Ohio RETAIN Impact Evaluation

Study Overview
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Brief Summary
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The Retaining Employment and Talent after Injury/Illness Network (RETAIN) demonstration is a collaborative effort between the U.S. Department of Labor (DOL) and the Social Security Administration (SSA) to improve employment outcomes for individuals who experience injuries or illnesses that put them at risk of exiting the labor force and relying on disability programs and other public supports in the long term. RETAIN projects include a combination of medical provider services, stay-at-work/return-to-work (SAW/RTW) coordination services, and other SAW/RTW services. This evaluation will focus on the Ohio Department of Job and Family Services' implementation of Ohio RETAIN. The evaluation will document how the project is implemented, describe enrollees, estimate the project's impacts on enrollees' outcomes, and assess whether the benefits outweigh the costs.

Detailed Description
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The Ohio Department of Job and Family Services has partnered with Mercy Health to implement Ohio RETAIN in Youngstown, Toledo and Cicinnati catchment areas. SSA contracted with Mathematica to conduct an independent evaluation of the program. Under the RETAIN model medical providers receive training and incentives to use occupational health best practices. The state agency also coordinates SAW/RTW services for the enrollee, fosters communication among Ohio RETAIN stakeholders about the treatment enrollee returning to work, and monitors the enrollee's medical and employment progress. The Business Resource Network and OhioMeansJobs provide additional support for workplace-based interventions and retaining or rehabilitation of enrollees. Ohio recruits potentially eligible workers as they receive care from medical providers. The evaluation team randomly assigns each enrollee to either a treatment group that is eligible to receive the full set of RETAIN intervention activities or a control group that is not. The evaluation team then compares the outcomes of the treatment and control groups and gathers evidence on how Ohio RETAIN shaped the outcomes of enrollees who were eligible for its services, regardless of whether they participated in those services. Data sources include enrollment data, surveys, administrative records, program data, and qualitative data.

Official Title
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One-Year Impact Evaluation of Ohio Retaining Employment and Talent After Injury/Illness Network (RETAIN)

Conditions
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Disability

Intervention / Treatment
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* Other: Ohio RETAIN


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18- 65 Currently employed or actively seeking employment Live in Youngstown (Mahoning, Columbiana, and Trumbull Counties), Toledo (Lucas County), and Cincinnati (Butler, Clermont, Hamilton, and Warren Counties Provider prescribed limitations of work, FMLA paperwork submitted for provider completion, documentation of work limitations in office notes, or an illness/injury which has previously resulted in work limitations based upon the nurse's clinical judgement and experience for a treatment barrier that is prolonging recovery and return to work Has a qualifying musculoskeletal injury or exacerbation or a qualifying cardiovascular procedure Qualifying musculoskeletal injury or exacerbation: (a) Has occurred in the last 3 months and has limited their ability to work; (b) Not work related; (c) Surgery was in the last 3 months with continued limitations at work; (d) Upcoming surgery within 1 month. Qualifying Cardiovascular procedure: (a) CABG (Coronary Artery Bypass Graft) scheduled or done; (b) TAVR (Coronary Valve replacement with open heart entry to exclude trans-catheter) approach scheduled or done; (c) (Abdominal Aortic Aneurysm) open entry approach scheduled or done; (d) Aorto-bifemoral bypass with activity restrictions for 4 weeks or more scheduled or done; (e) Cardiac Catheterization with stent placement with: i) Cardiac Rehab ordered at time of Cardiac Catheterization or ii) No Cardiac Rehab ordered at time of Cardiac Catheterization, but Cardiac Rehab has been ordered at Cardiac Catheterization follow up appointment. Exclusion Criteria: Retired Has or is pursuing a Bureau of Workers' Compensation claim for this injury Has applied for or is currently receiving Social Security Insurance or Social Security Disability Insurance Has substance abuse disorder Has legal representation Pregnant Has a terminal disease Multiple trauma patient with multi-system involvement requiring being off work/recovery for more than 3-6 months.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: RETAIN Programming<br>The experimental group receives the full set of RETAIN intervention activities. | Other: Ohio RETAIN<br>* RETAIN projects include a combination of medical provider services, stay-at-work/return-to-work (SAW/RTW) coordination services, and other SAW/RTW services. The evaluation compares the treatment group that is eligible to receive the full set of RETAIN intervention activities and an active comparator that is not.<br>|
| No Intervention: Control<br>Medical providers who treat both treatment and control group enrollees receive training on stay-at-work/return-to-work best practices | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Share of enrollees employed in the fourth quarter after enrollment | Share of enrollees employed in the fourth quarter after enrollment obtained from state unemployment insurance wage records. These files include individual-level wage records for six quarters surrounding enrollment in the study, including the quarter prior to enrollment, the quarter of enrollment, and four post-enrollment quarters. | Measured over the three months in the fourth quarter after enrollment | 
| Enrollee earnings in the fourth quarter after enrollment | Sum of enrollee earnings in the fourth quarter after enrollment obtained from state unemployment insurance wage records. These files include individual-level wage records for six quarters surrounding enrollment in the study, including the quarter prior to enrollment, the quarter of enrollment, and four post-enrollment quarters. | Measured over the three months in the fourth quarter after enrollment | 
| Share of enrollees that applied for SSDI or SSI during the 12 months after enrollment | Share of enrollees that applied for SSDI or SSI during any of the 12 months after enrollment obtained from SSA program data. These files include detailed information about Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) applications SSDI and SSI awards, SSDI and SSI benefit amounts and enrollee characteristics (for enrollees who have ever applied for SSA program benefits) | Measured in the 12 months after enrollment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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disability, employment, unemployment