31 July 2023
ROCHESTER When Ginger LaVan was preparing herself for right-side total hip replacement last year, she already had experience with getting health accommodations through her employer, Charter Communications.
“When you’re in an office setting like that, particularly after surgery, it’s important to be able to get a doctor’s note for any kind of desk modifications you need,” said LaVan, who works in customer service support. “I had eye surgery a couple of years ago, so I basically wear sunglasses at work all day because the LED lights are so bright it’s difficult for me to see.”
This time around, LaVan would spend three months away from work while she recovered from her surgery. While LaVan said her employer was supportive, she got extra help through Minnesota’s Retaining Employment and Talent After Injury/Illness Network, a fledgling state program known as MN RETAIN.
The program’s overarching purpose is to help Minnesota’s workers stay in or rejoin the workforce after illness, injury or other health hiccups by having return-to-work case managers act as liaisons between the patient, their employer, their health care provider, and other parties.
“I think one of the goals of RETAIN is to break down silos between health care and industry and state government and workforce development, to bring together all of the people that are interested in helping workers stay at work and get back to work,” said Dr. Laura Breeher, co-medical director for MN RETAIN.
There hadn’t been a statewide program like this prior to 2018, when Minnesota was one of eight states that received U.S. Department of Labor and Social Security Administration grants to launch worker retention programs. While RETAIN is nestled under the Minnesota Department of Employment and Economic Development’s umbrella, Mayo Clinic serves as the lead health organization partner, and workforce assistance is coordinated through Workforce Development Inc.
“It was a small pilot program initially focused in southeast Minnesota,” Breeher said.
After testing the model with a small cohort of patients just 150 RETAIN applied for a second, $19.5 million grant in 2020 to expand the program’s reach. As of early July, more than 1,400 Minnesotans have been enrolled in the experimental program; half of the participants receive support through RETAIN, while the other half serve as a control group.
Now halfway through its second phase, RETAIN has been met with some hesitancy and misunderstanding. Many workers and employers don’t know it exists.
“How do you utilize a program that you don’t know about?” said Nancy Omondi, director of adult programs in DEED’s Employment and Training Program Division. “Given this is a new program, the first thing is: do employees know about the program? So, sharing the information about the program availability is very important.”
As the RETAIN staff try to raise awareness around the program and do some myth-busting (no, it’s not workers’ compensation, and it’s not an exclusive program for Mayo employees), the work is underway to make RETAIN a permanent program once the federal grant expires in 2025.
“We’re really excited about the program,” Omondi said.
How MN RETAIN works
While the program’s focus is on keeping Minnesotans employed, the vast majority of participants aren’t enrolled due to a workplace injury.
“We wanted to make RETAIN very accessible to a lot of workers,” Breeher said. “Workers who have workplace injuries would potentially qualify, but also workers that have personal medical conditions that are impacting work, like heart attack, stroke, cancer, mental health disorders. The vast majority of our participants do have personal medical conditions rather than work-related conditions.”
LaVan is in that majority. She was introduced to the program one month before her hip surgery on July 5, 2022. She landed in the intervention group and was matched with a return-to-work case manager.
“RETAIN called about once a week or once every two weeks, depending on how our schedules lined up, and we could make sure I was OK and everything was going to plan as far as my recovery and working towards my ability to go back to work,” LaVan said.
The return-to-work case managers at the core of RETAIN’s efforts can negotiate modified working conditions with a participant’s employer, refer them to career development resources, and connect them with rent, utilities and transportation assistance.
“It’s a new role within health care that we’ve introduced as part of the grant right now that is a free service that we’re providing to participants in the intervention group,” Breeher said. “Embedding that return-to-work case manager as part of the care team helps expedite getting those patients to the resources that they need so that they don’t go down the path of disability or losing their employment.”
A few weeks after her surgery, LaVan said her case manager asked if she was planning on returning to her job at Charter Communications and if she needed any modifications to make that possible.
“They were willing to help me get those things in place if I needed to,” LaVan said. “They would be a liaison for me to help deal with my employer, my supervisor and HR going back to work.”
LaVan had her workplace accommodations lined up she already had a standing desk and could shorten her workdays but she did accept financial help through RETAIN.
“Money’s a little tight after three months of being off work, right?” LaVan said. “I was able to get a gas card to make sure I can get back and forth to work.”
Now, more than a year after her surgery, LaVan continues to work 6.5-hour days in her job.
“I’m really lucky; I have a great employer,” she said. “If I had an employer where they weren’t going to be real cooperative about giving me a reduced schedule because I’m coming back or working with some modifications, then, yes, that help from MN RETAIN would be critical.”
