Kaiser Foundation Health Plan recently settled a 2014 class-action lawsuit stemming from two allegations that it dumped patients with severe mental illness.
Plaintiffs Douglas Kerr and Barbara Knighton alleged that in separate incidents, Kaiser psychiatrists told them their sons needed to be transferred to locked residential facilities called IMDs (institutions for mental disease) for treatment, according to court documents. Knighton and Kerr claimed they were both told they should remove their children from their Kaiser health plans in 2014 to be transferred to these county-run institutions — a change that shifted the costs of treatment from Kaiser to government-funded programs such as Medi-Cal.
Despite the settlement, Kaiser said in a statement it continues to dispute some of the claims included in the lawsuit.
“In certain relatively rare cases, Kaiser Permanente members entered a specialized type of locked mental health facility that often preferred Medi-Cal coverage to private insurance,” Kaiser Vice President of Communications John Nelson said in an emailed statement. “In some of these cases, cancellation of Kaiser Permanente coverage was required to enter the facility. However, this was not Kaiser Permanente’s requirement, and we cover many members’ care at such facilities. Any decision to cancel coverage was made by a court-appointed conservator.”
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Under terms of the settlement, finalized in December, Kaiser has agreed to inform other patients who may have similar circumstances that they can re-enroll in their Kaiser health plans. Kaiser will also pay the two plaintiffs $10,000 each and reimburse up to $1.2 million in attorneys’ fees. It was not immediately known how many other patients could be in the affected class.
A notice authorized by the Los Angeles County Superior Court sent out in June states in part that: “(Kaiser) will be issuing notices to mental health physicians, therapists, social workers, discharge planners, and case managers regarding coverage of locked residential psychiatric facilities and how Kaiser members in LPS (Lanterman–Petris–Short) conservatorships should be transferred to these facilities.”
A class-action website has been set up for those whose health coverage “was canceled to gain admission to a locked psychiatric residential facility.”
The settlement was signed in July by Kaiser Northern California and Southern California regional leadership, according to preliminary approval order, which required the website to be set up within 30 days of Aug. 1, 2018.
A major health care workers union said the settlement “underscores why 4,000 mental health clinicians” went on strike last week. The National Union of Healthcare Workers said in a press release that the case was exemplary of Kaiser’s issues relating to “quality of care for mental health patients.”
“This settlement validates what thousands of Kaiser mental health clinicians were saying last week on picket lines across California: Kaiser is illegally denying patients appropriate mental health care, and it must work with clinicians to fix the problem,” union President Sal Rosselli said in a prepared statement.
The class period for the settlement runs from Sept. 9, 2010, to July 24, 2018. Sept. 21, 2018, was the final day to opt out or object to the class-action suit.
About 4,000 health care workers went on a rolling five-day strike from Dec. 10-14 across dozens of Kaiser locations, including more than 300 in the Sacramento region. The strike was in response to reported understaffing issues limiting patient access to mental health services, union leaders said.
Striking health workers and labor experts told The Bee last week that health worker strikes are usually centered around issues relating to patient care or working conditions rather than wage disputes.
Union spokesman Matt Artz recently told The Bee that the ratio of mental health clinicians to Kaiser members has remained mostly unchanged since 2015, despite California Department of Managed Health Care findings that patients were having trouble accessing care that year.
In July 2017, Kaiser Permanente and union reached an agreement to correct these types of violations with help of an outside consultant.
This article was updated Dec. 20 at 5 p.m. to clarify details of the lawsuit.