Health & Medicine

4,000 Kaiser mental health therapists give union OK to call indefinite strike

This is what Kaiser Permanente employees said on last day of union strike

About 4,000 Kaiser Permanente’s behavioral health workers walked out of their jobs on Dec. 10, 2018 and launched a five-day strike. Employees want to improve access to care for their patients.
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About 4,000 Kaiser Permanente’s behavioral health workers walked out of their jobs on Dec. 10, 2018 and launched a five-day strike. Employees want to improve access to care for their patients.

Roughly 4,000 mental health clinicians at Kaiser Permanente have authorized their union, the National Union of Healthcare Workers, to declare an open-ended strike as early as June if they have not secured a new contract with their employer.

“An open-ended strike is really the last thing we want to do,” said Kenneth Rogers, a Kaiser psychologist and NUHW member. “We want to bargain effectively with this employer. We want this thing to come to a conclusion. They don’t need to propose to us everything we want. They just need to propose something serious and ... engage in a process that will be handled seriously, that will come to a quick resolution.”

John Nelson, Kaiser’s vice president of communications, said NUHW’s announcement is another tactic in the union leadership’s ongoing campaign to create pressure for management to agree to their financial demands. The health care giant reached out last week to all of its California therapists, Nelson said, to let them know management believes it’s making progress toward a strong contract that not only is in the best interests of both sides but that can help create ways to return to working collaboratively to address the very real challenges the nation faces with mental health care.

Since then, Nelson said, “NUHW leadership has responded to our communication to therapists with a daily flurry of press releases, more allegations, renewed advertising smears, and more. It’s as predictable as it is cynical.”

Rogers said Kaiser has made a lot of promises that it will make a meaningful offer, but that’s not what the NUHW bargaining team has seen so far.

“We’ve also called for changes to the process of bargaining,” Rogers said. “A lot of the problems with the bargaining sessions themselves is that there’s just way too much theater. When people think of bargaining, they probably think of people in a room talking back and forth and this goes on all day. We’d have sessions where we’re hardly meeting. I mean, we take the whole day, but we don’t spend time actually bargaining.”

The therapists, psychologists, social workers and other clinicians represented by NUHW hit the picket line in a five-day strike just before Christmas 2018, but 80 percent of members have now signed petitions saying they are prepared to walk out for an indefinite period.

Members want an agreement that ensures patients get the help with mental and behavioral health conditions they need in a timely fashion, Rogers said. To ensure that happens, he said, members want Kaiser to agree to expand positions for clinicians and ensure they have the time they need to do both therapy sessions and indirect patient care such as letters, session notes and other paperwork.

In late March, NUHW filed a complaint with the California Department of Managed Health Care, asserting Kaiser is falsely blaming Sacramento and Roseville patients for failure to keep an appointment when they do not obtain their diagnostic assessments within a state-proscribed 10-day time frame.

In actuality, the complaint stated, Kaiser does not schedule the patients for an appointment with a specific time and date. Rather, a Kaiser representative tells the patients to go to an open-access clinic where they must wait for several hours to be seen. On particularly busy days, the NUHW stated, Kaiser officials turn patients away at the door because they do not have the staff to serve the high volume of patients.

When patients are unable to navigate this system within 10 days of being notified to do so, the complaint stated, they receive a letter saying they failed to keep their appointment.

For several years now, Kaiser has been under state-ordered outside monitoring since the California Department of Managed Health Care found it had violated California’s mental health parity law and standards for timely access to care. The agency issued a report in June 2017 saying 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.

In response to questions from The Bee in December, Nelson said Kaiser therapists are meeting the established regulatory standard for first appointments for mental health and wellness on average more than 90 percent of the time, statewide.

“We also monitor return visits and are ensuring that we follow therapists’ care plan recommendations for the timing of these visits,” he said. “As documented by the therapists themselves, we are meeting their recommendations between 86-94 percent of the time.”

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