Skip to page content
Office of Disability Employment Policy
Bookmark and Share
ODEP - Office of Disability Employment Policy - Driving Change Creating Opportunity

S@W/R2W Research & RETAIN Demonstration Projects

Home | News & Events | Research & Publications | About RETAIN | FAQs | Grant Recipients | Contact Us

Responses to Questions Not Answered on Prospective Applicant Teleconference

  1. Regarding eligible applicants, what constitutes an "equivalent entity with responsibility for labor, employment, and/or workforce development"? For example, would a Vocational Rehabilitation agency or a Workers' Compensation agency qualify?
  2. Page 11 of the Funding Opportunity Announcement states:

    "Eligible applicants include:

    • State Departments of Labor, State Workforce Development Agencies, or an equivalent entity with responsibility for labor, employment, and/or workforce development; and
    • Entities described in section 166(c) of WIOA relating to Indian and Native American programs."

    Although technically a workforce development partner, Vocational Rehabilitation (VR) cannot be a lead applicant. However, beyond the required secondary partners for the RETAIN Leadership Team, applicants have flexibility to choose the types of other entities represented on the RETAIN Leadership Team that are relevant to their proposed target population and scope of the project. Therefore, it is at a state applicants' discretion to include VR as part of the Leadership Team. Additionally, the roles and responsibilities of both required and applicant's chosen partners on the Leadership Team will be defined by the applicant.

    If a state chooses to include VR on their Leadership Team and/or as a future proposed service provider, state VR agencies should focus on retention services and target populations not traditionally served by VR and who are at imminent risk of leaving their job or the labor force due to an injury or illness. This should also be approved in the VR State Plan.

    In contrast, a state workers' compensation agency located within a state department of labor can be an eligible lead applicant. While an independent workers' compensation entity, private or public, cannot be the primary applicant, similarly to VR, it can be a partner on the Leadership Team if applicable to a states' proposal.

  3. Regarding the role of the workforce development system. There is a great deal of discussion about the role of health care providers in helping injured or ill workers stay on the job or return to work. It is less clear how the workforce system fits into RETAIN. Can you clarify or expand on this?
  4. RETAIN provides a new opportunity for the workforce system to focus on an innovative early-intervention strategy to help minimize the economic impact of injury or illness on workers and employers. The RETAIN funding opportunity envisions a strong leadership role for the workforce system, which will work in close partnership with the health care system to provide the workforce development supports necessary to help the target population return to work or stay at work. Note that the individuals targeted for services under a RETAIN project might not, on their own, be aware of or find an American Job Center, and DOL expects that the workforce system's partnership with health care providers will provide an additional mechanism for recruiting individuals who need services.

    While health care providers will address workers' health-related needs, the workforce system will address and coordinate workers' employment-related needs, such as skills assessment, retraining, education, or support services. For example, the workforce system can develop a proactive partnership with the business community to provide consultation, technical assistance, and support to employers on workplace accommodations, developing temporary light-duty jobs, assistive technology, and facilities and workplace access through collaboration with community partners and employers, across States and nationally. These tools will enable employers to retain and return employees who may be at risk of developing a work disability due to injury or illness. Additionally, the workforce development system can also assist employers with using available financial support by accessing local, State, and Federal tax credits.

    Working together, the workforce system, health care system, and other partners will contribute to a holistic strategy that helps workers impacted by injury or illness stay at work or return to work. The RETAIN Leadership Team from each state should work together to identify the types and modes of services, and optimal points of engagement for the workforce system.

  5. Regarding the definition of a health care system. Given that this opportunity arose to some extent in the spirit of the COHE program in Washington State, which is extremely unique in the United States of having formal health systems participate in disability treatment, prevention, and management, how strict are you going to be in defining what a health care system is?
  6. At its root, a health care system is an organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations.

    On the call, we provided the definition as included on page 8:

    "The Compendium of U.S. Health Systems, 2016, defines a health system as an organization that includes at least one hospital and at least one group of physicians that provides comprehensive care (including primary and specialty care) who are connected with each other and with the hospital through common ownership or joint management."

    We also recognized on the call that health care systems look different in various parts of the country and indicated that we would take a broad interpretation of the definition. The purpose of providing a definition in the FOA was to provide clarity to applicants not familiar with health care policy terminology and was not intended to provide a strict legal definition. The definition we provided is from the Agency for Healthcare Research and Quality at the Department of Health and Human Services. This page on their website acknowledges that the definition of a health system is expected to evolve over time and provides a number of examples: https://www.ahrq.gov/chsp/chsp-reports/resources-for-understanding-health-systems/defining-health-systems.html.

    We would like to reiterate our intention to take a broad interpretation of what constitutes a health care system.

