National Institute of Mental Health (NIMH) Employee Engagement Survey

Request for Approval under the “Generic Clearance for the Collection of
Routine Customer Feedback” (OMB#: 0925-0648 Exp Date: 03/31/2018)
TITLE OF INFORMATION COLLECTION:
National Institute of Mental Health (NIMH) Employee Engagement Survey
PURPOSE:
The National Institute of Mental Health (NIMH) Engagement Survey is used to assess current
staff perceived retention risk, engagement and satisfaction levels, and organizational climate to
provide NIMH Senior Leadership with insight into NIMH’s organization health. Results of the
survey are used to determine action areas and initiatives to increase employee engagement and
satisfaction and improve organizational health.
DESCRIPTION OF RESPONDENTS:
The survey will be open to all NIMH employees (federal and contract staff). All respondents are
current employees of NIMH.
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form
[ ] Usability Testing (e.g., Website or Software
[ ] Focus Group

[X] Customer Satisfaction Survey
[ ] Small Discussion 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: Melba Rojas and Megan Kinnane, NIMH
To assist review, please provide answers to the following question:
Personally Identifiable Information:
1. Is personally identifiable information (PII) collected? [ ] Yes [X] No
2. If Yes, is the information that will be collected included in records that are subject to the
Privacy Act of 1974? [ ] Yes [ ] No
3. If Applicable, has a System or Records Notice been published? N/A [ ] Yes [ ] No
Gifts or Payments:

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

ESTIMATED BURDEN HOURS and COSTS

No. of Respondents

No. of Responses per
Respondent

Time per
Response
(in hours)

Total
Burden
Hours

Federal Government
Contractors

30

1

5/60 hours

3 hours

Totals

30

30

Total Burden
Hours

Hourly Wage Rate*

Total Burden
Cost

3

$31.69

$95

Category of Respondent

Category of Respondent
Federal Government
Contractors
Totals

3 hours

$95

*Source: U.S. Department of Labor, Bureau of Labor Statistics (May 2015) 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: $1,006

Staff
Federal Oversight
Health Scientist
Administrator
Management Analyst

Fringe (if Total Cost to
applicable)
Gov’t

Grade/Step

Salary

% of
Effort

GS 14/1

$108,887

.005%

$545

GS 13/1

$92,145

.005%

$461

Contractor Cost
Travel
Other Cost
$1,006

Total

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

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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?
[X] 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)
[X] Web-based or other forms of Social Media
[ ] Telephone
[ ] In-person
[ ] Mail
[ ] Other, Explain
2. Will interviewers or facilitators be used? [ ] Yes [X] No

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