Procurement Method Comments

TCM2-G4 Nanning Traditional Chinese Medicine Hospital–Medical facility–Office furniture and equipment

0.09 1 OCB

HZ1-CW3 Hezhou People’s Hospital (site 1)–Ventilation and air conditioning

1.41 1 OCB

HZ1-CW4 Hezhou People’s Hospital (site 1)–Elevators 0.25 1 OCB HZ1-CW5 Hezhou People’s Hospital (site 1)–Power distribution

system 0.22 1 OCB

HZ1-G2 Hezhou People’s Hospital (site 1)– Intelligent engineering and information systems

1.24 1 OCB

HZ1-G3 Hezhou People’s Hospital (site 1)–Central oxygen supply and suction system

0.26 1 OCB

HZ1-G4 Hezhou People’s Hospital (site 1)–Common facilities and equipment

0.86 1 OCB

HZ1-G5 Hezhou People’s Hospital (site 1)–Physical therapy, rehabilitation facilities, and medical equipment

0.45 1 OCB

OCB = open competitive bidding. Source: Asian Development Bank.

Goods and Works

Package Number General Description

Estimated Value ($ million)

Estimated Number of Contracts

Procurement Method Comments

HZ1-G6 Hezhou People’s Hospital (site 1)–Kitchen facilities 0.11 1 OCB

HZ1-G7 Hezhou People’s Hospital (site 1)–Entry identification system 0.064 1 OCB

HZ2-CW3 Hezhou People’s Hospital (site 2)–Ventilation and air conditioning 1.06 1 OCB

HZ2-CW4 Hezhou People’s Hospital (site 2)–Elevators 0.21 1 OCB

HZ2-CW5 Hezhou People’s Hospital (site 2)–Power distribution system 0.40 1 OCB

HZ2-G3 Hezhou People’s Hospital (site 2)–Central oxygen supply and suction system 0.26 1 OCB

HZ2-G4 Hezhou People’s Hospital (site 2)–Common facilities and equipment 0.83 1 OCB

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Comments

Package Number General Description

Estimated Value ($ million)

Estimated Number of Contracts

Procurement Method Comments

HZ2-G5 Hezhou People’s Hospital (site 2)–Physical therapy, rehabilitation facilities, and medical equipment 0.45 1 OCB

HZ2-G6 Hezhou People’s Hospital (site 2)–Kitchen facilities 0.11 1 OCB

HZ2-G7 Hezhou People’s Hospital (site 2)–Entry identification system 0.10 1 OCB

OCB = open competitive bidding. Source: Asian Development Bank.

Consulting Services General Description Estimated Value

($) Estimated Number

of Contracts Recruitment

Method Comments

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6. Open Competitive Bidding (Advertised Nationally)

56. The Borrowers Law of Tendering and Bidding of the People’s Republic of China promulgated by Order No. 21 of the President of the People’s Republic of China on August 30, 1999, are subject to the following clarifications required for compliance with the Guidelines:

(i) All invitations to prequalify or to bid shall be advertised in the national press, or official gazette, or a free and open access website in the Borrowers country. Such advertisement shall be made in sufficient time for prospective bidders to obtain prequalification or bidding documents and prepare and submit their responses. In any event, a minimum preparation period of thirty (30) days shall be given. The preparation period shall count (a) from the date of advertisement, or (b) when the documents are available for issue, whichever date is later. The advertisement and the prequalification and bidding documents shall specify the deadline for such submission.

(ii) Qualification requirements of bidders and the method of evaluating the qualification of each bidder shall be specified in detail in the bidding documents, and in the prequalification documents if the bidding is preceded by a prequalification process.

(iii) If bidding is preceded by a prequalification process, all bidders that meet the qualification criteria set out in the prequalification document shall be allowed to bid and there shall be no limit on the number of prequalified bidders.

(iv) All bidders shall be required to provide a performance security in an amount sufficient to protect the Borrower/Project Executing Agency in case of breach of contract by the contractor, and the bidding documents shall specify the required form and amount of such performance security.

(v) Bidders shall be allowed to submit bids by mail or by hand. (vi) All bids shall be opened in public; all bidders shall be afforded an opportunity to be

present (either in person or through their representatives) at the time of bid opening, but bidders shall not be required to be present at the bid opening.

(vii) All bid evaluation criteria shall be disclosed in the bidding documents and quantified in monetary terms or expressed in the form of pass/fail requirements.

(viii) No bid may be rejected solely on the basis that the bid price falls outside any standard contract estimate, or margin or bracket of average bids established by the Borrower/Project Executing Agency.

(ix) Each contract shall be awarded to the lowest evaluated responsive bidder, that is, the bidder who meets the appropriate standards of capability and resources and whose bid has been determined (a) to be substantially responsive to the bidding documents and (b) to offer the lowest evaluated cost. The winning bidder shall not be required, as a condition of award, to undertake responsibilities for work not stipulated in the bidding documents or otherwise to modify the bid as originally submitted.

(x) Each contract financed with the proceeds of the Loan shall provide that the suppliers and contractors shall permit ADB, at its request, to inspect their accounts and records relating to the performance of the contract and to have said accounts and records audited by auditors appointed by ADB.

(xi) Government owned enterprises in the Borrower’s country may be permitted to bid if they can establish that they (a) are legally and financially autonomous, (b) operate under commercial law, and (c) are not a dependent agency of the Borrower/Project Executing Agency.

(xii) Rebidding shall not be allowed solely because the number of bids is less than three.

43

D. Consultant's Terms of Reference 57. Project management and capacity development. A firm will be engaged to support the executing and implementing agencies and PIEs for the project implementation, covering all project components and corresponding major deliverables. The team will be comprised of the following experts: (i) team leader, (ii) deputy team leader, (iii) procurement specialists, (iv) financial management specialists, (v) environment safeguards specialist (internal monitoring), (vi) social development and resettlement safeguards specialist, and (vii) project performance monitoring specialist. Specific tasks may include, but not limited to the following tasks:

(i) each consultant should preferably have a master’s degree or equivalent professional knowledge and expertise in respective fields;

(ii) consultants will support the executing and implementing agencies and PIEs in project management and capacity building to ensure compliance with ADB guidelines and requirements for project implementation, including (a) project performance management system (PPMS); (b) procurement of goods and works; (c) disbursement and contract management; (d) construction planning, supervision, and monitoring; (e) reporting requirements; (f) safeguards management, implementing, and monitoring; (g) implementation and monitoring of SDGAP activities; (h) human resources development plan, corporate planning, and financial management; and (i) awareness raising and promoting the enabling environment for implementing project components. The consultants will also provide capacity development support to the executing and implementing agencies and PIEs including, ADB’s requirements on procurement, disbursement, safeguards, and financial management;

(iii) set up the project implementation management framework, operational procedures, document filing system, and work plan to guide and facilitate project implementation;

(iv) set up a PPMS in accordance with ADB requirements, including establishing baseline and operation mechanism for data collection, analysis and reporting, and introducing management information system tools, as appropriate;

(v) conduct contract management during project implementation with respective technical consultants, monitor construction progress, conduct regular site visits and provide technical inputs to construction planning, supervision, and monitoring for quality control of construction under each component; prepare progress reports, review and certify the contractor’s claims for payments, provide expert inputs, review justification for contract variations, and prepare necessary documentation; and coordinate project implementation among contractors and stakeholders, and coordinate daily operational tasks;

(vi) establish an efficient and effective financial management system for project implementation in accordance with ADB policy and procedural requirements;

(vii) provide support to ensure compliance with ADB’s requirements on environment, involuntary resettlement, ethnic minorities, and gender and social development;

(viii) prepare necessary information for ADB’s loan administration missions; (ix) help the executing agency, the implementing agencies, the PIEs and other relevant

parties conduct domestic and international study tours, and organize training and workshops;

(x) prepare human resources development plan, corporate planning, and training plan, in consultation with the executing and implementing agencies and PIEs; and

(xi) organize and provide training for the executing and implementing agencies and PIEs on the skills necessary for construction supervision, project management,

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procurement, financial management, including conducting training indicated in Financial Management Action Plan (Table 14 of this PAM), implementation of social and environment safeguards for ADB requirements, project financial management, procurement procedures, and anticorruption measures.

