Kaiser mental health workers signal indefinite strike in Northern California

A union representing 2,000 Northern California Kaiser mental health workers on Aug. 2 announced plans for an indefinite strike that begins Aug. 15.

Among the reasons union representatives cited: high physician workloads and patients waiting weeks or even months for mental health care. Even as demand for care has increased, frustrated therapists are leaving the healthcare giant, union spokesman Matt Artz said.

“We don’t take the blow lightly,” said Sal Rosselli, president of the National Health Care Workers Union, which represents doctors, in a prepared statement, “but it’s time to take a stand and make Kaiser spend some of his billions for mental health care.”

Deb Catsavas, a senior vice president at Kaiser Permanente, said in an emailed statement that the threat of a strike is “sadly, a bargaining tactic that this union has used every time it has negotiated a new contract.”

Calling the union’s tactics “unethical and counterproductive,” Catsavas said the two sides were “close to an agreement” and that Kaiser “is committed to bargaining in good faith to reach a fair and equitable agreement that is good for our therapists and our patients.”

The company has drawn increased scrutiny from lawmakers for its mental health services in recent years. In May, the Department of Managed Health Care announced it would conduct a non-routine audit of Kaiser’s mental health services.

The union and Kaiser had another bargaining session scheduled for Friday, Artz said. He said Kaiser Northern California’s mental health workers, including psychologists, social workers, therapists and addiction counselors, have gone on short-term strikes six times in the past 4 years. This would be their first indefinite strike, meaning the union is not setting an end date.

Kaiser has 4.6 million enrollees in Northern California, Artz said, although that figure does not reflect how many of them currently have mental health benefits.

In a letter sent Sunday to the Department of Managed Health Care, which regulates health plans, the union asked the department to ensure that Kaiser continues to provide mental health care to patients during the strike, instead of canceling appointments.

Amanda Levy, deputy director for health policy and stakeholder relations for the Department of Managed Health Care, said the department is continuing to monitor access to services for patients affected by the strike.

“The law requires health plans to provide enrollees with necessary medical care within timely access and clinical standards at all times, including during an employee strike,” she said in an emailed statement.

Despite growing efforts at the state level to implement mental health equity laws, Kaiser mental health practitioners say they still struggle to provide adequate and timely care to patients.

Sarah Soroken, who has worked as a therapist at Kaiser Fairfield for six years, said access to treatment has worsened during her time there. She said the pandemic has worsened the situation, with more patients seeking care, even as more therapists are leaving.

“Right now we are at a crisis point,” she said. “Things are worse than ever.”

Kaiser is not the only provider facing a shortage of mental health practitioners. Complaints about the absences have also been filed by counties, school districts and nonprofits across the state. Artz said some Kaiser providers are being recruited to work at telehealth startups, where the money is good and the work-from-home opportunities are plentiful. Others are entering private practice.

The union says the rate at which mental health clinicians are leaving Kaiser nearly doubled last year, with 668 clinicians leaving between June 2021 and May 2022, compared with 335 clinicians the previous year. In a union survey of 200 of those doctors who were leaving, 85 percent said they were leaving because their workload was unsustainable or they felt they didn’t have enough time to complete work, and 76 percent said they were unable to “treat patients in accordance with standards of care and medical necessity.”

Some of these concerns are not new, although the pandemic has exacerbated them.

In 2013, the Department of Managed Health Care fined Kaiser $4 million for failing to provide adequate mental health treatment.

In a hearing this spring, lawmakers raised concerns about the state’s plans to shift an additional 200,000 Medi-Cal members to Kaiser, given problems with mental health treatment. Democratic Sen. Scott Wiener of San Francisco has introduced a bill to significantly increase fines for health plans that do not comply with state laws.

Another Wiener bill, SB 221, which took effect July 1, aims to ensure patients don’t face long delays for follow-up treatment through commercial providers like Kaiser. Specifically, the new law, which was sponsored by the union, requires patients to receive mental health follow-up care within 10 business days, unless a provider determines that a longer wait will not be harmful to the patient.

In a virtual press conference in late June, Kaiser mental health practitioners said the healthcare giant was nowhere near meeting those requirements.

Jocelyn Wiener writes about health and mental health for CalMatters, where this piece originally appeared. Email: [email protected]

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