Retaining Employment and Talent After Injury/Illness Network (RETAIN) demonstration

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Supporting Statement - RETAIN (Part B).docx	Supporting Statement B	Uploaded 2021-03-22	Repair queued
Supporting Statement - RETAIN (Part A).docx	Supporting Statement A	Uploaded 2021-03-19	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
246357	RETAIN Provider Surveys (R1 & R2)	Other-RETAIN PROVIDER SURVEY INSTRUMENTS (R1, R2)	New
246354	RETAIN Enrollee Surveys (R1 & R2)	Other-RETAIN ENROLLEE SURVEY INSTRUMENTS (R1, R2)	New
246353	RETAIN Staff Activity Logs	Other-RETAIN Staff Activity Logs	New
246352	RETAIN Service Users Interview	Other-RETAIN Service Users Interview Topics	New
246351	RETAIN Staff Interviews	Other-RETAIN Staff Interview Topics	New

ICR Details

OMB Control No:	ICR Reference No: 202103-0960-008
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Retaining Employment and Talent After Injury/Illness Network (RETAIN) demonstration
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/22/2021

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	25,528	0
Time Burden (Hours)	6,438	0
Cost Burden (Dollars)	0	0

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Abstract: The Social Security Administration and the Department of Labor are undertaking the Retaining Employment and Talent After Injury/Illness Network (RETAIN) demonstration, which will test promising early intervention approaches to improve the labor force participation and retention of individuals with recently-acquired injuries and disabilities and to reduce their future need for Social Security disability benefits. The Department of Labor (DOL) is funding the intervention approaches and American Institutes for Research to provide programmatic technical assistance for the demonstration. The Social Security Administration (SSA) is funding Mathematica to provide evaluation support for the demonstration, including evaluation-related technical assistance and conducting a comprehensive evaluation. The RETAIN demonstration consists of two Phases. The first involves cooperative awards to eight states to conduct planning and start-up activities, including the launch of a small pilot. During Phase 1, SSA will provide evaluation-related technical assistance and planning, and conduct evaluability assessments to assess which states’ projects would allow for a rigorous evaluation if continued beyond the pilot phase. DOL will select a subset of the states to continue to Phase 2, full implementation. During Phase 2, DOL will fund the operations and programmatic technical assistance activities for the selected states, and SSA will fund a full set of evaluation activities.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 667	01/06/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 14170	03/12/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
RETAIN Enrollee Surveys (R1 & R2)
RETAIN Provider Surveys (R1 & R2)
RETAIN Service Users Interview
RETAIN Staff Activity Logs
RETAIN Staff Interviews

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	25,528	0	0	0	25,528	0
Annual Time Burden (Hours)	6,438	0	0	0	6,438	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection that will increase the public reporting burden.

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Annual Cost to Federal Government: $3,866,667

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/22/2021

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