58. External safeguards monitoring. A firm will be engaged, comprising social and land acquisition and resettlement (LAR) and environment safeguards specialists, to conduct external monitoring on social and LAR safeguards and environment safeguards respectively, including the following major tasks:

1. Social Development and Social Safeguards

59. The external monitoring will ensure that the resettlement processes are being implemented in accordance with the requirements set out in the resettlement plan. The external monitoring and evaluation will also undertake an evaluation of changes in peoples’ standard of living as a result of project and project-related LAR activities. Specific tasks include, but not limited to the following:

(i) conduct baseline investigation of the affected population and their production levels before resettlement according to the resettlement plan;

(ii) review and verification of the PIE internal monitoring reports; (iii) impact assessment (e.g., restoration of incomes and living conditions) through

quantitative and qualitative studies; (iv) gender-sensitive consultations with affected persons; (v) assessment of compliance with government’s laws and regulations and the ADB

Safeguard Policy Statement’s (SPS, 2009) involuntary resettlement policy requirements outlined in the resettlement plan;

(vi) assist the implementing agencies in providing training for the resettlement working staff;

(vii) assist the implementing agencies in establishing the resettlement information management system;

(viii) carry out semiannual monitoring visits, which will include collection of necessary information relevant to the social and economic development in the subproject area, carry out sample socioeconomic surveys of the affected households, consultation meetings with the PIEs to discuss the implementation of resettlement plan provisions, monitor if GRM is functioning, and identify any corrective actions required to be taken up to ensure compliance with ADB SPS requirements;

(ix) submit semiannual resettlement monitoring and evaluation reports to GPMO and ADB;

(x) monitor and report on the process of public consultation and participation including stakeholder consultation in line with SDGAP and provide advice to the implementing agency and PIEs, as required;

(xi) monitor and report on the various activities outlined in SDGAP and progress including adequate budget support and trained staff to implement SDGAP;

(xii) provide training to resettlement focal and SDGAP implementation staff; (xiii) make recommendations and due diligence to resolve any issues or problems and

provide advice to the executing and implementing agencies and PIEs; and (xiv) submit post-completion report with quality acceptable to the GPMO and ADB 1

year after completion of resettlement plan implementation.

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2. Environment Safeguards

(i) conduct sampling and monitoring of environmental quality data related to the project;

(ii) conduct external monitoring on EMP implementation status and additional environmental monitoring, if necessary, to verify that issues reported in the internal environmental monitoring reports, quarterly progress reports, and semiannual environmental monitoring reports are in compliance with ADB’s safeguards and other relevant policies;

(iii) conduct independent verification of the project’s environmental management performance, identify any environment-related implementation issues, propose necessary corrective actions, and reflect these in a corrective action plan;

(iv) determine if any adverse impacts have occurred during project implementation, compare the predicted impacts with the actual environmental impacts, assess the effectiveness of the mitigation measures, and suggest remedial and enhancement measures, as required;

(v) make recommendations and due diligence to resolve any issues or problems on implementing the EMP;

(vi) participate in ongoing stakeholder consultations and evaluation and report on how environmental grievances, if any, are handled, make recommendations to resolve any issues or problems, and provide independent advice to GPMO, the implementing agencies and PIEs; and

(vii) submit English and Chinese external environmental monitoring verification report to the GPMO, the implementing agency, and ADB with quality acceptable to ADB on annual basis during project implementation period.

60. Construction supervision. A firm will be engaged to closely monitor and manage on-site construction activities, including all projects sites of this project, based on international best practices and project requirements. The team will be comprised of the following experts: (i) chief site supervision engineer, (ii) assistant engineers, (iii) safety control engineers, and (iv) costing engineers. Major tasks include issue of order to commence and to cease of works, review and approval of the construction methods proposed by the contractors, inspection and acceptance of works, review and check of bills of quantity, issue of payment certificate, approval of contract variation with contractors, quality control and safety management of works, and on-site construction supervision. Major tasks will include the following:

(i) provide holistic on-site construction supervision in accordance with the contract and relevant standards and codes, including assignment of site supervisor and engineers to closely monitor and manage the progress and quality of construction;

(ii) review and check the implementation and compliance with related processes and technical regulations, review, supervise or test related materials, equipment or works and accept or reject before covering;

(iii) inspect and participate in the acceptance of all works to be permanently covered, and/or participate in completion commissioning and acceptance;

(iv) review requested contract variations and issue notice of variation and assist site engineer to determine the unsettled unit price, daily wage, and/or alternative plans;

(v) review bills of quantity, bills prepared by contractors, and endorse the payment, partial or full completion of works; and monitor financial and physical progress of works completed by contractors;

(vi) assist in solving disputes with contractors, and to explain and/or clarify ambiguous items in the contracts which have not been clearly identified;

(vii) review and advise on the claims and compensations requested by contractors;

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(viii) manage, record, and report on all site meetings organized at key sites, including ensuring the implementation of the agreed measures and steps; and

(ix) assist to prepare reports as required by GPMO and ADB. 61. Technical capacity development in elderly care sector. A firm will be engaged to provide capacity development for staff of PIEs and elderly care institutions which will be created under the project, and conduct the hospital data analysis to monitor the performance indicators of the project outcome as indicated in the design and monitoring framework (DMF) of the RRP and this PAM. Major capacity development activities include (i) strengthening hospital discharge management system; (ii) strengthening capacity to provide rehabilitation (physical therapy and occupational therapy) appropriately; (iii) strengthening capacity of the elderly care institutions and their relevant staff to adequately provide care services, such as care for activities for daily living, dementia care, and terminal care; (iv) development of a capacity building plan of those institutions to further strengthen their capacity to ensure proper and sustainable provision of care services; and (v) ensuring the elderly care-related functions and services to be delivered under each elderly care institution are technically appropriate. Major team members include (i) team leader (geriatric care specialist with discharge management expertise); (ii) geriatric nursing specialists (with care planning expertise); (iii) social workers (with counseling expertise); (iv) long-term care specialists (care management, care givers, dementia care); (v) rehabilitation therapists (physical therapy, occupational therapy, and speech therapy); and (vi) elderly care operation specialist. Training and workshops on discharge management system target all relevant staff of PIEs, such as doctors, nurses, social workers, and rehabilitation therapists, except NSWI, as well as key staff of elderly care institutions, which will be created under this project, such as operation managers and team leaders of nurses and caregivers. Training on rehabilitation targets doctors, nurses, rehabilitation therapists of all PIEs and all elderly care institutions which will be created under this project. Training on elderly care, including care for ADL, dementia care and terminal care, targets doctors, nurses, therapists, caregivers, and social workers of all elderly care institutions which will be created under this project, as well as relevant staff of PIEs. The sensitization workshops discuss the issue of discharge management in terms of transition care and care coordination with stakeholders of PIEs, including managers, doctors, nurses and social workers, and the relevant officials from key bureaus and agencies, including GPMO, NPMO, HPMO, Health Commission and Civil Affairs Bureau. The last sensitization workshop will further disseminate the knowledge and experiences on the improved discharge management and coordinated elderly and health care with the presence of government representatives. Major roles of those experts would include the following:

(i) Team leader (geriatric care specialist with discharge management expertise). The specialist is a trained geriatric specialist (medical doctor) experienced in clinical and managerial work in discharge management, transition care, and care coordination. S/he will be the team leader and be responsible to deliver the following tasks assisted by his/her team: (a) develop and deliver the overall planned capacity building package; (b) prepare a critical review of the current discharge management system,

transition care, and care coordination between the health and long-term care (LTC) sector and make workable recommendations to reform the system;

(c) propose a model for discharge management and care coordination between the health and LTC sectors to serve as a vision for Nanning and Hezhou for future reforms and sector expansion with clear objectives, an indicator framework, operational mechanisms, and financial and information and communications technology aspects. A model of discharge management should (i) clarify care needs after hospitalization, including

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needs for medical care, medication, rehabilitation, and long-term care; and (ii) help identify where and how an elderly person can access his or he needed care;

(d) pilot the proposed model including staff training, organizational and operational changes, development of a monitoring system, and make recommendations for its further implementation and dissemination (regulatory changes, capacity building, funding. etc.);

(e) help each PIE reform their respective discharge management systems to strengthen their capacity in integrated and coordinated health and elderly care, support each PIE to implement reformed discharge management systems, review the implementation, and help PIEs establish strengthened discharge management systems;

(f) document the reform plans for each PIE’s discharge management system and its implementation;

(g) organize and deliver at least three sensitization workshops with the presence of government representatives to discuss discharge management, transition care, and care coordination (assessment, pilot model, and dissemination);

(h) prepare documentation on management and services delivery in discharge management, care coordination, and integration of care;

(i) provide technical assistance to the LTC facilities/institutions to be established under the project to ensure the development of facilities with an appropriate range of services, including personal care, basic medical and nursing care if any, modern rehabilitation services, social work services, palliative care, social and recreational activities, accommodation and meals provided in a home-like environment, and emergency support; and provide capacity building for recruited personnel;

(j) lead to prepare a capacity development plan of the elderly care institutions, which will be created under the project, to further strengthen their capacity to ensure proper and sustainable provision of care services;

(k) lead the training on chronic disease management; (l) support the training, led by the rehabilitation therapists, on rehabilitation

including needs assessment of rehabilitation and on-the-job training (OJT) on rehabilitation care;

(m) support the training, led by the long-term care specialists, on care for ADL and dementia care, including OJT;

(n) support the training, led by social workers, on terminal care and family counseling, including OJT;

(o) lead the training, including OJT, on pain management as a part of terminal care; and

(p) lead to conduct the hospital data analysis on the PIEs to monitor the performance indicators with targets of the project outcome as indicated in DMF of the RRP and this PAM; prepare the report summarizing the achievement of the project outcome, including the quantitative achievements in the performance indicators with targets (a and b in DMF); and submit the report to the executing agency and ADB.

