Government have permitted to establish (20) Dialysis Units at RIMS Adilabad/District & Area Hospitals & CHCs in the State in the interest of dialysis patients under PPP model with certain terms and conditions.
Commissioner, Telangana Vaidya Vidhana Parishad, Hyderabad has submitted proposal for establishment of following another (14) Dialysis Centres in TVVP Hospitals for needy treatments to Renal Failure patients who are spending much time for travelling to Headquarters for Dialysis.
14 New Dialysis Units at Telangana District Hospitals on PPP
1. Area Hospitala, Sircilla, Karimnagar
2. Area Hospital, Godavarikhani, Karimnagar
3 Area Hospital, Jangoan, Warangal
4 CHC Narsampet, Warangal
5 Area Hospital, Kothagudaem, Khammam
6 CHC Sathupalli, Khammam
7 Area Hospital, Miryalguda, Nalgonda
8 Area Hospital, Huzurnagar, Nalgonda
9 CHC Vikarabad, Rangareddy
10 CHC Maheshwaram, Rangareddy
11 Area Hospital, Malakpet, Hyderabad
12 Area Hospital, Zaheerabad, Medak
13 Area Hospital, Banswada, Nizamabad
14 Area Hospital, Bhodan, Nizamabad
Old 20 Dialysis Units at Telangana District Hospitals on PPP
1 District Hospital, Tandur, R.R.District
2 Area Hospital, Vanasthalipuram, R.R. District, Hyd.
3 District Hospital, Sangareddy, Medak
4 Area Hospital, Siddipet, Medak
5 Area Hospital, Medak
6 Area Hospital, Mancherial, Adilabad
7 Area Hospital, Nirmal, Adilabad
8 RIMS, Adilabad
9 Community Health Centre, Utnoor, Adilabad
10 District Hospital, Nalgonda
11 Area Hospital, Suryapet, Nalgonda
12 Area Hospital, Bhadrachalam, Khammam
13 Community Health Centre, Eturunagaram, Warangal
14 Area Hospital, Mahabubabad, Warangal
15 District Hospital, Karimnagar
16 Area Hospital, Jagityal, Karimnagar
17 Area Hospital, Gadwal, Mahabubnagar
18 Area Hospital, Nagar Kurnool, Mahabubnagar
19 Area Hospital, Wanaparthy, Mahabubnagar
20 Area Hospital, Kamareddy, Nizamabad
3. The Commissioner, TVVP has also submitted that the Chief Executive Officer, Aarogyasri Health Care Trust, TS, Hyderabad has convened meetings with HODs and Nephrologists to evolve guidelines for establishment of dialysis Units under PPP model on the issue of reuse of dialyzer was discussed at length. Accordingly, they have submitted that the Standard Treatment Guidelines issued by the Government of India on Dialyzer Reuse states that “Reuse of dialyzers remains among the most controversial aspects of Haemodialysis. While being banned by law in certain countries in the world, it is widely carried out in others for cost saving, and has in fact been validated by the manufactures and regulatory and authorities for certain devices. The reuse of certain other devices, tubings, and end caps is even more controversial. The method of reprocessing, manual Vs automated, the use of different chemicals and disinfectants is also highly variable as is the use of tests of performance. This guideline attempts to provide a comprehensive outline of all the above controversies with a basis for the practices recommended”. (Standard treatment Guidelines Haemodialysis issued by the Ministry of Health and Family Welfare, Government of India. Attention was also drawn wherein orders issued by Health & Family Welfare Department of Tamil Nadu State has paid compensation to the patients effected by Hepatitis ‘C’ virus while undergoing dialysis treatment in Government Stanley Medical College Hospital, Chennai.
4. Further, the Professor & Head, Department of Nephrology, NIMS has also stated that they are following single use dialysis to prevent the spread of HCV in the unit from 2010 onwards and with the above strategy. (1) The spread of HCV was prevented in the Unit (2) Requirement of RO water for reuse came down significantly (3) The chemicals used for reuse like H2O2, Hypochlorite, and Formaldehyde etc., are reduced in the unit there by environmental pollution was reduced (4) the quality of dialysis was assured, as there is no need for checking the fiber bundle volume each time (5)The cost of the dialysis disposables reduced drastically as bulk purchases was done directly from the manufactures. It was also stated that single use dialysis is being practiced for Aarogyasri Patients also for ensuring better quality of dialysis and also to prevent the spread of viral infections. The current bundled payment will be able to suffice for undertake this policy in the Government sector as there is requirement of bulk purchase of the disposables and reduced usage of disinfecting chemicals and decrease utilization of RO Water, which will decrease the recurring cost. They have also submitted that, latest review article also suggest for phasing out the of reuse by cutting down the cost by allowing local manufacturing of the Dialysis Disposables.
