A. BACKGROUND

Mongolia has received a credit from the International Development Association (IDA) for the Strengthening Fiscal and Financial Stability Project (SFFSP). The Objective of the SFFS Project is designed to improve fiscal policy and sustainability in a mineral-based economy, protect the poor and vulnerable, and restore confidence in the financial sector. The project is designed into five components: (I) Strengthening Macroeconomic and Fiscal Management; (II) Improving the Efficiency of Public Financial Management; (III) Enhancing Financial Sector Stability; (IV) Strengthening the Social Protection System; (V) Project Management and Monitoring. The objectives are to Strengthening fiscal responsibility and implementing relevant policy measures, improving fiscal discipline, strengthening the resiliency of the banking system, improving public expenditure quality in social protection, providing support for Project implementation, coordination, monitoring, and evaluation, including, inter alia, audit arrangements, reporting requirements, procurement, and financial management activities respectively. For more details, please refer to the Project Appraisal Document Report No.PAD2269. 

The demographic burden of the elderly population in Mongolia has declined sharply from 1989 to 2000, but has stabilized since 2000 and is being now increased from 2018. In 2009-2018, the total number of elderly people has increased by 44.3 percent, particularly, 55-59 year olds by 1.9 times, 60-64 year olds by 1.7 times, 65-69 year olds by 13.4 percent and over 70 year olds by 17.6 percent. This is due to the fact that children from a period of the high birth rate (baby boom) in the 1960s moved to the ranks of the elderly population and the average life expectancy of Mongolians increased as well. As the population ages, the structure and lifestyle of the Mongolian family are changing. In 10 years between 2009 and 2018, the total number of households increased by 178.0 thousand, of which urban households increased by 150.0 thousand and rural households by 28.0 thousand. During this period, the number of single elderly people starting a household increased 1.8 times. According to the National Statistical Office of 2018, the average life expectancy was 63.8 years for males and 72.7 for females and the number of elderly people aged above 80 years was increasing, especially for women.

Single elderly and single people with disabilities, are mostly lacking self-reliance, immature, and dependable,  and are unable to live independently, especially, persons with disabilities are not self-sufficient to protect their lives.  These people should remain under the state protection, thus, the Government provides services such as food, medical, cultural, psychological, and Institutional Nursing care services, providing them with special care services according to Article 19 of the Law on Social Welfare; creating favorable conditions and protecting the legitimate interest of beneficiaries in accordance with the respective legislation, prioritizing the livelihoods of the vulnerable targets.

Currently,  institutional nursing homes for elders and disabled persons are being operated throughout the country.  There are 8 state and locally owned nursing homes which are located in Uvs, Bayan-Ulgii, Khovd, Khovsgol, Dornod, Dornogovi, and Bayankhongor provinces, including the National Elders Care Center located in Batsumber Soum, and are funded from State and local budget, and operated under the local organizational management level based on the principles of territorial location and regions. Moreover, there are four private institutional care centers in Ulaanbaatar, funded privately, and two more have been operating with the support of international religious organizations. A total of 12 Institutional Care centers are now operating in Mongolia in accordance with the relevant legislation, and they serve with about 400 nurses. 

According to the Law on Social Welfare, nursing homes should be categorized as elderly, disabled, and children, but most care homes have mixed categories of caregivers. The fact that caregivers with different levels of skills and needs of different quality and accessibility of services live in the same nursing home, that is actually limiting the ability of the nursing home to provide a wide range of services for them.

The current system of Nursing home services (Institutional Care Services) based on a non-competitive platform which means the system is in lack of alternative services offered, and there is a lack of specialized care centers for mentally disordered people, and there is also an absence of programs, projects, and implementation plans that had been developed on the basis of the need of the people those require special cares, as well as the social services for poor at the nursing homes. Moreover, there is a need to increase public awareness and understanding of the nursing homes and services, outpatient care facilities, recurrent connection after the Nursing home check-off. The non-existence of such programs and limited opportunities for implementing such projects and programs are challenging the Government. 