(ii) Geriatric nursing specialist with care planning expertise. The specialist is a

trained geriatric nurse with at least 10 years of experience in geriatric departments of hospitals and LTC facilities. He/she will report to the team leader and closely collaborate with other team members to help deliver the following tasks:

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(a) contribute to the development and delivery of the planned capacity building package described above and support the organization and delivery of at least three sensitization workshops for government representatives;

(b) assist in preparing the review of the current discharge management system, transition care, and care coordination between the health and LTC sector; and assist in making workable recommendations to reform the system;

(c) contribute to the development of the model for discharge management and care coordination and its piloting;

(d) contribute to the development and implementation of reform plans for respective PIEs’ discharge management systems to strengthen their capacity in integrated health and elderly care;

(e) contribute to provide technical assistance and capacity building to the LTC facilities to be established under the project, especially for nursing and palliative care;

(f) prepare documentation on management and nursing services delivery in LTC facilities;

(g) with team leader, provide training on chronic disease management; (h) with therapists, lead the training on rehabilitation, including needs

assessment of rehabilitation and OJT; (i) support the training on pain management as a part of terminal care; and (j) support to conduct the hospital data analysis on PIEs to clarify the

achievements in the performance indicators with targets (a and b in DMF) of the project outcome as indicated in DMF.

(iii) Long-term care specialists. The specialists are a trained LTC manager with

operational experience in providing LTC services in different care settings, including dementia care and terminal care. He/she will report to the team leader and closely collaborate with other team members to help deliver the following tasks: (a) lead in providing technical assistance to the LTC facilities to be established

under the project to ensure the development of facilities with an appropriate range of services, including personal care, basic medical and nursing care if any, modern rehabilitation services, social work services, palliative care, social and recreational activities, accommodation and meals provided in a home-like environment, and emergency support;

(b) organize and implement capacity building for recruited personnel for the LTC facilities, including doctors, nurses, and caregivers;

(c) provide technical support to managers of the facilities to run the LTC facilities in an efficient and appropriate manner with the satisfaction of the facility users and their families;

(d) assist in developing care coordination between the health and LTC sectors to improve patients’ transition between providers;

(e) contribute to the development and implementation of reform plans for respective PIEs’ discharge management systems to strengthen their capacity in integrated health and elderly care; particularly, support to include a care plan in the discharge management system;

(f) support the organization and delivery of at least three sensitization workshops for government representatives;

(g) prepare documentation on management and services delivery in LTC facilities;

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(h) lead to provide practical training on long-term care and dementia care; (i) with social work specialists, lead to provide practical training on terminal

care for the elderly people and their families; (j) with social work specialists, lead to provide practical training on counseling

for the elderly and their families; (k) support the training on chronic disease management, rehabilitation, and

pain management; and (l) support to conduct the hospital data analysis on PIEs to clarify the

achievements in the performance indicators with targets (a and b in DMF) of the project outcome as indicated in DMF.

(iv) Rehabilitation therapists. The specialists are therapists (physical, occupational,

and speech therapists) experienced in clinical and managerial work in developing rehabilitation departments in hospitals and LTC facilities. Her/his area of managerial expertise should cover preferably physiotherapy, ergotherapy, and speech therapy for adults and children. He/she will report to the team leader and closely collaborate with other team members to help deliver the following tasks: (a) assess the current state of rehabilitation services in selected hospitals and

LTC facilities; (b) propose measures to address the gaps of the current situation in hospitals

and LTC facilities, including human resources and equipment requirements with the aim of reaching an acceptable level of rehabilitation services with a mix of traditional and modern therapy;

(c) lead the preparation and deliver of a capacity building program for LTC facilities to be established under the project;

(d) assist in developing care coordination between the health and LTC sectors to improve patients’ transition between providers;

(e) prepare documentation on management and rehabilitation services delivery in LTC facilities;

(f) lead to provide practical training on rehabilitation of physical, occupational, and speech therapies, including needs assessment for rehabilitation and OJT;

(g) support the training on LTC, chronic disease management, and pain management; and

(h) support to conduct the hospital data analysis on PIEs to clarify the achievements in the performance indicators with targets (a and b in DMF) of the project outcome as indicated in DMF.

(v) Social work specialists. The specialists are trained social workers with skills in

counseling psychology, with 10 years of experience in discharged management and LTC psychological and social work services. He/she will report to the team leader and closely collaborate with other team members to help deliver the following tasks: (a) provide technical assistance to the LTC facilities to be established under

the project to ensure the development of facilities with appropriate social and counselling services for regular and palliative care departments;

(b) organize and implement capacity building for recruited personnel for the LTC facilities, including doctors, nurses, social and psychological/counseling workers, and caregivers;

(c) assist in developing care coordination between the health and LTC sectors to improve patients’ transition between providers;

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(d) contribute to the development and implementation of reform plans for respective PIEs’ discharge management systems to strengthen their capacity in integrated health and elderly care;

(e) prepare documentation on management and psychological/counseling and social work services delivery in LTC facilities;

(f) with LTC specialists, lead to provide practical training on terminal care for the elderly people and their families;

(g) with LTC specialists, lead to provide practical training on counseling for the elderly and their families;

(h) support training on LTC, chronic disease management, and pain management; and

(i) support to conduct the hospital data analysis on PIEs to clarify the achievements in the performance indicators with targets (a and b in DMF) of the project outcome as indicated in DMF.

62. Elderly care facility architect. An individual elderly care facility architect will be engaged to ensure that the designs of facilities, created under this project, are technically appropriate to meet the respective functionalities of elderly care. He/she will deliver the following:

(i) review preliminary design of each facilities and provide recommendations on the preliminary design to meet adequate functionality and ensure age-friendly design and elderly-centered concept, support to improve the preliminary design, report the quality of preliminary design to GPMO and ADB, and support GPMO and ADB to assess the quality of preliminary design for the clearance; and

(ii) review detailed design of each facilities, provide recommendations on the detailed design to meet the functionality adequately and ensure the age-friendly design and the elderly-centered concept; support to improve the detailed design; report the quality of detailed design to GPMO and ADB; and support GPMO and ADB to assess the quality of detailed design for the clearance.

63. Public–private partnership specialist. An individual PPP specialist will be engaged to support Hezhou PMO and Guangxi Guidong Hospital (GGH), the PIE, to monitor the PPP-related key performance indicator (KPI), verify KPI achievement, and make the performance-based payment to the private partner. Details of tasks include:

(i) support Hezhou PMO and GGH to set up an institutional arrangement to carry out the KPI monitoring, verification, and performance-based payment to the private partner;

(ii) provide capacity development training for Hezhou PMO and GGH on KPI monitoring, verification, and performance-based payment; and

(iii) help Hezhou PMO and GGH conduct monitoring and verification of KPI, and performance-based payment.

VII. SAFEGUARDS

64. Potential impacts of the project are classified as B for environment, B for involuntary resettlement, and C indigenous peoples. The project has been screened, categorized, and assessed to reflect the PRC and its provincial laws, regulations, and guidelines, and the safeguards policies of ADB as outlined in the Safeguard Policy Statement (SPS) (2009).28

28 ADB. 2009. Safeguard Policy Statement. Manila.

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65. Grievance redress mechanism. GGZAR through GPMO is the executing agency. NMG and HMG are the implementing agencies. A project-specific GRM is needed to be established as part of the EMP to receive and manage any community concerns which may arise due to the project. The GRM is common for both initial environmental examination (IEE), EMP, and the resettlement plan. GPMO will ensure that each PIE (NSWI, NTCMH, GGH, and HPH) will establish GRM at the respective subproject levels within 2 months of loan effectiveness date, as detailed in the EMP and resettlement plan. For the PPP subproject, GRM will be established at the PIE level, i.e., GGH to be responsible for ADB safeguards compliance of the PPP subproject. The relevant requirements will be included in the PPP concession agreement.

