Association for Public Policy Analysis & Management

Each year, millions of American workers experience an injury or illness that puts them at risk of leaving the workforce. When workers leave the labor force because they become sick or have an accident, it can be detrimental – for the workers, their families, their employers, and for the economy. Workers experience adverse effects on their health, family finances, and quality of life. Recognizing the important of improving stay-at-work/return-to-work (SAW/RTW) outcomes, the U.S. Department of Labor's Office of Disability Employment Policy in partnership with the Employment and Training Administration and the Social Security Administration, developed the Retaining Employment and Talent After Injury/Illness Network (RETAIN) Demonstration Projects.

RETAIN is engaging eight state teams in a series of demonstration projects focused on helping workers stay at, or return to, the workforce following an illness or injury. Central to these projects is the early coordination of healthcare and employment-related supports and services. These supports and services include training in occupational health best practices for participating health care providers, active involvement of a Return-to-Work Coordinator throughout the medical recovery period, enhanced stakeholder engagement and communication, and retraining and rehabilitation services. To accomplish this, grantees will provide services through an integrated network of partners that includes close collaboration between state and/or local workforce development entities, healthcare systems and/or healthcare provider networks, and other partners such as employers or insurers.

The RETAIN Demonstration Projects are funded in two phases. Phase 1 has a duration of eighteen months and includes planning and start-up activities, as well as the launch of a limited pilot demonstration. Each grantee has been provided approximately $2.5 million for Phase 1. The eight grantees awarded Phase 1 funding are California (Employment Development Department), Connecticut (Department of Labor), Kansas (Department of Commerce), Kentucky (Department of Workforce Investment), Minnesota (Department of Employment and Economic Development), Ohio (Department of Job and Family Services), Vermont (Department of Labor, Division of Workers Compensation and Safety), and Washington (Employment Security Department). A subset of Phase 1 grantees will be selected for Phase 2, which will have a duration of 42 months and provide each grantee with approximately $20 million in funding.

This study describes the motivation for the RETAIN Demonstration projects, including a review of the status quo, evidence on the costs associated with work disabilities, and the potential benefits to stakeholders. We present a general RETAIN SAW/RTW model and describe specific RETAIN state grantee program characteristics for Phase 1 grantees, including the target population, participating organizations, and coordination and training efforts. While each state grantee’s project follows general RETAIN SAW/RTW guidelines, implementation strategies vary to take into account state differences in insurance, healthcare, and employment landscapes. We highlight these differences in implementation strategies and discuss challenges and preliminary lessons learned as they relate to: developing organizational partnerships across healthcare providers, the workforce development system, and others; data sharing; physician training and participation; communication strategies; and the referral process for injured/ill workers.