Fast track NIMH Employee Engagement Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 Expiration Date: 05/2021)

TITLE OF INFORMATION COLLECTION:

NIMH Employee Engagement Survey 2020

PURPOSE:

The purpose of this collection is to assess the engagement of all NIMH employees as they telework, and as they transition back to the onsite workplace.

DESCRIPTION OF RESPONDENTS:

The respondents will include all Federal employees, Contractors, and Fellows, that work at NIMH.

TYPE OF COLLECTION: (Check one)

☐ Customer Comment Card/Complaint Form ☒ Customer Satisfaction Survey

☐ Usability Testing (e.g. Website or Software) ☐ Small Discussion Group

☐ Focus Group ☐ Other: __________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: ^{___CHRISTOPHER A CHAI_____________________________________________}

To assist review, please provide answers to the following questions:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? ☐Yes ☒No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? N/A ☐Yes ☐No

3. If applicable, has a System or Records Notice been published? N/A ☐Yes ☐No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? ☐Yes ☒No

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Federal government contractors	359	1	4/60	24
Total		359		24

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Federal government contractors	24	$34.90	$837
Total			$837

*U.S. Department of Labor, Bureau of Labor Statistics (May 2019) Metropolitan and Nonmetropolitan Area Occupational Employment and Wage Estimates (All Occupations) Washington-Arlington-Alexandria, DC-VA-MD-WV Area - https://www.bls.gov/oes/current/oes_47900.htm#00-0000

FEDERAL COST: The estimated annual cost to the Federal government is: $258

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Administrative Officer	15/1	$142,701	1		$143
Contractor Cost
Management Analyst		$115,000	1		$115
Travel
Other Cost
TOTAL					$258

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? ☒Yes ☐ No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

This is a full population survey of all current NIMH FTE and contract staff.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

☒ Web-based or other forms of Social Media

☐Telephone

☐In-person

☐Mail

☐Other, Explain

2. Will interviewers or facilitators be used? ☐Yes ☒No