66. The GRMs set out procedures for managing public concerns and complaints and safeguard issues that may arise during project implementation. The GRMs will be established before the start of any construction work of the subprojects. Each GRM will provide a set of procedures to receive, record, and resolve concerns or/and complaints of affected persons and communities. The GPMO will have final responsibility for management, implementation, and reporting of the GRM. The environmental officer, assigned by GPMO, will coordinate the GRM tasks to ensure that a full record is maintained of grievances received (both written and oral) and how these are resolved. This record will be made available to ADB review missions and summary information contained in the annual project progress reports. The circumstances that would trigger corrective action to be taken and requirements for corrective action plan, are described in the GRM. It will provide contact details of the focal point at the implementing agencies, PIEs, contractors’ teams, and other relevant safeguard authorities such as municipal government and environment protection bureaus. All contractors, including PPP concessionaire, will be briefed by GPMO and/or the implementing agencies on safeguard requirements of subprojects and the role of GRMs. 67. Multiple entry points to each GRM will be available including verbal and written complaints, hotline number, anonymous drop boxes, and email contacts. Environmental and social safeguard complaints or disputes will be handled in accordance with the GRM established for the project. The GRM procedures, reporting timelines, roles and responsibilities of all agencies, are described in the EMP. GPMO will report on complaints and the degree of their resolution to ADB in project progress reports and annual safeguard monitoring reports.

68. Prohibited investment activities. Pursuant to ADB’s Safeguard Policy Statement (2009), ADB funds may not be applied to the activities described on the ADB Prohibited Investment Activities List set forth at Appendix 5 of the Safeguard Policy Statement (2009). GPMO, NMG, and HMG, as the implementing agencies, and PIEs will ensure that their investments are in compliance with applicable national laws and regulations and will apply the prohibited investment activities list (Appendix 5) to subprojects financed by ADB. A. Environment

69. Environment due diligence. The project is classified as category B for environment. An IEE report, including an EMP was prepared and disclosed on the ADB website in June 2019. The IEE incorporates the results of the domestic environment impact assessments that were submitted for approval by the Nanning/Hezhou environmental protection bureau. The EMP defines mitigation measures, monitoring requirements, and institutional responsibilities to ensure proper environmental management throughout the project design, construction, and operation. The EMP is supported by capacity development and institutional strengthening activities under the project.

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70. Anticipated impacts and benefits. The project will improve the living environment of the community by demolishing old buildings and constructing new modernized elderly care facilities, with updated water supply, treatment facilities for wastewater and solid/medical wastes, and electricity connections in Nanning. Similarly, the subprojects in Hezhou will involve construction of new elderly care facilities after demolition of old low population areas and agricultural fields.

71. Potential environmental impacts of the project during demolition, construction, and operation stages include impacts on air, noise, water quality, land leveling; disposal of demolition/construction waste, 29 solid waste, medical waste, and disturbance to local communities and traffic safety. Impacts will be avoided and/or mitigated through the implementation of the EMP. The IEE concludes that full and effective implementation of the EMP will result in minor residual impacts that are within the limits of the PRC, ADB standards, and international best practices as defined in the EMP.

72. Environmental management plan implementation arrangements. The GPMO will have the overall responsibility for supervising the implementation of the EMP, coordinating the project level GRM and reporting to ADB. The GPMO will internally assign one safeguards officer (GPMO-SO) to supervise the effective implementation of the EMP. To ensure that the contractors, including the PPP concessionaire, comply with the EMP provisions, the GPMO-SO will prepare and provide the following specific clauses for incorporation into the bidding documents: (i) ensure activities proposed in the EMP are completely budgeted by the bidders in their proposals; (ii) provide environmental clauses for contractual terms and conditions as per PRC, ADB, and international good practices to the bidder; 30 and (iii) ensure environmental audit information of all associated facilities to the project such as demolition waste receiving land fill site, hazardous waste site, medical waste agencies etc., is provided to each bidder.

73. Construction contractors and the PPP concessionaire will be responsible for implementing the stipulated mitigation measures defined in the EMP during the construction period. Each contractor will assign a person responsible for environment, health, and safety who shall be responsible for implementation of EMP at the site. Each PIE will assume day-to-day responsibility for supervising the performance of the contractors or the PPP concessionaire and their adherence to the EMP and environment monitoring plan. Each PIE will work with loan implementation consultants (LIC) to (i) review and approve contractors’ EMP implementation, (ii) conduct site inspections, and (iii) prepare six monthly monitoring reports on EMP implementation to GPMO.31 Based on this report, the GPMO-SO, supported by LIC, will prepare annual environmental monitoring reports in English, and submit them to ADB for appraisal and disclosure until the issuance of project completion report.

74. The effectiveness of the mitigation measures listed in the EMP will be evaluated through environmental monitoring and reporting, and periodic review missions of ADB. Environmental 29 If any asbestos–containing materials are found during the demolition of old facilities, the executing agency shall

engage services of certified agency capable to handle and dispose asbestos containing materials in accordance with international best practices.

30 During the design, construction, and operation of the project, the borrower/client will apply pollution prevention and control technologies and practices consistent with international good practice, as reflected in internationally recognized standards such as the World Bank Group’s Environment, Health and Safety Guidelines. These standards contain performance levels and measures that are normally acceptable and applicable to projects. When host country regulations differ from these levels and measures, the borrower/client will achieve whichever is more stringent. If less stringent levels or measures are appropriate in view of specific project circumstances, the borrower/client will provide full and detailed justification for any proposed alternatives that are consistent with the requirements presented in this document.

31 Environment consultants will be included the LIC.

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monitoring will be conducted by the government environment monitoring agencies or certified monitoring companies of project components. Assurances for environmental safeguards have been prepared and are included in the loan and project agreements.

75. Public consultation. Information disclosure and public consultations were conducted with key stakeholders in accordance with the PRC Interim Measures for Public Consultation in Environmental Impact Assessment (2019) and ADB’s SPS. Public concerns about noise and dust due to land levelling; demolition/construction waste; solid waste, wastewater, sludge, odor, traffic safety, medical waste storage and transport; and indoor air quality were documented and shall be addressed during implementation by the contractors and PIEs.

76. Environment budget. The GPMO shall make available the necessary budget and human resources through each of the PIEs and the implementing agencies to fully implement the EMP. GPMO will engage external safeguard monitoring experts, under the project, to ensure compliance with EMP. 32 For any unanticipated environmental risks and impacts which may include any change in scope of work or a design change to a subproject arise during construction or operation of the project that were not considered in the IEE and/or EMP, the GPMO should promptly inform ADB in writing of the occurrence of such risks or impacts, with detailed description of the event and the proposed action plan for incorporation in the updated EMP, as necessary. The update of the EMP shall be done by LIC working in consultation with GPMO-SO and the implementing agencies which is required to be approved by ADB before it is implemented.

77. The total estimated cost of EMP implementation is $0.895 million. EMP implementation will be scheduled to precede the project design and construction schedules. Under the supervision of GPMO, the PIEs will ensure that such funds are made available on a timely manner.

Table 16: Estimated Costs for Implementing the Environmental Management Plana

No. Type of Expenses Cost Estimates

($) Source of Fund 1 Awareness activities for EMPb 5,000 LIC’s budget 2 Support the implementation of mitigation activitiesc 713,000 Contractors’ cost 3 Reviewing and revising the EMPd 20,000 LIC’s budget 4 Environment parameters testing (quarterly) - included in civil

works contract 26,000 Construction supervision

budget/PMO budget 5 Training and consultancye 20,000 LIC’s budget 6 Monitoring activities document 81,000 LIC’s budget

7 Public consultation and feedback (one consultation per year up to PCR submission and grievance redress)

10,000 Construction supervision/PMO budget

8 External safeguards monitoring consultants 20,000 Loan monitoring budget Total 895,000

EMP = environmental management plan, LIC = loan implementation consultants, PCR = project completion report, PMO = project management office. a Breakdown of costs are included in the initial environmental examination/environmental management plan document. b Includes activities to provide awareness on EMP to relevant stakeholders and public communities in surrounding areas of

construction sites as well as informing them of the roles and responsibilities of various parties involved. c Mitigation activities are approximately 0.5% for individual package. Cost for asbestos management is excluded from the

budget. d Revision of initial environmental examination/EMP, if major change in scope happens during implementation (estimate two

times). e Training costs for items. Source: Asian Development Bank. 32 External environment monitoring consultant will be engaged under the loan.

