Roughly 4,000 members of the National Union of Healthcare Workers voted Sunday to postpone a planned five-day strike against Kaiser Permanente after unexpected news that the company’s CEO, Bernard Tyson, had died.
Officials from the Oakland-based health care giant confirmed Sunday morning that Tyson, 60, had died unexpectedly in his sleep.
“We offer our condolences to Bernard’s family, friends and colleagues,” said NUHW President Sal Rosselli. “Our members dedicate their lives to helping people through tragedy and trauma, and they understood that a strike would not be appropriate during this period of mourning and reflection.”
Union stewards told The Sacramento Bee on Sunday that they had not yet determined a new date for the strike. The planned strike would have been the second time that Kaiser’s behavioral health workers picketed during a holiday season. They say they are seeking to improve patients’ access to care .
Rosselli, who has led health care unions in California for more than 30 years, said he had known Tyson since the 1980s, when he was a manager at Kaiser in Oakland.
“While we had our differences, I had tremendous respect for him and his willingness to collaborate with workers to make Kaiser the model provider of medical services in California,” said Rosselli, who spearheaded the formation of the Coalition of Kaiser Unions. “We weren’t able to achieve that same level collaboration when it comes to Kaiser’s mental health services, but I believed that he did want Kaiser to achieve real parity for mental health care.”
Wait times at issue
Leaders of the National Union of Healthcare Workers said last week that they had hoped to achieve improvements that would reduce wait times for return appointments, but the Kaiser management touted news that California’s Office of the Patient Advocate had given the company’s behavioral and mental health care a five-star rating for overall effectiveness and quality of care.
Before Sunday’s news, Kaiser Permanente said it’s the 12th consecutive year that its two California health plans have been the only ones to obtain the highest rating from the patient advocate.
“This recognition demonstrates the high-quality mental health services provided by our physicians, therapists and nurses to our members, patients and the communities we serve. We have made substantial investments to reduce stigma in our communities, and to increase access and convenience in mental health care,” said Janet Liang, president of Kaiser Permanente Northern California. “We are pleased to be recognized for the significant progress we’ve made to address the growing demand for quality mental health care in our country.”
Ken Rogers, an Elk Grove psychologist and a member of NUHW’s executive board, said he and his colleagues certainly provide excellent care — but only after Kaiser members wait four to eight weeks to get a return visit.
“We hire the best,” Rogers said. “We have a comprehensive system of care. This is a system that, if looked a certain way, is going to be good, but it’s also a system that is consistently not returning patients quickly enough.”
The backlog of patients makes for dreadful working conditions, Rogers said, adding that he regularly uses personal time to fit in return calls or office visits with patients.
“I’m always giving to the organization, and I’m not getting paid for any of that because I know what their response would be if I went to management and said this was happening,” he said. “They would say, ‘Well, just do less. Work within your hours.’ ”
John Nelson, Kaiser’s vice president of communications, said the company has not only offered an excellent wage and benefit package to NUHW therapists but also has agreed to allow them more time to do the paperwork and calls that come with practicing in the field. The company also has acknowledged the issue of return visits, Nelson said, and it has agreed to make more time for them.
In addition, he said, Kaiser has “taken important steps to help address the nation’s crisis in mental health care – hiring hundreds of new therapists, building new treatment facilities, and investing $40 million to help people enter the mental health care profession. A strike does nothing to advance our important work to advance care, nor does it help us achieve a mutually beneficial contract.”
Patients should keep appointments
Nelson said last week that patients should plan to come to their appointments if they do not receive a cancellation call from Kaiser. He did not say how many patients might be affected.
“While we are asking our mental health therapists not to strike, Kaiser Permanente has contingency plans in place to ensure that our members continue to receive high-quality care,” Nelson stated. “All of our hospitals and medical offices are scheduled to remain open. And, we have taken steps to ensure members continue to receive high-quality mental health care provided by skilled physicians and clinical managers, as well as by contracted high quality licensed mental health professionals in the community.”
Rogers said a number of his patients had appointments canceled when the NUHW went on strike in December 2018.
“It’s going to be a setback for care. It’s not something that we desired,” Rogers said. “The desired outcome has been and is to meet and actually settle this contract.”
Rogers said the company’s offer in June was a radical change from last year, so the union agreed to call off a planned indefinite strike and put the new offer up for a vote with membership. Union leadership did not recommend a yes vote, though, and the membership voted down the contract offer by 88 percent.
Rogers said he had felt that the company and union would likely be able to reach agreement by the end of last summer on language that would address NUHW members concerns but that management negotiators had not agreed to meet to discuss it. He said company leaders were blaming NUHW leadership for rejection of the contract offer and for this year’s strike.
“No leadership is that good. Nobody is that persuasive,” Rogers said. “If you were calling me and talking to me about my work and how everything is going and I’m telling you, ‘Oh ... it’s so great. I’m treated like every other provider in Kaiser. I’ve got all the time in the world to do whatever, and I never stay late except in an emergency. I’m seeing my patients whenever I want and everything’s a breeze,’ I’m not going out on strike under those conditions.”
Complaint with the state
In late March, NUHW filed a complaint with the California Department of Managed Health Care, asserting that 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-mandated 10-day time frame.
In actuality, the complaint says, 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 says, 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 because DMHC had found it 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.
Nelson has said that 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.