5. The Government, after careful examination of the said proposal hereby accord permission to the Commissioner, TVVP., Hyderabad for establishment of Dialysis Units at the mentioned in para-2 above, for needy treatments to Renal Failure patients who are spending much time for travelling to Headquarters for Dialysis in addition to earlier (20) units permitted in the G.O.2nd read above under PPP model through tender process with following modified terms and conditions:-
(1) New Dialysis Disposables (Dialyzer, AV blood tubing and transducer protector) used for each session.
(2) To follow Hub and spoke model for managing of Dialysis units established in peripheral institutions. Department of Nephrology of Osmania, Gandhi and NIMS will function like as Hub to control the standards followed in the process of Dialysis by the service provider at peripheral hospitals.(spokes)
Price activity schedule :
i) Public partner
a) Nodal centre (Osmania,Gandhi & NIMS i.e.Hub) Rs.100/-
b) Peripheral Dialysis centre Rs.150/-
(D.Hs, A.Hs & CHCs i.e.Spokes)
ii) Private company (Service provider) Rs.1,000/-
Bid with highest discount % will be L-1 Bidder)
(3) To invite the bids for entire State as a single package.
(4) Bidder should be the manufacturer of dialysis machine & disposables or manufacturer of dialysis machine & disposables in association with service providers who has the experience in running these services across the world without any major adverse remarks on the service delivery. Turn over should be Rs.25.00 crores in past two year E.M.D. Rs.20.00 lakhs.
(5) The Bidder should have a minimum of (2) years of experience in carrying out similar type of assignment/service in private and public sector globally.
(6) The Bidder should have experience to operate and manage dialysis facilities, having at least a total of 50 Hemodialysis machines.
(7) The Service provider has to bear the water charges for the dialysis unit.
(8) The Service provider will provide only Paramedical and Nursing Staff and MBBS Doctor. Doctors available at peripheral Dialysis centers shall issue the death certificates in case of death of any patient while the dialysis process is in progress or immediately after the dialysis procedure if the death is within the facility.
(9) In addition to the 20 Dialysis units already permitted vide G.O.Rt.No.803 Dt:18-12-2015 in (20) TVVP hospitals, (14) more units in TVVP Hospitals permitted details as mentioned in para-2 above.
(10) To reduce the contract period from 5 years to 3 years.
(11) The Medical Superintendent of the peripheral hospital will enter into the agreement with the service provider.
(12) The Medical Superintendent will provide space free and power on cost.
(13) The tender/agreement can be cancelled at any point of time without assigning reasons thereof.
(14) The bidder should establish the needed infrastructure at both ends for the Tele monitoring by the Expert Centre.
(15) The following Technical Committee is hereby constituted for Technical Evaluation of the bids.
(i) Chief Executive Officer, Aarogyasri Health Care Trust, Hyderabad – Convenor
(ii) Director of Medical Education, TS, Hyderabad.
(iii) Commissioner, TVVP, Hyderabad
(iv) Managing Director, TSMSIDC, Hyderabad
(v) Nephrologist from Osmania Hospital
(vi) Nephrologist from Gandhi Hospital
(vii) Nephrologist from NIMS, Hyderabad.
6. The above Committee shall monitor the performance/ functioning of these units once in a month.
7. The Commissioner, Telangana Viadya Vidhana Parishad, Hyderabad is directed to call tenders under PPP model with above terms and conditions and after selection of service provider to each Hospital, the Commissioner of Telangana Vaidya Vidhana Parishad and the Hospital Development Societies are authorized to execute a Memorandum of Agreement (MOA) with service providers that shall be valid for a period of (3) five years from the date of signing of the Agreement which includes the above conditions.
8. The Commissioner, TVVP., Hyderabad is requested to issue instructions to the Medical Superintendents of District (Hospitals) and Area Hospitals/Community Health Centres to earmark space for the establishment of the dialysis units, to enable the service providers to establish units at their own cost after remodeling and refurnishing the premises. The Commissioner, TVVP., Hyderabad and Chairman of the Hospital Development Societies are requested to enter into a Memorandum of Understanding (MoU) with the service provider duly ensuring that the terms and conditions mentioned at para ( 5 ) above are incorporated in the Agreement. There shall not be any financial burden on the State Government or the District & Area Hospitals, except for providing space for dialysis unit for a period of (3) years.
G.O.RT.No. 525 Dated: 11-08-2016 Read the following:- 1) From the Commissioner, Telangana Vaidya Vidhana Parishad, Hyderabad letter Rc.No.332/HEC/TVVP/2015, dated:29-7-2015 and 19-08-2015. 2) G.O.Rt.No.803 HM&FW(B2)Dept.,Dt:18-12-2015. 3) From the Commissioner, Telangana Vaidya Vidhana Parishad, Hyderabad letter Rc.No.276/HEC/TVVP/2015, dt:4-1-2016,11-5-2016,19-5-2016