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78. Climate risk and vulnerability assessment. A climate risk and vulnerability assessment found that all five project sites have a medium risk to climate change impacts. The implementing agencies and PIEs will ensure that the detailed project designs by the design institutes or the PPP concessionaire incorporate engineering design adjustments derived from assessment results, as proactive adaptation measures. Anti-flooding designs and evacuation devices are the principal measurements to mitigate predicted climate events. Heating and cooling systems will be installed in all project facilities to help elderly people and practitioners adapt to extreme climate conditions. All buildings shall achieve the domestic energy efficiency standards. Preserving existing buildings, using renewable energy, increasing energy efficiency, and resource savings are the four main methods to mitigate greenhouse gas emission. B. Involuntary Resettlement

79. The project is categorized as B for involuntary resettlement. The project requires 11.38 hectares (ha) of land, comprising 4.94 ha of rural collective lands and 6.44 ha of state-owned lands. Acquisition of rural collective lands will be required for the second elderly care facility under HPH’s subproject and will affect 56 households with 296 persons in Xiadao village.33 The house demolition of 26 households with 152 persons will require relocation and involve significant impacts. Agriculture is not the source of livelihood of 45 households with 208 persons losing collective cultivated lands, and the impacts on household incomes were assessed to be less than 1%. A draft resettlement plan was prepared following the laws and regulations of the PRC, those of GZAR and Hezhou Municipality, and ADB’s SPS (2009). HMG will be responsible for compensation and provision of support and assistance prior to land acquisition and relocation activities. The other four project sites will be located on state-owned lands and will not require any additional land acquisition. For these project sites, a due diligence of land acquisition and compensation was carried out to confirm that there are no past or present concerns related to involuntary resettlement. 80. GPMO will ensure that (i) the resettlement plan agreed between HMG and ADB is updated based on detailed design and submitted to ADB for review and concurrence prior to land acquisition and relocation activities and implemented in accordance with applicable Government laws and regulations and ADB’s SPS (2009); in case of any inconsistency between Government laws and ADB’s policy, the latter will prevail; (ii) all affected persons are given adequate opportunity to participate in resettlement planning, updating, and implementation; (iii) counterpart funds for LAR activities are provided according to the budget and project schedule; (iv) any additional costs in excess of the resettlement plan budget estimates are met within the project schedule; (v) GPMO and the PIEs will designate adequate staff and resources to supervise and monitor updating and implementation of the resettlement plan and submit semiannual internal monitoring reports to ADB; (vii) the GRM established is effective and functional; and (viii) the PMO engages an external monitor acceptable to ADB to verify implementation and carry out its own monitoring evaluation of resettlement activities on a semiannual basis and assessment 1 year after completion of resettlement plan implementation. 81. The PIEs shall not hand over a specific section of a contract to the civil works contractor until: (i) payment of compensation has been fully disbursed to the affected people and rehabilitation measures are in place for that specific section as per the agreed resettlement

33 Amongst the 56 households, 30 households with 144 persons will be affected by land acquisition, 11 households

with 88 persons by house demolition, and 15 households with 64 persons affected by both land acquisition and house demolition.

55

plan; (ii) affected people who were compensated for that specific section have vacated the site; and (iii) the specific section of the subproject is free from any encumbrances.

VIII. GENDER AND SOCIAL DIMENSIONS

82. A poverty and social analysis (PSA) and a SDGAP were undertaken during the project preparation phase in accordance with ADB guidelines on social dimensions. The PSA and SDGAP included a review of secondary data, household surveys, focus group discussions, and key informant interviews. The PSA and SDGAP assisted in the design of the project to ensure that they are socially inclusive and implemented with community participation. 83. Social development action plan. The project is categorized as having effective gender mainstreaming and a SDGAP has been prepared. The project will have significant benefits for both men and women because of new job opportunities and elderly care-related training opportunities. The increase in public awareness on elderly care and health care services will also help promote public understanding on the issue of population aging and related elderly care services. Both men and women strongly support the project and they perceive that the project will improve the quality of elderly care and health care services and create employment and income opportunities for them. Women’s participation in public consultation, training program, and relevant public awareness activities is integrated in the SDGAP which will help strengthen effective project implementation and sustainable development. 84. The following measures are included in the SDGAP: (i) equitable participation and consultation of men and women during project implementation, (ii) capacity building of the executing and implementing agencies, (iii) providing both men and women with employment opportunities associated with the project construction activities, (iv) OJT on elderly care-related services for both male and female relevant staff, and (v) strengthening public awareness on elderly care and health care services.

Table 17: Social Development and Gender Action Plan

Proposed Actions Indicators and targets Responsible Institutions Timeframe Budget

Output 1: Coordinated care services and facilities improved 1. Construct or renovate

facilities for elderly care 2. Improved public

awareness and benefits of coordinated elderly care and health care services

1.1. 4 elderly care facilities constructed or renovated with age-friendly design and gender-sensitive facility usea

1.2. 30% of the elderly people

who need coordinated carec received services provided by the elderly care institutions created under the project (disaggregated by sex)

2. Conduct at least two public

awareness activities on gender-sensitive facility use, and age-friendly design of which 50% of participants are women

PIEs, PMO, consultants,b health commission, civil affairs bureau, township (subdistrict) government, community/ village committee, and contractors assisted by PMO

2020–2025

Project budgetb

56

Proposed Actions Indicators and targets Responsible Institutions Timeframe Budget

3. Employment opportunities provided during the project construction and preparation

4. Training on rehabilitation

provided 5. Training on elderly care

provided 6. Male elderly care-

related workers are employed to reduce heavy workload of female workers

7. Young people to have

more interaction with elderly people and elderly care-related activities, such as intergeneration visits and conversation with the elderly organized

8. Hospital discharge

management (on three PIEs) improved

3.1. During the project construction phase, 1,190 jobs generated at least 20% of which will be first made available to the poord or women

3.2. During the project operation

phase, 150 skilled and 400 unskilled jobs generated of which 70% will be made available to women

4. By 2026, at least 300

therapists and other related staff of PIEs and elderly care institutions (of which 60% are women) who were trained on occupational and physical therapy report improved skills (2019 baseline: 0)

5. By 2026, at least 250 elderly

care-related staff trainede (of which 60% are women) report improved skills in elderly care (2019 baseline: 0)

6. 5 male elderly care-related

workers recruited 7. 2 intergenerational visits and

recreational activities conducted, records of participants in the activities (sex-disaggregated)

8. 50% of relevant staff of PIEs

(on the three hospital PIEs) received training on the respective improved discharge management systems (sex-disaggregated) Baseline:0

57

Proposed Actions Indicators and targets Responsible Institutions Timeframe Budget

Output 3: Management and policy development capacities in promoting integrated elderly care and health care services developed 1. Institutional capacity in

elderly care service and coordination improved

2. Awareness creation

programs organized for the elderly and their families on coordinated elderly and health care services

1.1. By 2026, at least 80% of domestic and international training participants reported enhanced knowledge on elderly care and health care integration of which 50% of participants are women (2019 baseline: not applicable)

1.2. Two gender and age-sensitive

trainings conducted to service providers and local relevant officials of which 50% of participants are women (sex-disaggregated data of persons attended)

2.1. Two awareness creation

programs organized 2.2. Records of attendees to

public consultations held (disaggregated by sex) Baseline: 0

PMO (executing and implementing agencies), relevant departments, bureaus and agencies, PIEs assisted by consultantsb health commission, and civil affairs bureau

2024–2026

Project budgeta

PIE = project implementing entity, PMO = project management office. a Gender-sensitive facility use provides separate rooms per gender. b The project consultants, engaged under the project, will support Guangxi PMO, PIEs, and implementing agencies

to conduct the proposed actions and monitor the indicators. c Elderly people who need coordinated care will be identified by the discharge management system of each PIE

which will be strengthened by the project. Of those identified elderly people who need coordinated care, 30% will receive the needed elderly care services at the elderly care institutions/facilities which will be created under the project.

d The definition of the poor follows the local standards of low-income at each project site. e Elderly-care related staff would include caregivers, care managers, and social workers. Source: Asian Development Bank.

85. To address the risks of spread of HIV/AIDS/STI in project areas, the project will (i) include clauses on HIV/AIDS/STI and other communicable disease awareness for the contractors/subcontractors, employees, and the PPP concessionaire into contract bidding documents; (ii) conduct public health and HIV/STI prevention education programs for the civil works’ contractors and labor force; (iii) establish health measures for construction workers (e.g., setting up a temporary infirmary using local medical resources); and (iv) conduct of diverse publicity activities on HIV/AIDS (e.g., brochures, posters, and leaflets). 86. Other social aspects. As per the loan assurances, construction workers hired from local communities will be trained on good sanitation practices and health and occupational safety measures while working at the construction sites. The concerned agencies will develop their capacity to protect workers’ legal and labor rights during project construction or project operation phases.

58

87. Labor issues. Core labor standards will comply with national laws and regulations. Civil works contracts will stipulate priorities to (i) employ local people for works, (ii) ensure equal opportunities for women and men, (iii) pay equal wages for work of equal value, (iv) pay women’s wages directly to them, and (v) not employ children or forced labor. The GPMO, implementing agencies, and PIEs are responsible for coordinating activities and ensuring the implementation of the SDGAP, covering all subprojects. The PIEs will monitor compliance of the contractors and the PPP concessionaire with these project assurances in conjunction with the Department of Human Resources and Social Security and Department of Civil Affairs of GZAR, and the implementing agencies and GPMO will supervise the monitoring. The GPMO shall assign or appoint one social development staff member during project implementation to ensure timely and appropriate implementation of the SDGAP.

88. Gender and social dimensions monitoring. The PPMS will include monitoring of the SDGAP. Clear targets and indicators have been established and some indicators are also captured in the design and monitoring framework. The social development and LAR safeguards specialist, engaged under the project, will assist PIEs to set up an effective monitoring system and to ensure implementation of the SDGAP, covering all subprojects. The SDGAP will be monitored semiannually and reported through the quarterly project progress reports and during ADB review missions.