While LaVan didn’t need workforce development help from RETAIN, case managers can point participants to those opportunities.
“A good portion of our participants in the intervention group we’re referring to Workforce Development for services like resume development, career training, job search assistance, those sorts of things,” Breeher said.
Right now, most patients’ entry point into RETAIN comes through their health care provider’s referral. While Mayo Clinic was the sole health care provider in the program’s first phase, RETAIN has since added a few partners, Breeher said: TRIA Orthopedics, NovaCare Rehabilitation, Fulcrum Health and Rochester Clinic.
Dr. Jengyu Lai, a podiatrist and certified lifestyle medicine provider, said Rochester Clinic joined RETAIN in the spring of 2022.
“When a patient comes in, regardless if they are having any work-related injuries or anything, as long as we sense they have an injury or there’s any mental (health) issue or anything that affects their job function, we ask them,” Lai said.
Lai has referred a handful of patients to RETAIN so far. He said some patients have gotten in touch with the program right away, while others waited, thinking that the opportunity was too good to be true.
“We can schedule their intake person (with MN RETAIN) in our office which we have done a few times,” Lai said. “Then, if they contacted the patient and the patient didn’t respond or the patient was a no-show, RETAIN would send us an email, say hey, this is what happened. And then we would talk to the patient. Sometimes it takes a long process.”
How employers use MN RETAIN
Pat Eckert found himself on the employer’s side of RETAIN when one of his employees, a carpenter, got hurt in February. Lai had referred the employee to the state program.
“I just put him on light duty for a little bit, and then they get a hold of him and give him different options,” said Eckert, who owns Eckert Construction in Rochester.
Eckert said he has a good impression of the program, especially since gives construction workers different options to use in their recovery.
“I blew out both my knees when I was in my 20s,” he said. “I had the one done, then the other one blew on me you’re six months off at a time. I couldn’t go back to work. … This would have been an awesome program.”
There have been some misunderstandings about the program from employers, however. In the early days of RETAIN, Breeher said there was a misconception that the program was only for Mayo Clinic employees.
“In fact, our Mayo Clinic health care workers we’ve actually excluded from enrollment in RETAIN because we have a pre-existing internal return-to-work program,” Breeher said.
Some employers also show hesitancy with the program, Omondi said, because they are unsure of the differences between RETAIN and workers’ compensation, or because they don’t want an employee’s modified work situation to put them at risk of further injury.
“You have someone who is ill or injured, recovering or maybe delicate, what if they fall at work again? What if they lift something by mistake and get more injured?” Omondi said. “Those are the work comp issues that employers are very sensitive about.”
This is a place where those return-to-work case managers can step in, Omondi said, to ensure that the employee’s working conditions are safe, and that employers know “this is what we are recommending and they can handle that based on our assessment.”
To boost employers’ awareness of RETAIN, the program is enlisting “Employer Champions” whose employees have benefited from the program.
“Employers who have been successful can share the word, and other employers can see, ‘Oh, yeah, that program, it really works,” Omondi said.
The future of MN RETAIN
Enrollment in RETAIN’s second phase is open through May 2024, Breeher said. The goal is to enroll 3,200 participants in this phase to measure the effectiveness of the program’s interventions.
“We’re able to enroll anyone who lives and works in Minnesota who has a medical issue that’s impacting their work whether work-related or not work-related as long as they have worked at least one day in the last three months,” Breeher said. “We’re enrolling participants in counties all throughout Minnesota, including those where we don’t have a core health care sub-recipient.”
One area where RETAIN is succeeding, Omondi said, is in enrolling Minnesotans of color. Currently, 19% of RETAIN participants are part of a racial minority group.
“Of all the states, it’s only Minnesota that has a sub-strategy for supporting and enrolling the BIPOC community,” she said. “As we outreach on the employer side, we are also outreaching to the communities very intentionally and very, very specifically.”
Come 2025, RETAIN will need a new source of funding to continue operations. Omondi said DEED is figuring out how to pitch the Minnesota Legislature on funding RETAIN in the state’s next budget biennium.
“We anticipate bringing success back to the legislature with additional enrollments, additional partners and showing how many Minnesotans we have helped to stay at work or return to work,” Omondi said. “We will have a good case highlighting the success of the program.”
A permanent iteration of RETAIN is something LaVan is hopeful for.
“What they’re trying to do is help people survive a little easier,” she said, “remove a little bit of that stress of the unknown and just help them get by until they’re back on their feet.”
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