Terms of Reference
Consultancy Services of an Mechanical Electrical Plumbing/Information Technology Firm for Upgrading and New Construction Works
to Thirteen Health Facilities
for
SUPPORT FOR THE HEALTH SYSTEM STRENGTHENING FOR THE PREVENTION AND CARE MANAGEMENT OF NON-COMMUNICABLE DISEASE PROGRAMME
1.0 BACKGROUND
The Ministry of Health has received a loan from the Inter-American Development Bank to support the Health Systems Strengthening for the Prevention & Care Management of Non- Communicable Diseases (NCD) Programme.
The programme objective is to improve the health of Jamaica’s population by strengthening comprehensive policies for the prevention of Non-Communicable (Chronic) Diseases (NCDs) risk factors and improved access to an upgraded and integrated primary and secondary health network in prioritized areas with an emphasis on chronic disease management, that provide more efficient and higher quality care.
The Programme has two broad components as follows:
Policy – Based Component
Investment Component
The Policy-Based Component will look at policies that will consolidate regulatory measures to address the preventable causes of NCDs and to reorient health systems to address prevention and control of NCDs through a people-centred primary health chronic care model.
The Investment Component, in turn, will finance activities to consolidate integrated health networks and improve the management, quality and efficiency of health services. The Policy Based Component will benefit the Jamaican population at-large, while the Investment Component will have approximately 800,000 potential direct beneficiaries who reside in the catchment areas of the health services networks that will receive investments.
The Investment Programme has two (2) components and an allocation to support programme administration and evaluation:
Component 1 – Organization and consolidation of integrated health services networks
This component will finance the purchase of medical equipment and the improvement of infrastructure for primary health care services in the catchment areas of three priority hospitals to increase their capacity in health promotion and disease prevention, especially regarding chronic, non-communicable diseases. The investments will focus on strengthening the diagnostic and screening capability as well as the clinical and resolutive capacity of health clinics.
This Component will further finance the upgrading and or expansion of three (3) hospitals selected on criteria relating to strategic role in the national hospital network, supply-demand gap analyses, and physical needs assessment. The hospitals will benefit from infrastructure upgrading and or expansion as well as modernization.
Sub-Component 1.1 – Strengthening Primary Care
1.1 The purpose of this subcomponent is to increase the physical capacity for service provision at the primary care level in three (3) priority geographical areas. Approximately ten (10) health centres have been identified to receive investments in medical equipment and infrastructure refurbishment and expansion. The subcomponent will finance: (i) the preparation of building designs for the construction of new infrastructure on the sites of existing facilities (three centres), expansion of existing structures (four centres), and refurbishing (three centres); (ii) the physical works required for infrastructure improvement; (iii) the purchase of medical equipment including essential diagnostic and treatment items for NCDs, such as sphygmomanometers, electrocardiogram machines, pulse oximeters, defibrillators, computerized chemistry machines, etc.); (iv) engineering services for construction supervision; and (v) corrective and preventive maintenance of medical equipment.
Sub-Component 1.2 – Increasing the Capacity and Efficiency of Hospital Services
This subcomponent will address urgent needs to enhance patient safety and services in three (3) hospitals whose catchment areas contain the health centres identified in subcomponent 1.1. financing from this subcomponent will be allocated to:
(i) the building and engineering designs for the infrastructure improvement and expansion;
(ii) the construction in three hospitals according to contracted plans and designs;
(iii) the purchase of medical equipment to raise clinical capacity to partially account for existing demand;
(iv) the purchase of imaging equipment, including computerized tomography machines;
(v) purchase of industrial style laundry machines;
(vi) construction supervision services; and
(vii) the design and implementation of a corrective and preventive equipment maintenance programme.
Component 2 – Improvement of Management, Quality and Efficiency of Health Services
This component will provide technical assistance to design and implement the Chronic Care Model (CCM) in the participating health services networks; to review and develop care pathways and protocols; and to prepare change management, continuous quality improvement and social media marketing for behaviour change strategies. It will also finance the implementation of the fourth Jamaica Health and Lifestyle Survey. This component will further support:
(i) the creation of a strong foundation for a digital health ecosystem, including the adoption of standards for interoperability, system architecture, updated governance structure, and other key elements;
(ii) the design and implementation of a sustainable Electronic Health Record (EHR) platform focusing on digitalization of key processes within the improved CCM; and
(iii) the strengthening of telehealth/telemedicine/telementoring capacity to include chronic care management, and the establishment of norms and processes for its institutionalization.