IX. PERFORMANCE MONITORING, EVALUATION, REPORTING, AND COMMUNICATION

A. Project Design and Monitoring Framework

Impact the Project is Aligned with Integrated elderly care and health care services in Guangxi Zhuang Autonomous Region established (Opinion 82 on Implementation of Elderly Care and Health Care Integration Promotion)a

Results Chain Performance Indicators with

Targets and Baselines Data Sources and

Reporting Mechanisms

Risks Outcome By 2027 Utilization of coordinated health care and elderly care services in Guangxi Zhuang Autonomous Region increased

a. 30% of the elderly people who need coordinated careb received services provided by the elderly care institutions created under the project; disaggregated by sex (2019 baseline: 0)

b. 30% of the elderly patients,

hospitalized in PIEs, supported by the improved discharge management systemc (2019 baseline: 0)

a–b. Project monitoring reports of GPMO and/or annual report of civil affairs bureaus of Nanning and Hezhou

Shifting priorities of Guangxi government on health care and elderly care service coordination

Outputs 1. Coordinated care

services and facilities improved

1a. By 2026, reform plans for discharge management systems implemented (2019 baseline: 0)

1a–e. Semiannual project monitoring reports of GPMO

Staff turnover of trained employees in the identified elderly care institutions

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Results Chain

Performance Indicators with Targets and

Baselines

Data Sources and Reporting

Mechanisms

Risks 1b. By 2026, four elderly

care facilities and a medical facility, with age-friendly design and gender-sensitive facility use constructedd (2019 baseline: 0)

1c. By 2026, at least 300

therapists and other related staff of PIEs and elderly care institutions (of which 60% are women) who were trained on occupational and physical therapy report improved skills (2019 baseline: 0)

1d. By 2026, at least 250

elderly care-related staff trainede (of which 60% are women) report improved skills in elderly care (2019 baseline: 0)

1e. By 2026,

recommendations for a capacity-building plan for identified care provision preparedf (2019 baseline: not applicable)

2. Public–private partnership project for integrated elderly care and health care services provision developed

2a. By 2025, one elderly care institution for

the coordinated care services commences operation under a PPP model (2019 baseline: 0)

2a. Semiannual project monitoring reports of GPMO

The private sector has insufficient interest in the elderly care and health care market. The viability support by the public sector is inadequate to catalyze the private sector participation in the elderly care and health care market

3. Management and policy development capacities in promoting integrated elderly care and health care services developed

3a. By 2021, Hezhou PPP subproject awarded (2019 baseline: not applicable)

3b. By 2023,

recommendations for elderly care facility

3a–b. Semiannual project monitoring reports of GPMO

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Results Chain

Performance Indicators with Targets and

Baselines

Data Sources and Reporting

Mechanisms

Risks

designs to meet functionalities of the elderly care institutionsg incorporated in preliminary and detailed design (2019 baseline: not applicable)

3c. By 2026, at least 80%

of domestic and international training participants reported enhanced knowledge of elderly care and health care integration, of which 50% of participants are women (2019 baseline: not applicable)

3c. Training

questionnaires

Key Activities with Milestones 1. Coordinated care services and facilities improved 1.1 Complete detailed design by Q4 2020. 1.2 Organize and complete bidding process by Q3 2021. 1.3 Construct and procure equipment by Q4 2024. 1.4 Implement reformed discharge management systems by each PIE except Nanning Social Welfare Institute by

Q1 2026. 1.5 Prepare and submit recommendations of capacity-building plan by Q4 2022. 1.6 Complete training on occupational and physical therapy by Q1 2026. 1.7 Complete training of elderly care-related staff by Q1 2026. 2. Public–private partnership project for integrated elderly care and health care services provision

developed 2.1 Launch tender by Q4 2020 2.2 Complete construction by Q2 2024. 2.3 Commence operation of an elderly care facility under PPP by Q2 2025. 3. Management and policy development capacities in promoting integrated elderly care and health care

services developed 3.1 Incorporate and finalize designs for elderly care facilities by Q4 2020. 3.2 Prepare and implement PPP model for Hezhou subproject by Q4 2025. 3.2.1 Identify a feasible PPP modality for integrated elderly care and health care services provision by Q2 2020. 3.2.2 Finance and structure a PPP model for Hezhou PPP subproject by Q4 2021. 3.2.3 Support PPP implementation by Q4 2025. 3.3 Strengthen capacity of policy development and elderly care service provision by Q4 2025. 3.3.1 Provide training on elderly care services support by Q4 2025. 3.3.2 Provide training on care and rehabilitation by Q3 2025. 3.3.3 Provide training on discharge management by Q3 2025. 3.3.4 Prepare and conduct domestic and international training by Q2 2025. 3.3.5 Disseminate experience and knowledge on elderly care and health care integration by Q4 2025.h

Program Management Activities Complete selection of project implementation support consultants by Q3 2020. Engage construction supervision by Q1 2021. Prepare and manage implementation and procurement plans (Q4 2020–Q4 2025). Monitor project performance and ensure timely delivery of outputs (Q4 2020–Q2 2026). Inputs Asian Development Bank: $100.00 million (loan) Government: $93.52 million

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Assumptions for Partner Financing Not applicable GPMO = Guangxi project management office, PIE = project implementing entity, PPP = public–private partnership, Q = quarter. a Government of Guangxi Zhuang Autonomous Region. 2016. Opinion [82] on Implementation of Elderly Care and

Health Care Integration Promotion. Nanning; and Government of Guangxi Zhuang Autonomous Region, Department of Civil Affairs. 2016. Promote Involvement of Private Sector in the Elderly Care Sector. Nanning.

b Elderly people who need coordinated care will be identified by the discharge management system of each PIE that will be strengthened by the project.

c Discharge management systems will be strengthened in PIEs (except for Nanning Social Welfare Institute, which is not a hospital) under the project to support proper transfer of elderly patients after hospitalization to elderly care institutions and homes, etc., based on needed care and their family conditions.

d Gender-sensitive facility use provides separate rooms per gender. e Elderly-care related staff will include caregivers, care managers, nurses, and social workers. f The plan includes gender- and age-sensitive training. g The target functionalities of the elderly care institutions are summarized in Table 2 of the Project Administration

Manual (accessible from the list of linked documents in Appendix 2). h The knowledge dissemination activity could be organized by collaborating with other elderly care related technical

assistance activities. Source: Asian Development Bank.

B. Monitoring

1. Project Performance Monitoring

89. The PPMS indicators, as specified in the design and monitoring framework, will include number of (i) elderly people using elderly care services, (ii) elderly care service providers, (iii) beneficiaries of coordinated elderly care and health care services, (iv) elderly people who are received and serviced at the elderly care institutions which will be created under the project, (v) trained rehabilitation therapists (for occupational therapy and physical therapy) and elderly care-related staff, (vi) reform plans of hospital discharge management, and (vii) an implementation arrangement through a PPP model for Hezhou PPP subproject. At the start of project implementation, the executing and implementing agencies and PIEs, with support of the project management consultant will develop comprehensive PPMS procedures to generate data systematically on project outcome, inputs, and outputs of each subproject. These will be used to measure the project impact, outcome, outputs, and compliance with ADB safeguard policy requirements. The GPMO will ensure to (i) refine the PPMS framework, (ii) establish and/or verify the baselines, (iii) confirm achievable targets, (iv) finalize the monitoring and recording arrangements, and (v) establish data collection systems and reporting procedures no later than 9 months after the loan effectiveness. A project performance monitor specialist, engaged under the project, will support the executing and implementing agencies and PIEs to conduct appropriate project monitoring. Disaggregated baseline data and output and outcome indicators gathered during project processing will be updated and reported quarterly through the quarterly progress reports and after each ADB review mission. These quarterly reports will provide information necessary to update ADB's project performance reporting system.34 90. Hospital data analysis. The elderly care technical firm, engaged under the project, will conduct the hospital data analysis on PIEs to monitor the performance indicators with targets of the project outcome (targets a and b of outcome in DMF) and examine the achievements of those performance targets. The elderly care technical firm will summarize the performance achievement in a report, and submit it to the GPMO and ADB. 34 ADB's project performance reporting system is available at

http://www.adb.org/Documents/Slideshows/PPMS/default.asp?p=evaltool

62

91. Compliance monitoring. The GPMO, the implementing agencies, PIEs, and project management consulting service will conduct compliance monitoring, covering all subprojects, submit periodic (at least semiannual) reports to ADB concerning the use of the loan proceeds, project implementation, project implementation performance, and compliance of loan and project covenants. These reports will also include (i) progress reports on project implementation including resettlement, ethnic minority elements, and SDGAP; (ii) consolidated annual reports; (iii) annual internal environment progress and monitoring report and external environment compliance auditing report; (iv) semiannual external resettlement monitoring report including ethnic minority elements, and SDGAP; and (v) a project completion report, which should be submitted not later than 3 months after the completion of the project facilities. The compliance status of loan and project covenants will be reported and assessed through quarterly progress report and consolidated annual reports. ADB review missions will verify the status.