Mongolia’s Institutional Care Assessment was conducted in 2015 by the Ministry of Population and Social Protection. The study carried out an environmental and situational assessment of the Nursing houses for Elders and Children (Orphanage Houses), and some relevant international experience of institutional care and long-term care system and services were reviewed to support the policymaking procedures. The consultancy service contributed to the development of legislative frameworks such are i) The National Standard requirements for Nursing Care Services MNS 5823:2016 ii) The “Regularity Procedure of the State Policy on Supporting Elderly Care Houses, and Services, operating in Private Sector" was developed and approved by the joint order (No.2018A/03/03) of Minister of Finance and the Minister of Labor and Social Welfare. 

However, due to a rapidly changing internal migration, urbanization, family structure, and the role of women in the family, the traditions of the elderly care have been adversely affected, thus, the private sector interest in the paid short and long-term cares on elderly has been increasing, requiring the improvement of state policy and financial support.  

Specific objectives of the Government Action Plan of Mongolia 2016-2020, article 3.3.26 specifies that: “Expand the care, rehabilitation and nursing services for the elderly and support the establishment of a private nursing home”, in addition, pursuant to the “Implementation Plan for the Government Action Plan” the quality and accessibility of nursing homes shall be enhanced and the program for “Specialized Institutional Care for Elders” shall be reformed. 

Therefore, considering the above situation, MLSP received technical assistance from the  SFFS project for preparing a draft of the “Specialized Institutional Care Program” that defines and determines a carefully planned future of elderly care in Mongolia. The Reform Program was approved by Government Resolution No. 84 of March 4, 2020.

The program will be implemented in 2020-2023 and aims to improve the availability and quality of care services for the elderly by improving the legal environment, financing system, management, and organization of specialized care services for the elderly. Among the objectives of the program are to improve the legal environment, update standards, address long-term care for the elderly in the form of insurance, provide funding for nursing homes from the health insurance fund, support the establishment of private nursing homes, and introduce and diversify care services, strengthening the human resources of the care centers.

Therefore, there is a need to hire a consultant to develop recommendations and proposals for the development of alternative care services, to support cooperation with the private sector, and to develop draft decisions necessary to improve the legal environment for care services in accordance with the legislation.

B. OBJECTIVE OF THE ASSIGNMENT

The objective of this assignment is to draft regulations and guidelines for improve care services, and support the private sector particularly within the framework of the objectives and measures set forth in the reform program for specialized care for the elderly, and develop proposals and recommendations for financial support and improvements for care service. 

C. SCOPE OF THE WORK

The Consultant will perform the following tasks:

Task I. Within the framework of public-private partnership, develop recommendations to expand on private and public-private joint nursing homes and specialized care services for the elderly, to set fees for paid care services, financial and other support (taxes, soft loans, insurance, etc.) and draft the regulation to the financing of specialized centralized care services, investment, procurement of goods and services;

Task II.  Develop the recommendations and draft regulations to provide funding from the Health Insurance Fund for the cost of medicines and equipment required for the permanent care of an elderly in specialized centralized care services;

Task III. Develop the draft order on norms of per capita expenditure on food, clothing, medicine, sanitation, and soft goods in accordance with the inflation rate (approved by the Minister of Finance and the Minister of Population Development and Social Welfare on November 6, 2013, order No. 247 / A / 163);

  Task IV. Develop proposals, regulations and financing mechanism for the phased introduction of paid services for temporary and home care from specialized care services for the elderly in accordance with the needs;

Task V. Develop the draft regulations on procedures for receiving, spending and monitoring donations to specialized centralized care services and nursing homes;

Task VI. Organize the public consultations and discussion(online and offline)  on developed proposals and draft decisions to amend the relevant legislation, including the participation of relevant governmental and non-governmental organizations, professional and research organizations, legal entities, and citizens whose legitimate interests and rights might be affected and prepare a bibliography of the comments and recommendations that both does not incorporate and incorporated into the draft amendments. Obtain feedback from relevant organizations and researchers on prepared proposals.

D.DELIVERABLES

The Consultant shall present the progress and results of the work to the Policy Planning Department of the MLSP and receive guidance and recommendations. The Consultant will prepare the following reports and drafts, and other relevant information, research, reports, and drafts may be added in the course of the work.

