Press coverage of RETAIN beginning -- article in WorkCompCentral today
Jennifer Christian MD
To my knowledge, this article (attached and text pasted below) is the first public media story about RETAIN. It appeared in a workers’ compensation e-newsletter called WorkCompCentral. Thanks to Peter Rousmaniere, a nationally-known consultant and journalist from Vermont, for noticing its appearance and sharing it with us.
Let’s hope there are many more – and that they are favorable. One critical success factor for RETAIN is how the program is perceived. It is important that there be strong public awareness of the program and its benefits.
Let’s share everything we see in the press or other mass media. See full text of the article pasted below and attached.
Jennifer Christian, MD, MPH
President / Chief Medical Officer
Office: 508-358-5218 (preferred)
This article appeared on WorkCompCentral – August 10, 2018
WCC RETAIN Grants 8 10 18
Feds to Award States $100M in Return-to-Work Grants
By Eddie Curran
National Topic: A federal project that seeks to reconfigure the methods used to get injured and sick employees back to work as soon as possible has taken its first major step, receiving proposals from states seeking grants of up to $22.5 million apiece.
The five-year, $100 million pilot project bears the name RETAIN, for, Retaining Employment and Talent After Injury, and is to a considerable degree based on an early return-to-work program by the state of Washington.
RETAIN is based on a workers’ comp model, and the applicants are state agencies that oversee workers’ comp. However, the project will serve workers who are injured or become sick off the job as well as on.
While mental illness and other disabilities are part of RETAIN, the focus is on workers with musculoskeletal injuries.
In a nutshell, the purpose of RETAIN is to establish a system whereby within days, if not sooner, of a worker getting injured, the employer and medical personnel, working with the employee, develop a plan to get the worker back on the job as soon as possible, even if it’s in a reduced capacity, such as with adjusted responsibilities or even in a different job altogether.
A return-to-work (RTW) coordinator will reach out to the worker, physician and employer, and develop the plan.
Dr. Jennifer Christian, a Massachusetts-based disability expert who has been involved with the federal Office of Disability Employment Policy in the RETAIN project, said studies have shown that every day employees are away from work, the greater the likelihood that they won’t return. Often, they go on government assistance, and from a professional and personal standpoint, never recover.
“The purpose is to demonstrate that with a concentrated, integrated, organizational multi-sector effort, worker disability can be prevented, and people can keep their jobs and avoid going on disability and government assistance,” said Christian.
“But RETAIN is only a supplementary service. It doesn’t replace existing programs," she added. "RETAIN funds won’t pay for medical care or or wage-replacement benefits. It doesn’t replace any existing program.”
The program focuses on the first three months after a worker is injured, and project assistance concludes six months after the injury.
RETAIN is the result of research conducted from 2013 to 2017 by the Office of Disability Employment Policy, in partnership with the Labor Department’s Employment and Training Administration and the Social Security Administration.
The five-year demonstration program is divided into two phases. Those states that submitted applications by the July 23 deadline were seeking to participate in Phase 1. Eight states will be chosen by the end September. Each will receive up to $2.5 million to be used over the 18 months of the first phase.
“Through the RETAIN demonstration project, we hope to learn how to best increase employment retention and labor force participation of people who develop or are at risk of developing what we call work disability,” said Jennifer Sheehy, deputy assistant secretary for ODEP, during a June 7 conference call with potential applicants and interested parties.
“By work disability, we mean an injury or illness that has the potential to interfere with or prevent ongoing employment,” Sheehy continued. “Importantly, the injury or illness can occur either on the job, where it would likely qualify for workers' compensation if available, or the injury or illness can occur off the job. Here it would not necessarily qualify for workers' compensation.”
The lead applicant for each state must be its labor or workforce development agency, or equivalent.
Required co-applicants include the state’s health department, one or more health care systems or health care provider networks, and the states' workforce development boards. There may be other team members as well.
Grant winners are to develop plans for their return-to-work program and establish the infrastructure that will be needed to implement their project. That's to include providing training for employers and health care workers on best practices, and building relationships with local stakeholders whose support will be essential.
Two other RFPs are to be awarded as well. The first will be a technical assistance contract, awarded to a firm that will assist the states with the RETAIN goals. The second contract, to be funded by the Social Security Administration, will be awarded to a firm that will evaluate the performance of the grant winners.
At the end of Phase 1, four of the eight states will be selected to participate in Phase 2. Each will receive up to $19.75 million to implement the projects designed in the first phase.
If the project bears fruit, and the Department of Labor believes RETAIN has allowed it to develop successful plans for states to use, the models would presumably be used nationwide.
“The goal is to have several states come up with a model that works for their geographics, their demographics and the configuration of their state systems, and to determine which ones worked well, and which ones had problems,” said Christian.
Christian noted that early return-to-work programs are not uncommon, but for the most part are limited to large, well-managed companies. To a considerable degree, the goal of RETAIN is to make such arrangements available to small companies and their employees.
ODEP makes no secret in acknowledging the project’s debt to the State of Washington’s early return-to-work program, called COHE, for Centers for Occupational Health and Education.
That program began with a pilot site in 2002. Now there are six regional COHE centers throughout the state, all funded by the Washington state Department of Labor & Industries, which runs the state's monopoly workers' comp insurance system.
Studies and audits of the COHE centers have found that participants were less likely to be off work and receiving disability benefits one year after a claim, missed far fewer days of work, and that combined medical and disability costs were reduced, by $510, per participant.
A U.S. Department of Labor analysis published in 2016 concluded that COHE participants were 26% less likely to receive Social Security disability benefits.
One purpose of RETAIN, according to ODEP, is to “test key features of the Washington COHE model” in other states and to apply the test to “a population beyond workers’ compensation.”
The hope is that, in five years, the federal government and participating states will have built on COHE’s success, and will have developed models that can be applied throughout the country and help keep more people in the workforce and off government assistance.
No such program can succeed without support from, and participation of, local employers and medical professionals, said Christian.
She said a similar program in the United Kingdom was found to have failed due to lack of referrals from companies and the medical community.
“In order for a program to get referrals, the doctors and employers have to be aware of the program and perceive it as a good program,” Christian said. “It not only has to be visible but have a good reputation. You have to build relationships with the stakeholders in the community.”
Christian said that while there may be people in the background in the workers’ comp and the managed care industries who have qualms or may even oppose RETAIN and its goals, none have stepped forward.
“Those who thrive on dysfunction may be opposed to it,” she said, but RETAIN “doesn’t clearly and directly gore anybody’s ox that I know of. That’s part of the reason why the government was able to put $100 million into the program, because it had strong bipartisan support right from the start,” she said.