  7. Regarding conflicts of interest. Will required partners or others who serve on the RETAIN Leadership Team be precluded from bidding on contracts to provide services to RETAIN participants? For example, would a private health care system be allowed to serve on the Leadership Team and bid on health care service provider contracts that may be put into place for the pilot or Phase 2?
  8. It is the intention in the RETAIN project that organizations involved on the Leadership Team on Phase 1, including health care systems and other health care service provider, will have a role in implementation in Phase 2. This is because grantees in Phase 2 will be selected based on factors including, but not limited to, the strength of their organizational capacity that will be demonstrated in the implementation of their pilot in Phase 1. With that said, sub-awards made by the primary applicant/awardee will be governed by state regulations. As such, applicants are encouraged to consult their state's contracting/procurement policy for guidance about conflicts of interest and maintaining the integrity of contract/grant competitions.

    Although DOL's involvement in the cooperative agreement administration will allow DOL to approve post-award RETAIN-related sub-contracts (see page 10 of the Funding Opportunity Announcement), the RETAIN cooperative agreements will establish a relationship between the Department of Labor (DOL) and the primary applicant/awardee. DOL will have no direct authority over sub-award competitions. However, applicants may wish to review FAR 9.505 and 9.508, which list general rules and examples of Organizational and Consultant Conflicts of Interest.

  9. Regarding the randomized intervention component. Many of the interventions described in the FOA are known to be beneficial, so randomization may not be ethical (for example, delaying care for participants). Can you comment on this?
  10. No one will receive care that is worse than what they would receive in the absence of the intervention.

    As mentioned on the call, applicants do not have to propose a specific evaluation design. However, they must express willingness to work with the evaluator to support Social Security Administration's national evaluation. Pages 18-20 of the Funding Opportunity Announcement contain the Information on the evaluation.

    The independent evaluator will be responsible for determining the research (evaluation) design, including whether or not there is randomization. The evaluator will be required to get Institutional Review Board (IRB) approval to ensure the protection of the participants. Finally, if randomization is included, we suspect that it would be done at a site level, and individuals would be eligible to receive the program services if they chose to visit a service provider in the treatment group.

  11. Regarding partner eligibility for a health care system and the potential for targeting its employees as the RETAIN target population. One participant discussed a health care system that provides occupational medicine services to its employees only and asked whether that could be an eligible partner.
  12. On the call, we advised that as long as recruitment targets can be met, that should be fine. We would like to add two things to this response:

    1. Applicants are required to justify the relevance in addition to the size of their target population (e.g., show evidence of high rates of work disability and transition onto DI/SSI).
    2. Applicants must demonstrate how the activities proposed in the project will differ from those already occurring (e.g., if the organization already provides occupational services to its employees, what would the proposed contrast be?).

    These factors are discussed in the Funding Opportunity Announcement on pages 25-26, as well as briefly on page 42.

  13. Regarding HIPAA. Health care providers cannot provide other agencies with information about who may be eligible for RETAIN because it would violate HIPAA. How does DOL envision states will address this?
  14. Projects must satisfy the application requirement to demonstrate legal authority to share required data with DOL and SSA, as discussed on pages 19 and 34 of the Funding Opportunity Announcement. In order to do so, we expect projects will need to obtain informed consent from all participants. Applicants should describe in their proposals how they would address this issue as it relates to referrals between health- and employment-related services (or other project partners), in addition to sharing data with federal partners. Reviewing such issues and identifying solutions is an appropriate role for the RETAIN Leadership Team.

    Below is general information on the HIPAA Privacy Rule and potential areas of intersect with RETAIN. Applicants are strongly encouraged to review information from the Department of Health and Human Services (see links at the end of this response) and consult with experts on any additional privacy rules that may apply in specific states.

    The HIPAA Privacy Rule establishes the conditions under which protected health information may be used or disclosed by covered entities for research purposes. The RETAIN Demonstration Projects meet the definition of research set forth in the HIPAA Privacy Rule.

    According to the Department of Health and Human Services, "The Privacy Rule… permits covered entities to use or disclose protected health information for research purposes when a research participant authorizes the use or disclosure of information about him or herself. To use or disclose protected health information with authorization by the research participant, the covered entity must obtain an authorization that satisfies the requirements of 45 CFR 164.508." The HIPAA Privacy Rule also discusses Institutional Review Board (IRB) approval and documentation required to obtain a waiver for research purposes.

    By law, this rule applies only to covered entities, which include health plans, health care clearinghouses, and certain health care providers. The Department of Health and Human Services recognizes that most health care providers do not carry out all of their health care activities and functions by themselves and often utilize the services of other vendors or businesses, which are known as "business associates" under the Privacy Rule. Certain RETAIN partners could be considered business associates for purposes of HIPAA.