Deliverable 1. Recommendations to expand on private and public-private joint nursing homes and specialized care services for the elderly, to set fees for paid care services, financial and other support (taxes, soft loans, insurance, etc.) and draft regulation to the financing of specialized centralized care services, investment, procurement of goods and services (referring to Task I);

Deliverable 2. Recommendations and draft regulations to provide funding from the Health Insurance Fund for the cost of medicines and equipment required for the permanent care of an elderly in specialized centralized care services (referring to Task II); 

Deliverable 3. The draft order on norms of per capita expenditure on food, clothing, medicine, sanitation, and soft goods in accordance with the inflation rate (approved by the Minister of Finance and the Minister of Population Development and Social Welfare on November 6, 2013, order No. 247 / A / 163) (referring to Task III);

Deliverable 4. The draft developed proposals, regulations and financing mechanism for the phased introduction of paid services for temporary and home care from specialized care services for the elderly in accordance with the needs (referring to Task IV);

Deliverable 5. The draft regulations on procedures for receiving, spending and monitoring donations to specialized centralized care services and nursing homes (referring to Task V);

Deliverable 6. Final Report including the summary of comments and recommendations based on the consultations with the key stakeholders and the public referring to Task VI).

E. CONSULTANT’S QUALIFICATIONS/ SELECTION CRITERIA 

A Consultant will be selected in accordance with the Individual Consultant Selection Method set out in the Procurement Regulations: The following is the link to the World Bank’s website: https://policies.worldbank.org/sites/ppf3/PPFDocuments/Forms/DispPage.aspx?docid=083b3f94-a932-4395-a410-834f8bc14f8c

Education: A suitable candidate should have at least a master’s degree in law, economics or Social Science 

Professional qualifications: A suitable candidate should have experience with social welfare policies and strategies and experience in drafting and developing policies and laws would be a plus 

Experience: A candidate should have at least 15 years of directly relevant professional experience in the field of social protection

Language literacy: Have excellent skills in Mongolian and intermediate skills in English;

Other: Excellent communication and interpersonal skills with the ability to function effectively and collaboratively in a team environment, high proficiency in processing the documents, being punctual, and ability to bear the workload.

F. SUPERVISION AND REPORTING

The consultant will report directly to the Director of Policy, Planning Department (PPD), and Head of the SFFS Component D/State Secretary of MLSP. The consultant will work on a day-to-day basis under the guidance of the Director of PPD on technical matters related to the assignment. Work progress will be presented during the working group meeting or other meetings as needed.   

The Director of PPD shall evaluate the performance on the agreed deliverables and approve the invoices for the delivered outputs.   

The consultant will prepare a 3-5 pages’ summary progress report detailing the achievements and impediments in executing the entire assignment effectively.  The MLSP and SFFS PIU will provide input to the evaluation of the consultant’s performance. 

G. CONTRACT DURATION AND PAYMENT CONDITION

The expected commencement date of the contract is August 2020.  The contract will have a duration of 4 months through November 2020. 

Based on the evolving needs of the Client and performance of the consultant, the contract may be extended if needed. If any task is not finished and approved by the Client within the agreed-upon timeline, the consultant should complete the task/s without any additional cost.

Payments will be released upon satisfactory completion of all deliverables due for each task, according to the following schedule:

• Submission of Deliverable 1 stated in the ToR conditional on the Client’s approval: 25 % of the total contract amount;

• Submission of Deliverable 2, 4 and 5 stated in the ToR conditional on the Client’s approval: 25 % of the total contract amount; 

• Submission of Deliverable 3 stated in the ToR conditional on the Client’s approval: 25 % of the total contract amount; 

• Submission of Deliverable 6 stated in the ToR conditional on the Client’s approval: 25 % of the total contract amount.

H. INSTITUTIONAL ARRANGEMENTS

The MLSP will provide office space for the consultant to work with the technical working group as well as the MLSP officials.  The consultant will have access to all necessary data and information.

If you possess the above qualifications, please submit following documents via email to procurement@sffs.mn:

    1. Cover letter indicating why she/he considers her/himself suitable for the position.

    2. Detailed CV highlighting relevant skills/experience.

    3. Copy of diplomas or certificates; and,

    4. 2 reference letters from previous last two employers no later than 17:00, August 21, 2020.

The submitted documents will not be returned to the applicants. Please note that incomplete applications would not be considered for evaluation. Only selected candidates will be contacted. Candidates can be interviewed. Contact address: Attn: Bayarmaa Losol, Procurement specialist, Strengthening Fiscal and Financial Project.

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