As Kaiser strike ends, therapists say they hope behavioral health patients will benefit

On Friday, the last day of a five-day union strike, psychologists, therapists and others said they hoped their protest would make their employer, Kaiser Permanente, see that they want changes that will improve access to care for behavioral health patients.

Roughly 4,000 members of the National Union of Healthcare Workers walked out of their jobs at Kaiser on Monday. The strike affected 325 workers in the Sacramento region, 58 in Fresno and 32 in Modesto and 66 in San Joaquin County, said NUHW spokesman Matt Artz.

On Day 5, nearly 100 workers gathered outside Kaiser’s South Sacramento Medical Center on Bruceville Road. Kaiser therapist Pushpa Autry and psychologists Kenneth Rogers and Muhammad Meatcham were among them. The strikers picketed at different facilities throughout the week. Roughly 200 protesters gathered during the Monday morning rush hour outside Kaiser’s Sacramento Medical Center on Morse Avenue.

Psychologist Kenneth Rogers, who represents his co-workers on the NUHW bargaining team, said he expects his employer will return to the negotiating table with a better offer on wages and benefits, but that’s not why he and others are on strike.

“We didn’t do this for the money. We didn’t do this so the offer would improve,” he said. “We did this because there are systemic patient care concerns that we have in terms of getting our patients seen, getting enough staffing for our patients to be seen and to fix problems with recruitment and retention that the employer continues to deny. Whether or not they will address those concerns is yet to be seen.”

Kaiser nursing executive Michelle Gaskill-Hames said the company expects to resume bargaining next week and is confident that, with active engagement on both sides, both parties can reach a contract agreement.

“Kaiser Permanente has been on a path to be the best mental health and addiction care program in the nation,” she said. “The quality of the care we provide has been recognized by the state’s Office of the Patient Advocate, and by national quality organizations. We don’t think there is any other organization that is doing more than we are to make mental health care better in the United States.”

NUHW leaders have said that the ratio of mental health clinicians to Kaiser members has remained essentially unchanged since 2015, despite findings from the California Department of Managed Health Care showing that patients were having trouble accessing care that year. NUHW said Kaiser has maintained roughly one full-time equivalent clinician for every 3,000 Kaiser members in California.

In a follow-up report issued in June 2017, the DMHC stated that it would continue to monitor Kaiser’s performance for 18 months to assess whether it was providing timely access to care for patients with behavioral health problems. DMHC regulators said that in July 2017, they reached an agreement with Kaiser to correct violations and enlist an outside consultant to help it do so. The agency has been monitoring Kaiser since 2013, when it levied a $4 million against the HMO for violating the California’s Mental Health Parity Act and standards for timely access to care.

Meatcham said: “I’d love it if I could see my patients more often. That’s why I’m out here. I would love it if I could have more co-workers to meet the patient need. That’s the bottom line for me is to have more coworkers who are actually there day in and day out to do the work. We’re just not getting the resources that we need in that way to meet the need that’s out there.

While Kaiser has stressed getting more new patients in for sessions, Rogers said, patients are waiting longer to see a therapist for follow-up visits. The union hopes to change that with a new proposal, Roger said. Right now, the company requires that therapists be in sessions with patients 75 percent of the time.

The union wants the company to amend this rule and say their schedule must be booked up to 80 percent of the time. Patients cancel appointments, Rogers said, and when they do, therapists will be able to slide other patients into the time or spend time making notes on prior sessions. Therapists typically wait until after a session to write notes, he explained.

Gaskill-Hames, the chief nurse executive for Kaiser in Northern California, said this will reduce the amount of time caregivers spend seeing patients, meaning fewer appointment times for patients. She said the company is working hard on recruiting therapists amid a nationwide shortage of such caregivers and is offering competitive wages to do so.

“Across Kaiser Permanente in Northern California, the majority of psychologists earn $138,000 or more, and the majority of social workers earn $111,000 or more,” according to the statement released by Gaskill-Hames.

Late last week, the California Nurses Association, representing 19,000 Kaiser RN’s and nurse practitioners statewide, and the IUOE Stationary Engineers Local 39, whose workers operate and maintain the physical plant systems of hospitals and other facilities, announced that they would honor the picket line.

Kaiser has stated that the union’s principal demands at the bargaining table have not been about improving care and access but rather about higher wages and benefits. The last time the NUHW bargained for a new contract with Kaiser, it took five years to reach a deal, Rogers said, and raises alone did not make up for going without wage increases for so long.

The current NUHW contract expired in September. The company and the union have been bargaining since June.

“Throughout the strike, Kaiser Permanent continued to provide high-quality and safe care to our members and patients, though some non-emergency appointments had to be rescheduled,” Gaskill-Hames stated. “We regret the inconvenience caused to our patients.”

Autry, the Kaiser therapist, said that, after five days of picketing, she’s gotten to speak with colleagues from Kaiser facilities all around the Sacramento region, and she’s discovered that all of them have frustrations very similar to her own.

“The low staffing is affecting everybody,” she said. “There’s a sadness that we can’t take care of our patients the way we want to, and I think that’s what actually gets us out here. It isn’t so much for ourselves. It’s about: ‘Are we really serving our patients?’ I’m hearing that from everybody all across the lines.”

In interviews with The Bee, labor expert Kate Bronfenbrenner of Cornell University said she’s found that disagreements over wages are typically not enough to get health care workers to strike. Usually, she said, their issues center around working conditions and patient care.

This story was originally published December 14, 2018 at 2:52 PM.