Justification for No material Nonsubstantive Change

Justification Statement – Non-substantive Change

Retaining Employment and Talent after Injury/Illness Network (RETAIN)

Demonstration Projects and Evaluation

Expiration Date: 5/2022

ODEP is requesting approval for a non-substantive change relating to the Baseline Participant form part 1 that is part of the currently approved information collection under OMB Control No. 1230-0014, in which RETAIN grantees administer the Baseline Participant form part 1 to prospective enrollees. A revision has been made to the project structure for Phase 2 of RETAIN, as a result of which DOL-CEO and a third party contractor will receive data from this form, including PII. This necessitates a revision to the Privacy Act Statement, which in the Phase 1 version of the document had referred specifically to DOL-ODEP receiving de-identified data. Since this revised form will replace the original version, there will be no change to the burden in terms of hours or cost.