2. Safeguards Monitoring 92. Implementation of the EMP and the resettlement plan will be monitored by internal environment, resettlement, and social development specialists. ADB requires external monitoring safeguard consultants to monitor implementation of EMP and resettlement plan.

(i) Environmental Monitoring

93. Two types of project monitoring will be conducted under the EMP.

94. Internal monitoring. This will be conducted by the LIC, contractors, the PPP concessionaire, and construction supervision companies supervised by GPMO-SO. It includes the monitoring of construction activities such as dust and noise at all construction sites that require demolition of buildings, land levelling, proper disposal of demolition waste, quality of discharged construction wastewater, and erosion control, etc. It also includes daily inspection and internal compliance assessment with the approved site management plans of contractors, including construction site health and safety for the community and the workers. During operations, internal monitoring will check the environment management of facilities and the emergency response preparedness. The internal environment progress and monitoring report will be submitted by the GPMO to ADB annually during construction and operation until the project completion report is submitted.

95. Monitoring for environment parameters. A local environmental monitoring agency will be contracted by the PIEs, including the PPP subproject, to measure the effects and monitor the values of noise, dust, and wastewater in the project area, which extends from the construction site boundary to any nearby sensitive receptors under the supervision of GPMO-SO, based on the frequency specified in the EMP. The testing results of the environment data monitored by the agency shall adhere to EMP requirements and shall meet all PRC and ADB standards as well as international best practices. Any non-compliance will be highlighted in the above-mentioned environment testing results provided by the agency to the PIE. The GPMO shall, based on inputs from PIEs, incorporate these results in the annual environmental monitoring reports that are prepared by the GPMO with support from the LIC and submitted to ADB for review.

96. Compliance monitoring or auditing. EMP compliance monitoring is the systematic evaluation of the overall progress of the implementation of EMP measures. Evaluation of the compliance with the EMP will be undertaken regularly by the GPMO-SO and the LIC, who will report EMP implementation progress and compliance through semiannual project progress reports and annual environmental monitoring reports. The reports will identify environment-related

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implementation issues and necessary corrective actions and reflect these in a corrective action plan. The reports will also include safeguards aspects of the operation and performance of the project, GRM, environmental institutional strengthening and training, and compliance with all covenants under the project.

97. External monitoring. ADB requires GPMO to retain qualified and experienced experts to verify the safeguards monitoring reports.35 These external experts will report on an annual basis directly to ADB to verify if sound environmental management practices were followed during implementation. In case the implementation of EMP measures is not satisfactory, the external safeguard monitoring experts will recommend actions to enhance environmental compliance. External monitoring reports will be submitted annually, 3 months after the internal environment monitoring reports are submitted by GPMO to ADB; and as needed when compliance/grievance issues occur.

98. Reporting. ADB will oversee project compliance based on the quarterly project progress reports and annual environmental monitoring reports provided by GPMO and review missions (generally 1–2 times per year). Disclosure of safeguards monitoring reports will be done both locally and on the ADB website.

(ii) Involuntary Resettlement Monitoring

99. The GPMO, the implementing agencies, PIEs, and the social development and resettlement safeguards specialist of the project management consulting services, will carry out an internal monitoring of resettlement plan implementation and submit semiannual monitoring reports to ADB. In addition, the PMO will also engage an external resettlement monitor (external social development and social safeguards) to assess whether the implementation of the LAR activities are consistent with the resettlement plan provisions and ADB Safeguard Policy Statement (SPS, 2009) requirements. The external resettlement monitor will submit semiannual monitoring reports to the GPMO and ADB during the period of resettlement plan implementation. After 1 year of the completion of resettlement plan implementation, the external resettlement monitor will assess the implementation of LAR provisions in the project and submit a resettlement completion report to GPMO and ADB.

(iii) Gender and Social Development Monitoring 100. The PPMS will include monitoring of the SDGAP. Clear targets and indicators have been established. The social development and resettlement specialist will assist the GPMO, implementing agencies, and PIEs to set up effective monitoring system, covering all subprojects, and work with the focal points in the GPMO, implementing agencies, and PIEs to ensure implementation of the SDGAP. The SDGAP will be monitored semiannually and reported via the quarterly project progress reports and during ADB review missions. C. Evaluation

101. The GPMO, implementing agencies, PIEs, and ADB will undertake annual or semiannual review missions to evaluate the progress of project implementation. The GPMO, implementing agencies, PIEs, and ADB will undertake a comprehensive midterm review 2 years after the start

35 An external expert is not involved in day-to-day project implementation or supervision. An external expert will be

engaged under the project.

64

of project implementation to have a detailed evaluation of the scope, implementation arrangements, resettlement, achievement of scheduled targets, and progress on the agenda for policy reform and capacity building measures. Feedback from the PPMS activities will be analyzed. Within 3 months of physical completion of the project, the executing agency will submit a project completion report to ADB.36

D. Reporting

102. The GPMO will provide ADB with (i) quarterly progress reports in a format consistent with ADB's project performance reporting system; (ii) consolidated annual reports including (a) progress achieved by output as measured through the indicator's performance targets, (b) key implementation issues and solutions, (c) updated procurement plan, and (d) updated implementation plan for the next 12 months; and (iii) a project completion report within 3 months of physical completion of the project. To ensure that projects will continue to be both viable and sustainable, project accounts and the audited project financial statements together with the associated auditor's report, should be adequately reviewed.

E. Stakeholder Communication Strategy

103. The stakeholder communication strategy is based on the principles of transparency, timeliness, meaningful participation and inclusiveness. The strategy ensures that vulnerable groups, such as the poor and women, who risk further marginalization, are provided opportunities for communication and feedback during project implementation. Meaningful participation is defined as a process that (i) is carried out throughout the project cycle, and (ii) provides timely disclosure of relevant and adequate information that is understandable and readily accessible to the affected persons. 104. The stakeholder communication strategy is designed to ensure a regular flow of reliable project information and interest and/or willingness to take advantage of the project benefits.

X. ANTICORRUPTION POLICY

105. ADB reserves the right to investigate, directly or through its agents, any violations of the Anticorruption Policy relating to the project. 37 All contracts financed by ADB shall include provisions specifying the right of ADB to audit and examine the records and accounts of the executing agency and all project contractors, suppliers, consultants, and other service providers. Individuals and/or entities on ADB’s anticorruption debarment list are ineligible to participate in ADB-financed activity and may not be awarded any contracts under the project.38

XI. ACCOUNTABILITY MECHANISM

106. People who are, or may in the future be, adversely affected by the project may submit complaints to ADB’s Accountability Mechanism. The Accountability Mechanism provides an independent forum and process whereby people adversely affected by ADB-assisted projects can voice, and seek a resolution of their problems, as well as report alleged violations of ADB’s operational policies and procedures. Before submitting a complaint to the Accountability 36 Project completion report format is available at: http://www.adb.org/Consulting/consultants-toolkits/PCR-Public-

Sector-Landscape.rar 37 Anticorruption Policy: http://www.adb.org/Documents/Policies/Anticorruption-Integrity/Policies-Strategies.pdf 38 ADB's Integrity Office web site: http://www.adb.org/integrity/unit.asp

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Mechanism, affected people should make an effort in good faith to solve their problems by working with the concerned ADB operations department. Only after doing that, and if they are still dissatisfied, should they approach the Accountability Mechanism.39

XII. RECORD OF CHANGES TO THE PROJECT ADMINISTRATION MANUAL

107. All revisions and/or updates during the course of implementation should be retained in this section to provide a chronological history of changes to implemented arrangements recorded in the PAM.

