April 20, 2017
Background: In a Corrective Action Plan dated March 25, 2017, The Oregon Health Authority stated: “If
there has not been progress toward a reduction of 10% in the average length of stay for members in
secure residential treatment, KEPRO will identify a plan to work toward or accomplish an appropriate
reduction in average length of stay. This references the incentives listed in the contract.”
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KEPRO has reduced the average length of stay (ALOS) in Secure Residential Treatment Facilities
(SRTFs) by 10% since the initiation of the current contract. This document addresses our plans
to improve the vacancy rate in state licensed mental health. There have been no scientifically
based studies of factors that affect length of stay in residential facilities.
Opinion papers posit that three factors may play a role: (1) fewer residents in a facility, (2)
gender and (3) ethnicity.
The State of Oregon currently has approximately 1,638 licensed beds; 310 beds in SRTFs, 254
beds in RTHs, 473 beds in RTFs and 601 beds in AFHs.
Given the lack of scientific evidence, KEPRO will be approaching the length of stay problem in
the following ways:

Staffing:
We have dedicated two LCSWs for full time work
in TEM. One of these will focus solely on SRTFs.
The other will focus on community licensed
beds. This will dedicate 80 man-hours a week to
TEM.

Prioritizing:
KEPRO has identified target populations for
priority review. In addition to the 120
questionable placements noted above, they are:
(1) improper diagnoses, (2) LOCUS analysis and
InterQual guidelines, (3) Length of stay reviews,
(4) Eligibility assessments and, (5) Hospital and
ED utilization patterns (through PreManage).
TEM evaluations will commence based on priority
status. Most will be conducted via record review
but more challenging cases will require face to
face visits for evaluation.

TEM Capacity:
We conservatively estimate that an episode of
TEM will take approximately two hours. At that
rate, four TEMs for SRTF members and four TEMs
for community members can be completed daily.
At this rate, the majority of SRTF TEMs will be
done within 15 weeks. At this rate, achieving a
reduction of >10% should be well within reach.
Additionally, we have already identified 120
individuals to target based on data collected
(7.3% of licensed beds).
Accountability:
KEPRO will provide the Oregon Health Authority
with progress reports regularly. We are
confident that this approach will get the ALOS in
SRTFs reduced by greater than 10% in a timely
fashion.