(iii) the strengthening of telehealth/telemedicine capacity through the expansion of the ECHO model, the inclusion of chronic care in the platform, and the establishment of norms and processes for its institutionalization.
The Loan also supports Programme Administration and Evaluation
Programme Administration and Evaluation
This allocation will support the MOH in terms of strengthening its institutional capacity for project implementation. It will finance, inter alia, the consultants of the Project Execution Unit (PEU), specialized technical services, independent auditing, as well as surveys and studies regarding the implementation of the programme and evaluation of its impact. The PEU is structured to provide additional capability in the areas of project management, procurement, financial management, infrastructure upgrading, medical equipment specification, and health information technology. Technical and fiduciary staff from the MOH will work closely with the PEU specialists so that the MOH benefits from knowledge transfer and capacity strengthening.
2.0 OBJECTIVES OF THE CONSULTANCY
In keeping with Component 1 “Organization and consolidation of integrated health services networks’’, the Programme aims to improve health services delivery in three (3) hospitals and ten (10) Health centres namely:
Hospitals:
1) Spanish Town Hospital
2) St. Ann’s Bay Hospital
3) May Pen Hospital
Health Centres:
4) St Jago Park
5) Old Harbour
6) Greater Portmore
7) St Ann’s Bay
8) Ocho Rios
9) Brown’s Town
10) Chapelton
11) May Pen East
12) May Pen West
13) Mocho
The present work area in health centres and/or hospitals is sometimes inadequate to meet the needs of the population and/or Ministry of health plans especially in regards to NCDs.
3.0 OBJECTIVES
The Objective of the TOR is to engage a highly experienced Mechanical Electrical & Plumbing / Information Technology Firm who will be able to carry out Mechanical Electrical & Plumbing / Information Technology Supervision and Implementation on all (13) Health Facilities in specific areas slated for future upgrading and expansion.
4.0 DETAILED SCOPE OF WORK (SOW) AND DELIVERABLES
The Mechanical Electrical & Plumbing / Information Technology Firm selected will be solely responsible for the overall coordination of the Mechanical, Electrical, Plumbing, Medical Gas, Building Automation Systems, Fire Alarm, Fire Protection, and Data/IT trades and should fulfill the requirements of this TOR.
The SOW defines the extent of the services to be provided and the general method to be followed, the types of reports and the normal range of the recommendations which may be included by the Mechanical Electrical & Plumbing / Information Technology (MEP/IT) Firm who originates the work. The main objective of the consultancy is to support the MOH and its PEU with Mechanical Electrical & Plumbing / Information Technology expertise, particularly as it relates to effectively providing support to the execution of Component 1- Organization & Consolidation of integrated health services networks.
Main scope of work with deliverables required are given below.
4.1 The Mechanical Electrical & Plumbing / Information Technology Firm:
The MEP/IT Firm will be responsible for the overall coordination of the Mechanical, Electrical, Plumbing, Medical Gas, Building Automation Systems, Fire Alarm, Fire Protection, and Data/IT trades Supervision and Implementation on all (13) Health Facilities in specific areas slated for future upgrading and expansion.
The MEP/IT Consultancy is responsible for ensuring all the MEP/IT preparations are carried out properly, and for implementing the MEP/IT related activities as outlined in the Scope of Works (SOW) of the project.
Along with this, the MEP/IT Firm is also responsible for other duties as follows:
Prepare MEP/IT requirements to be included in the civil works design and implementation contracts on all proposed upgrading works facilities;
Supervise and coordinate from design through to implementation and commissioning for;
- Supervision and monitoring of compliance with MEP/IT activities through:
- Supervision both individually and in conjunction with site superintendents and MEP/IT contractor(s), the compliance with mitigation measures envisaged in the site-specific MEP/IT Plan for each facility included in the project;
- Ensuring fulfillment of monitoring plan for each MEP/IT objective included in the project for all facilities, including baseline data, regular field check and the efficiency of mitigation measures are practiced.