    For additional information, please visit:

  15. Further clarifying eligible lead applicants and state Vocational Rehabilitation agencies. The response to a question raised on the June 7, 2018, prospective applicant call about eligible applicants indicated that Vocational Rehabilitation (VR) agencies and independent workers' compensation agencies cannot serve as the lead applicant for a RETAIN cooperative agreement, but a workers' compensation that is housed within a state's department of labor is an eligible lead applicant in its capacity as part of the state's department of labor. By this line of reasoning, would a VR agency housed within a state's department of labor be an eligible lead applicant for a RETAIN cooperative agreement?
  16. Ultimately, this answer is based on the ability to serve the RETAIN target population, which consists of individuals who develop, or are at risk of developing, a "work disability." By work disability, we mean an injury or illness that has the potential to interfere with or prevent ongoing employment. Notably, this injury can occur either on-the-job OR off-the-job. Characteristics of the RETAIN population include:

    • Employed, or at minimum in the labor force, at the time of injury or illness
    • May or may not have a pre-existing disability
    • May or may not view their new condition as a disability and may or may not meet the Americans with Disabilities Act definition of "disability"

    Under State Plan Provisions of the Workforce Innovation and Opportunities Act, VR agencies may only provide retention services to individuals who are at imminent risk of losing their jobs and are otherwise eligible for VR program services. Given that those who are otherwise eligible for VR are those who already have significant disabilities, VR would not be able to serve the bulk of the population targeted by RETAIN. A VR agency that is part of the Department of Labor, however, would be able to easily partner with and leverage other departmental entities to serve the target population, and therefore could serve as the lead applicant.

    As stated in the answer to the previous eligibility question, if a state chooses to include VR on their Leadership Team and/or as a future proposed service provider, state VR agencies should focus on retention services and target populations not traditionally served by VR and who are at imminent risk of leaving their job or the labor force due to an injury or illness. This should also be approved in the VR State Plan.

    ODEP anticipates working closely with the awardees of RETAIN cooperative agreements throughout the period of performance to help support project success.

  17. Further clarifying eligible lead applicants and independent workers' compensation agencies. The response to a question raised on the June 7, 2018, prospective applicant call about eligible applicants indicated that independent workers' compensation agencies cannot serve as the lead applicant for a RETAIN cooperative agreement. In our state, the Department of Labor has expressed a desire to be a part of this project, but stated that it is unable to serve as the lead applicant. We would therefore like to serve as the lead applicant and work in close coordination with the State Department of Labor. Our plans include expanding services beyond the typical workers' compensation population to include non-occupational injuries and illnesses. In this instance, can we as an independent workers' compensation agency serve as the lead applicant with the commitment of the State Department of Labor to closely coordinate our efforts?
  18. Even in this circumstance, an independent workers' compensation agency is not eligible to serve as the lead applicant. Page 11 of the Funding Opportunity Announcement states:

    • "Eligible applicants include:
      • State Departments of Labor, State Workforce Development Agencies, or an equivalent entity with responsibility for labor, employment, and/or workforce development; and
      • Entities described in section 166(c) of WIOA relating to Indian and Native American programs."

    We strongly encourage the State Department of Labor to reconsider its position in order to take advantage of the RETAIN opportunity on behalf of the state and its workers. Please note that while a workforce development entity must be the lead applicant, the lead entity can contract with other entities such as colleges and universities to help administer the grant.

  19. Regarding letters of commitment. Are separate letters of commitment required from all members of the RETAIN Leadership Team and other partners, or would one letter indicating the commitment of multiple members or partners meet this requirement?
  20. One letter containing signatures of authorized individuals from multiple members or partners is acceptable.

  21. Regarding use of WIOA funds and the eligibility of RETAIN participants for WIOA services.
  22. As ODEP Deputy Assistant Secretary outlined during the first prospectus call, RETAIN is discretionary funding that is not necessarily tied to the administration of WIOA Title I Adult and Dislocated Worker programs. RETAIN is a pilot initiative to measure and test policy planning and implementation on Return to Work and Stay at Work Initiatives. Thus, there is flexibility in how states propose to integrate WIOA and RETAIN resources to serve participants.

    The eligibility of RETAIN participants for, and the availability of, training services under the WIOA Title I Adult and Dislocated Worker programs will depend on the circumstances of each individual participant and the State and local priority system that is in effect under WIOA 134(c)(3)(E). ETA provides detailed guidance regarding services provided through the Adult and Dislocated Worker programs in Training and Employment Guidance Letter (TEGL) 19-16, available here: https://wdr.doleta.gov/directives/corr_doc.cfm?DOCN=3851. To the extent feasible, DOL encourages RETAIN grantees to leverage WIOA Title I resources in serving RETAIN participants. However, as specified in the RETAIN Funding Opportunity Announcement on p. 14, "[RETAIN] Grant funds can be used to supplement services that are not currently available inside the workforce system..."

  23. Regarding sample sizes and applicants' role in evaluation of RETAIN.
  24. State applicants must identify their target population(s), the estimated size of the total population, and their projected enrolled sample size in their proposal's project narrative and also provide available details on the evidence base for their proposed target population (i.e., evidence of its long-term disability rate or SSDI/SSI transition rate) as required in the Funding Opportunity Announcement (See Section IV.B.3.a). However, applicants are not responsible for proposing or developing an evaluation design as part of their application. Rather, subsequent to the award of Phase I funding, state awardees will be required to collaborate with the independent evaluator to identify the most robust evaluation design appropriate for the service delivery model being implemented, as well as the sample size and recruitment strategies required to detect the impact of the intervention on labor force participation and application and receipt of Social Security Disability Income (SSDI)/Supplemental Security Income (SSI).