View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0960-0821
ICR Reference No:
202208-0960-004
Status:
Historical Active
Previous ICR Reference No:
202103-0960-008
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Retaining Employment and Talent After Injury/Illness Network (RETAIN) demonstration
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
09/18/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
08/19/2022
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2024
06/30/2024
06/30/2024
Responses
25,528
0
25,528
Time Burden (Hours)
6,438
0
6,438
Cost Burden (Dollars)
0
0
0
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. This is a Non-Substantive Change Request to update the placeholder questions on the Provider Survey with finalized questions as per our agreement with OMB when we received approval for the survey on 6/28/21.
Authorizing Statute(s):
None
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
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
Number of Information Collection (IC) in this ICR:
5
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
ICR Summary of Burden
Total Approved
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
25,528
0
0
0
0
Annual Time Burden (Hours)
6,438
6,438
0
0
0
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.
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
Agency Contact:
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov
Common Form ICR:
No
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:
08/19/2022
An official website of the United States government
The .gov means it's official.
The site is secure.