- Review material/equipment technical submittals from MEP/IT subcontractors and validate specification compliance
- Enforce MEP/IT quality control plan
- Assist in the development of the MEP/IT Construction and Commissioning Schedule
- Oversee MEP/IT installation by contractor(s)
- Perform inspections for MEP/IT subcontractor(s) &/or relevant product installations
- Assist in MEP/IT final punch list phase of project
- Coordinates with the Contractor(s) on MEP/IT works progress
- Provide schedule updates with MOH PEU and MOH stakeholders upon request to ensure project meets commissioning goals and requirements
- Attends regular project meetings for coordination and development for the resolution of critical issues. In addition, reviews RFI’s (Request for Information), ASI’s (Architect Supplementary Instruction), etc. that could have potential schedule and cost impacts relating to MEP/IT.
- Review of the work plans provided by Subcontractor(s) (as for MEP/IT requirements) and identification of bottlenecks not included in the proposed mitigation measures and MEP/IT activities and/or budget; MEP-Mechanical Electrical and Plumbing Activities
- Assist in designing and implementation of the provision of positive, negative and neutral air pressure regimes where necessary that are associated with operating theatres, intensive care, isolation rooms, CSSD, other relevant areas as well as the health facilities in general.
- Assist in the design and implementation of water systems to avoid Legionella transmission/distribution and any other harmful bacteria that may cause negative consequences in a health facility. The design should facilitate easy maintenance of good water quality in these facilities.
- Assist in the design and implementation of good water quality and ideal temperature surroundings to serve dialysis equipment and sensitive processes.
- Assist in the design and implementation of good Electrical power quality including measures against Harmonics and Electro-Magnetic Compatibility (EMC).
- Selection of integrated bedhead trunking systems combining power, data, medical gases and lighting are readily available and provide a concealed solution for dealing with multiple services, and importantly, to ensure ease of cleaning to reduce the risk of infection.
- The firm shall assist in the integration of LEED, green/eco-efficient building design practices during the project design and implementation phases
- Review and give acceptance of including relevant chapters on MEP and IT protection in the detailed design, technical specifications, and Bills of Quantities
- If required, the firm shall assist in developing designs for COVID-19 or related infectious diseases.
- Designs shall have future proofing as one of its core philosophies.
Other duties include overseeing and monitoring as it relates to all the health facilities slated for upgrading works:
Mechanical
- HVAC design and implementation
- Temperature Control Systems
- Heat Loss / Energy Calculations
- Boiler and Chiller Plant Design
- Electrical Service and Distribution Design
- Lighting Plans
- Plumbing Distribution Design
- Medical/Drain Waste and Vent Systems
- Medical Gas Systems
- Solar Hot Water Systems
- Photovoltaic Systems
- Fire Protection Systems
Electrical
- Power supply and distribution.
- Information and telecommunications systems.
- Control systems.
- Security and access systems.
- Detection and alarm systems.
- Interior and exterior lighting.
- Building management systems (BMS)
- Building automation and control system (BACS).
- Fire detection and alarm system.
- Access control in buildings.
Plumbing
- Heating and cooling.
- Waste removal.
- Potable cold and hot water supply.
- Water recovery and treatment systems.
- Rainwater, surface and subsurface water drainage.
- Fuel gas piping.
- Building heating systems.
- Cooling systems for buildings.
- Greywater recycling.
- Sustainable urban drainage systems.
- Passive water efficiency measures.
- Rainwater harvesting.
Information Technology
- Provide engineering and administration of storage and server infrastructures including testing systems for vulnerabilities
- Scheduling and managing backups and disaster recovery using various productions
- Planning and implementing software and firmware upgrades
- Assist in the designing and Implementation of high-level functional computer systems and networks
- Designs shall have future proofing as one of its core philosophies.
4.2 MEP & IT Report:
- Being accountable to the MOHW/PEU, the Consultant shall provide monthly progress reports, work plan, and following special-purpose reports: Monthly progress report on the activities proposed under the MEP/IT Plan for the selected sites included in the MOHW/IDB project, including the analysis of the efficiency of mitigation measures applied to minimize adverse impacts.