39 Accountability Mechanism. http://www.adb.org/Accountability-Mechanism/default.asp.

66 Appendix 1

APPENDIX 1: TEMPLATE FOR QUARTERLY PROGRESS REPORT 报告期 (Reporting period)

提交日期 (Date of Submission)

A. 项目介绍及基础数据 (PROJECT INTRODUCTION AND BASIC DATA) 1. 项目基本信息 (Basic Project Information) 项 目 号 (Project/Loan Number)

PRC: 50391/Loan XXXX

项目名称 (Project Title) Demonstration of Guangxi Elderly Care and Health Care Integration and Public–Private Partnership Project

接收人 (Recipient) People’s Republic of China 执 行 机 构 (Executing Agency)

Government of Guangxi Zhuang Autonomous Region

项 目 办 (Project Management Office)

Guangxi project management office

项目汇总费用表 (Project Summary Cost Estimates) ($ million) Item Amount A. Base Cost Subtotal (A) B. Contingencies C. Financial Charges During Implementation Total Project Cost (A+B+C)

项目融资计划 (Project Summary Financing Plan) Source 资金来源 Amount ($ million)

金额 Share of Total (%) 占比

Asian Development Bank 亚行 Ordinary Capital Resources 普通资金来源 Government (Counterpart) Total Project Cost

2. 项目批准、生效及关闭日 (Project Approval, Effectiveness and Closing Dates) 批准日期 (Approval date) 项目实施期限 (原) [Elapsed

project period (original)]

贷款协定、项目协定签字日 (Loan signing date)

关 帐 日 ( 修 改 后 ) (Loan closing date) (revised)

生效日期 (Loan effective date)

项目实施期限 ( 修改后 ) [Elapsed project period (revised)]

关帐日(原定) (Loan closing date) (original)

亚行上次项目检查时间 (Date of last ADB review mission)

Appendix 1 67

B. UTILIZATION OF FUNDS

Table 1: Withdrawal Progress of ADB Loan

Item Outputs 产出

Amount 投资额 ADB Loan 亚行贷款

Domestic Counterpart

Funds 国内配套资金

ADB Loan Withdrawal Progress 亚行贷款支付进程 Cumulated Up to the End of Last

Period 截至上期末 Amount This Period 本期

Cumulative amount 累计金额 %

$ million 百万美元 %

$ million 百万美元 %

$ million 百万美元 $ million 百万美元

1. Coordinated care services and facilities improved

2.

Public–private partnership project for integrated elderly care and health care services provision developed

3.

Management and policy development capacities in promoting integrated elderly care and health care services developed

Subtotal (A)

68 Appendix 1

C. 实施进度 (IMPLEMENTATION PROGRESS) 1. 报告期间项目实施进度情况 (Project Implementation Progress during the Reporting

Period by Outputs) [________________, (State the progress and achievements in implementation by output since the last progress report.)] 重点阐述本报告期的各项进展和成果，建议按照产出来分类描述 2. 项目实施安排 (Project Implementation Arrangements) [________________, (State assessment of project implementation arrangements such as establishment, staffing, and funding of the PMO, safeguards monitoring staffing)] 重点阐述项目执行过程

中的执行安排，例如，项目办的情况、安保方面监测的人员安排等， 3. 项目进度评价 (Assessment of Project Progress) (Assess progress in implementing the overall project to date in comparison with the original implementation schedule—quantifiable and monitorable target, (include simple charts such as bar or milestone to illustrate progress, a chart showing actual versus planned expenditure, S-curve graph showing the relationship between physical and financial performance, and actual progress in comparison with the original schedules and budgets, the reference framework or guidelines in calculating the project progress including examples are shown in the project administration memorandum [PAM]) (You can append existing chart/table/graph showing physical and financial progress as appendixes, if any.) 详细阐述项目的各方面进度，包括建设进度、财务进度等，可利用本项目管理手册中的项目总投资估算

表的格式，来表述本期进展以及累计进展。

4. 评价主要假设条件及风险的有效性 (Assessment of the Validity of Key Assumptions and Risks)

[评价实现量化后的实施目标所设想的主要假设条件及风险的有效性 (Assess the validity and key assumptions and risks in achieving the quantifiable implementation targets)]

5. Implementation of EMP 环境管理计划的执行情况 (Include implementation of activities in the environmental management plan for project activities) 综述环境管理计划中的各项活动执行情况 6. Implementation of RP 移民报告的执行情况 (Include implementation of activities in the resettlement plan for project activities) 综述移民计划中的各项活动执行情况 7. Implementation of GAP, SAP, EMDP 性别行动计划、社会行动计划和少数民族发展计划

的执行情况

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(Include implementation of activities in the GAP, SAP and EMDP for project activities) 综述性别行动计划、社会行动计划和少数民族发展计划中各项活动的执行情况

D. 项目建设目标 (PROJECT PURPOSES) 1. 建设内容/实施安排情况 (Status of Project Scope/Implementation Arrangements) [________________, (Assess the status of project scope/implementation arrangements compared with those in the project document, and whether major changes have occurred or will need to be made.)] 阐述项目的范围是否有变动，或者其他需要变更的地方 2. 项目成果实现的可能性及补救措施 (Likelihood of Achievement of the Project Outcomes and Remedial Measures) [________________, (Assess the likelihood that the immediate development objectives (project purpose) will be met in part or in full, and whether remedial measures are required based on the current project scope and implementation arrangements.)] 3. 主要假设和风险变更 (Changes to the Key Assumption and Risks) [________________, (If applicable, assess changes to the key assumptions and risks that affect attainment of the development objectives.)] 4. 其他建设内容 (Other Project Developments) [________________, (If applicable, state any other project developments, including monitoring and reporting on environmental and social requirements that might adversely affect the project's viability or accomplishment of immediate objectives.)] E. 相关条款的遵从 (COMPLIANCE WITH COVENANTS) [_________ (Summarize the status of the borrower’s and EA’s compliance with key financial, safeguards, and other covenants, particularly, for those covenants on due.)]

F. 主要问题与困难 (MAJOR PROJECT ISSUES AND PROBLEMS) [如适用，请归纳影响或有可能影响项目实施进度、法律条款合规性，及实现本期目标等的主要问题，提

出解决这些问题的建议（如变更建设内容、项目实施安排及贷款资金的再分配） (If applicable, summarize the major problems and issues affecting or likely to affect implementation progress, compliance with covenants, and achievement of immediate development objectives. Recommend actions to overcome these problems and issues (e.g., changes in scope, changes in implementation arrangements, and reallocation of loan proceeds) G. 下一汇报期工作计划 (WORK PLAN FOR NEXT 6 MONTHS)

70 Appendix 1

Executing Agency’s Progress Report Contents

A. Introduction and Basic Data

(i) loan number, project title, borrower, executing agency(ies) (EA), implementing agency(ies) (IA);

(ii) total estimated project cost and financing plan; (iii) status of project financing including availability of counterpart funds and

cofinancing; (iv) dates of approval, signing, and effectiveness of ADB loan; (v) original and revised (if applicable) ADB loan closing date and elapsed loan period

based on original and revised (if applicable) loan closing dates; and (vi) date of last ADB review mission.

B. Utilization of Funds

(i) cumulative contract awards financed by the ADB loan, cofinancing, and counterpart funds (commitment of funds to date), and comparison with time-bound projections (targets);

(ii) cumulative disbursements from the ADB loan, cofinancing, and counterpart funds (expenditure to date), and comparison with time-bound projections (targets); and

(iii) re-estimated costs to completion, need for reallocation within ADB loan categories, and whether an overall project cost overrun is likely.

C. Project Purpose and Implementation Progress

(i) status of project scope and implementation arrangements compared with those in the report and recommendation of the President (RRP), and whether major changes have occurred or will need to be made;

(ii) an assessment of the likelihood that the project outcome and outputs will be achieved in part or in full, and whether remedial measures are required based on the current project scope and implementation arrangements;

(iii) an assessment of changes to the key risks that affect achievement of the outcome and outputs, and quantifiable implementation targets;

(iv) other project developments, including monitoring and reporting on gender, safeguards (environment, resettlement and Indigenous Peoples), and social safeguards requirements that might adversely affect the project's viability or accomplishment of project outcome;

(v) assessment of project implementation arrangements such as establishing, staffing, and funding of the project management office or project implementation units;

(vi) information relating to the EA’s internal operations that impacts on implementation arrangements or project progress;

(vii) assessment of the progress of each implementation activity, such as, a. recruitment of consultants and their performance; b. procurement of goods and works (from preparation of detailed designs and

bidding documents to contract awards); c. the performance of suppliers, manufacturers, and contractors for goods

and works contracts; and d. comparison with the original implementation schedule—quantifiable and

monitorable target, (include charts such as bar or milestone to illustrate

Appendix 1 71

progress and actual versus planned expenditure, S-curve graph showing the relationship between physical and financial performance, and actual progress in comparison with the original schedules and budgets). The reference framework or guidelines in calculating the project progress including examples are shown in Appendix 2.

D. Compliance with Covenants

(i) the borrower's compliance with policy loan covenants such as sector reform initiatives and EA reforms, and the reasons for any noncompliance or delay in compliance;

(ii) the borrower’s and EA’s compliance with financial loan covenants including the EA’s financial management, and the provision of audited project accounts or audited agency financial statements; and

(iii) the borrower’s and EA’s compliance with project-specific loan covenants associated with implementation, safeguards (environment, resettlement, and Indigenous Peoples), social and gender dimensions, and other requirements specified in the loan agreement, and Sections VII. Safeguards and VIII. Gender and Social Dimensions of the PAM.

E. Major Project Issues and Problems

Summarize the major problems and issues affecting or likely to affect implementation progress, compliance with covenants, and achievement of project outputs and outcome, including the findings of any project procurement-related review that may have been undertaken. Recommend actions to overcome these problems and issues (e.g., changes in scope, changes in implementation arrangements, and reallocation of loan proceeds).