Attachment C, Monthly Staffing Report.pdf
PDF 352 KB Posted
- Attached to
- Service Desk and Deskside Support Services
- Solicitation number
- HHS0017021
- Issued by
- Texas
About this file
This is a Monthly Staffing Report form for RFO No. HHS0017021, issued by the Health and Human Services Commission (HHSC). The form serves as a reporting mechanism for contractors to document and track staffing levels across managed services positions on a monthly basis. The report requires contractors to provide a comprehensive staffing summary including total required positions, total staffed positions, total vacant positions, and an overall staffing compliance percentage calculation. Contractors must also detail filled positions with staff names, start dates, and employment status, as well as document any vacant positions with vacancy types and start dates. The form requires attestation that reported staffing levels accurately reflect the full calendar month and acknowledges that any month falling below the required 85% staffing compliance threshold constitutes a Service Level Occurrence under the contract terms.
The report includes mandatory training compliance verification requiring all staff to complete required training within 45 days of hire date, with contractors obligated to report any instances of non-compliance with detailed explanations. The contractor's authorized representative must sign and certify the report, providing their name, title, email, phone number, and submission date. HHSC maintains review authority over submitted reports, with the option to approve and accept or require further review, documented by the HHSC reviewer's signature and date. This reporting structure ensures ongoing accountability for staffing levels and employee training compliance throughout the contract performance period.
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Text version
Attachment C, Monthly Staffing Report
RFO No. HHS0017021 Attachment C
Attachment C, Monthly Staffing Report
Contractor: <Vendor Name>
Reporting Month: <Month, YYYY>
Reporting Period: <First Calendar Day of Month> – <Last Calendar Day of Month>
Date Submitted: <MM/DD/YYYY>
1. Staffing Summary
Metric Value
Total Required Managed Services Positions <Number>
Total Staffed Positions <Number>
Total Vacant Positions <Number>
Staffing Compliance Percentage <Calculated %>
Meets ≥85% Staffing Compliance? ☐ Yes ☐ No
Staffing Compliance Calculation:
Staffing Compliance (%) = � Total Staffed Positions
Total Required Positions � × 100
2. Filled Positions
Position Title
Program Area Staff Name Start Date Status
<Role> <Program> <Name> <MM/DD/YYYY> Filled
3. Vacant Positions
Position Title Program Area Vacancy Type Vacancy Start Date Notes
<Role> <Program> ☐ Anticipated ☐ Actual <MM/DD/YYYY> <Optional>
Vacancy types are reported to support staffing transparency and do not modify calculation methodology.
4. Training Compliance Status Update
To ensure ongoing training compliance, all staff must complete mandatory training within 45 days of their hire date. For multiple hires, please confirm whether the requirement is being followed for each individual. If there are any instances of non-compliance, kindly list those below:
Name Training Completed Within 45 Days?
If No, Explain Non- Compliance
[Candidate Name] ☐ Yes ☐ No [Details if applicable]
5. Staffing Compliance Attestation
The Contractor certifies that this report accurately reflects staffing levels and recruitment services for the full reporting month, calculated from the first Calendar Day through the last Calendar Day of the month.
Any month in which staffing compliance falls below 85% is acknowledged as a Service Level Occurrence under the Contract.
5. Contractor Certification
Prepared By: ___________________
Title: ___________________
Email: ___________________
Phone: ___________________
Signature: ___________________________
Date: ___________________
HHSC Review (HHSC Use Only)
☐ Approved/Accepted
☐ Requires Further Review
HHSC Reviewer: ________________________________________ Date: ________________________________________________ Comments:
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