- The report should include the following minimum sections: frequency of site visits, progress in implementation of MEP/IT Plan, problems, faults, general findings and recommendations for further work.
- Main focus should be made on compliance with MEP/IT on project sites.
- Periodical reports on instruction in labour safety measurements delivered to the technical staff of the Project.
- Any other additional (ADHOC) reports at the request of MOHW/ PEU staff.
5.0 Key Task and Responsibilities
- Review schematic & design development drawings for feasibility & program with MOHW stakeholders.
- Collaborate with PEU & MOHW stakeholders to understand the project specific needs.
- Assist in planning procedures based on start & completion times & staffing requirements for each phase.
- Maintain client (MOHW) stakeholders, MOHW PEU and designer relations.
- Review MEP/IT documents for constructability and ensure compliance with required codes and practices based specifications set out by the Jamaica Building Code 2018 and (IBC) International Building code 2018.
- Assist in the equipment procurement process by identifying long lead items & advise on purchase requirements.
- Participate in meetings with local officials during Permit/Approval phase.
- Provide input on project schedules.
- Review contractor(s) schedules of value.
- Manage RFI’s & documents for all MEP/IT related scopes if necessary.
- Manage submittal process for all MEP/IT related scopes.
- Review monthly payment requisitions for progress & advise on cost to complete.
- Attend monthly and Adhoc meetings as requested by the project team.
- Review & comment/Recommendations on contractor(s) change requests.
- Review & comment/Recommendations on contractor(s) submittals & shop drawings.
- Assist in start-up, testing, commissioning and acceptance to all MEP/IT systems & Controls systems.
- Reviewing and monitoring MEP/IT construction installations, field installation coordination and technical problem solving.
- Ensure that all agreed action points as related to MEP/IT are completed within agreed deadlines between PEU, MOHW stakeholders and contractor(s).
- Keep up to date with all aspects of relevant MEP/IT safety & welfare at work legislation, maintain log book and communicate relevant changes to the PEU.
- Submit monthly reports to the MOHW/PEU on relevant MEP/IT activities.
- Participate in monthly meetings when required to report on relevant MEP/IT progress.
- Assist in developing, monitoring and maintaining MEP/IT schedule in conjunction with the Project Supervision Team (PST).
- Analyze relevant MEP/IT contract documents for constructability, code compliance and functionality.
- Review and advise on MEP/IT requisitions and contract changes.
- Supervise MEP/IT related close out document delivery.
- Encourage and participate in MOHW staff training and development.
- Coordinate with PST & perform LEED analysis relating to MEP/IT systems; assist in draft LEED IAQ Management Plans.
- Identify MEP/IT deficiencies & report to PEU/MOHW stakeholders for inclusion on Deficiency Log; review with contractor(s) at weekly meetings.
6.0 Reporting/ Supervision
6.1 The MEP/IT consultants will be supervised by the PEU Civil/Engineer/Construction Specialist, the PEU ICT Lead and the PEU Project Manager; and will frequently liaise with:
- Internally: All relevant members of staff of the MOH as indicated by the Project Manager (Permanent Secretary, Administration, Procurement, Financial and Technical Officers)
- Externally: IDB team and Funding Agencies representatives, Technical Officers, Contractors, Consultants, Suppliers, External Auditors, Representatives of the various beneficiary ministries and agencies.
7.0 Implementation Arrangement
7.1.1 The Consultancy Services will be implemented for a period of (2) years with the possibility for extension.
7.1.2 The contract’s amount will be distributed in 24 monthly payments that will be dependent on satisfactory implementation of activities and delivery of required products, as agreed between the MOH/PEU and the consultant.
7.1.3 Ministry of Health through the PEU will be the executing agency and main recipient for the Consultancy Services with the Project offices as focal point in implementing the services.
7.1.4 Coordination meetings will be conducted between the PEU/Ministry of Health and the Consultant for the duration of the project, as may be needed, the expenses of which are to be charged to the Contract.
7.1.5 The Civil engineer/Construction Specialist PEU will provide the Consultant with the Project documents/support to enable the performance of the activities.
8.0 Cost of Consultancy Services
8.1.1 The contract for this consultancy is a fixed price contract, inclusive of tax and other incidental expenses and printing of reports / deliverables.
