Vermont 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 Vermont Department of Labor's implementation of Vermont RETAIN statewide. 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 Vermont Department of Labor is partnering with health care, employment, and other entities to implement Vermont RETAIN. 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 Vermont RETAIN stakeholders about the treatment enrollee returning to work, and monitors the enrollee's medical and employment progress. Providers at participating practices are trained in the Vermont Best Practice Resources and Training, which explains how to identify early and then manage the risk of work disability to help prevent long-term unemployment. Participants undergo a systematic assessment of barriers to work, work goals, and function in order to create a personalized RTW plan; RTW coordinators use a strength-based coaching model and provide care coordination through a customized mobile health app. Vermont plans to work with 68 primary care practices across the state and enrolls clusters of medical practices to participate in the study. The evaluation team randomly assigns each cluster to either a treatment or control group. Mathematica conducts random assignment of clusters on a rolling basis as Vermont enrolls clusters. Vermont invites eligible individuals who see a medical provider in either the treatment or control group to enroll in the study. Individuals who see a provider that has been randomly assigned to the treatment group and who enroll in the study are considered treatment group enrollees and are eligible for Vermont RETAIN services. Individuals who see a provider in the control group and enroll in the study are considered control group enrollees and are not eligible for Vermont RETAIN services. The evaluation team then compares the outcomes of the treatment and control groups and gathers evidence on how 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 Vermont Retaining Employment and Talent After Injury/Illness Network (RETAIN)

Conditions
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Disability

Intervention / Treatment
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* Other: Vermont RETAIN


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years or older Live or work in Vermont (or if out of work, lives in a border state and plan to work in Vermont) Currently employed or actively looking for a job Have an injury or illness that is limiting or could limit ability to stay at or return to work The injury or illness occurred, flared, or worsened within the past 6 months Exclusion Criteria: Has received care of coordination services from RETAIN before Has an active SUD that is currently untreated Has been out of work for more than 12 weeks due to injury, illness, or flare Currently applying for or receiving disability benefits from Social Security Administration

Ages Eligible for Study
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Minimum Age: 18 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: Vermont 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 a control group that is not.<br>|
| No Intervention: Control<br>This arm receives information about American Job Center services and assistance with opening a JobLink account if an individual doesn't have one. Medical providers at all practices will receive training on how to identify early and then manage the risk of work disability to help prevent long-term unemployment | |

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 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 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, unemployment, employment