The cost shall cover the following:
8.1.2 Remuneration/professional fees;
8.1.3 Incidental expenses – which would include costs for investigations and processing, support personnel/staff and other out-of-pocket expenses (e.g., supplies and materials, equipment, transportation/fuel, communication and coordination meetings)
9.0 Reporting/Deliverables and Payment Schedule
9.1.1 Billing for remuneration/professional fees shall be in accordance with the following delivery schedule and subject to the usual Government of Jamaica accounting and auditing requirements:
| ITEM | DELIVERABLES | FREQUENCY | DELIVERY DATE | SUPERVISION |
| 1.0 | 24 Status reports on the consultant’s above mentioned activities. | Monthly | 5 calendar days after the end of the reporting month | Civil Engineer/Construction Specialist / PM |
| 2.0 | Report on all relevant MEP/IT activities on all (13) Health Facilities | As required | As required | Civil Engineer/Construction Specialist / PM |
| 3.0 | Reports as requested by the PEU and the Bank concerning the project’s progress. | As required | As required | Civil Engineer/Construction Specialist / PM |
9.1.2 The deliverables shall be submitted by the Consultant in two (2) hard copies to the PEU/Ministry of Health for review. An electronic/soft copy in Microsoft Word Software or PDF to view (if not available to the PEU) shall be also submitted to PEU/Ministry of Health and Wellness.
10.0 Qualification of Firm
Prospective Firm must have:
Firm Experience
Minimum Seven (7) years’ experience with projects of MEP/IT related government and non-government commercial projects
Minimum Five (5) years’ experience with similar projects of MEP/IT related to health facilities projects
Key experts
Mechanical Electrical Plumbing Engineer
Education: Degree in Mechanical and/or Electrical Engineering
Experience with 5-10 years relevant experience in design and project or construction management of buildings registered with relevant professional bodies
ICT & Communications Engineer/Specialist
Education: BSC in ICT or other equivalent qualification
Education: Electronic and Communications Engineer with 5-10 years relevant experience in design and construction management of buildings
Other Requirements include:
- Professional Engineer –PERB registration an asset.
- Solid understanding of mechanical, process piping, plumbing, electrical, and building control systems for function as well as coordination between the different functional areas of the work.
- Experience with various construction delivery methods (i.e. IPD, LEAN, design-build/assist).
- Experienced leading Building Information Modelling Systems (BIM) (3D-6D) coordination efforts and are able to run clash detection software.
- Specific knowledge in Mechanical (HVAC, chillers, towers etc..) systems;
- Process-Piping (process utilities; RO/DI water, Acid Waste Neutralization, CDA, House Vacuum etc.) systems, plumbing systems (Domestic & Industrial water, Lab waste, Sanitary drain, roof over flow etc.)
- Electrical (PG&E feed to Main distribution panels — subpanels, lighting systems, Fire Alarm etc.) – familiarity with Jamaican Electrical Code (JS21 or later)
- Building Control Systems. Knowledge of communication systems; AV, Security & IT and Process Automation, SCADA System.
- Experience in MEP scheduling.
- Ability to read, analyze & interpret contract documents, safety rules, operating & maintenance instructions & procedure manuals.
- Ability to write routine reports & correspondence.
- Ability to present project reports effectively.
- Ability to resolve issues quickly with little or no supervision.
- Ability to interpret a variety of instructions furnished in written, oral, schematic, or schedule format.
- OSHA 10 Hour &, preferably, OSHA 30 Hour certifications.
- Knowledge of all facets of ground up Construction/New Renovation. Work in 3D design (computer-aided design, or “CAD”)
- Devise alternative mechanical structures
- Complete assigned tasks within time and budget restraints
- Draft standards and geometric, dimension, & tolerancing (GD&T) specifications
- Assist in supervising MEP/IT designs and estimates
- Proactive and willing to take on new challenges
- Work effectively under pressure
- Familiar with Engineering Product Data Management software (EPDM)
- Advance proficiency in various IT infrastructure elements – configuring and managing such as Routers, Firewalls, and Switches, and Wireless devices
- Advance proficiency in various IT platforms