Kaiser braces for 3-month strike, dangles incentives to mental health contractors
Kaiser Permanente is looking to contract with therapists who can help it survive at least three months of a strike by its mental health clinicians, luring potential recruits with promises of lucrative signing bonuses and pay premiums.
Licensed marriage and family therapist Sally Levy Albert said she resigned from the Kaiser network in March 2022 but received the offer in an email. In it, a Kaiser employee wrote: “We have a need to secure continued access to outpatient mental health services for our members over the next eight to 10 weeks as we work through contract negotiations currently underway with” the union representing mental health clinicians.
The Kaiser pitch promised a “substantial financial incentive” to those willing to commit to a pre-arranged number of 60-minute appointments each day for up to eight weeks, beginning Aug. 29.” Therapists also would be prepaid for the appointments they reserved for their members.
How big are those financial incentives? In voicemails left for some therapists, a caller identifying herself as a Kaiser contracts manager offered a signing bonus of $10,000.
Leaders for the National Union of Healthcare Workers said the offers show Kaiser has the resources to reach an agreement that would resolve the strike and improve working conditions.
“They’re offering these positions with the bonuses and the pay. (That) clearly indicates that Kaiser has the resources to address the fundamental problems that have precipitated the strike, which are the inadequate staffing levels that force patients to endure massive waits to get care,” said Fred Seavey, the research director for the striking union.
Kaiser Permanente leaders in a written statement acknowledged the company is recruiting contract therapists to get through the strike. Company executives said the National Union of Healthcare Workers is using the strike to create a crisis in access to mental health care at Kaiser.
“We are on our way to reaching agreements with hundreds of community-based mental health providers to open their schedules – for at least two months – to be able to treat more of our patients,” the statement read. “They are agreeing to do so on very short notice, and given (the union’s) open-ended strike, these providers’ support may continue to be needed to ensure continuity of care for our patients. We are grateful to them and look forward to a continued relationship with them as the union’s open-ended strike goes on.”
Delays in Kaiser mental health appointments
Kaiser’s offer to pay upfront and provide substantial incentives are a far cry from what independent therapists have come to expect from the company, provider Leslie Hansen said. Now retired, Hansen practiced for 40 years as a licensed marriage and family therapist in the Santa Rosa area and contracted with Kaiser for a portion of her career.
Many independent therapists in her region will take only clients who can pay out of pocket because they don’t want to deal with third-party insurers, Hansen said. She said insurers often make it difficult for therapists to get reimbursed, routing them through apps where they must file a dozen or more queries to get what they’re owed.
Typically, Kaiser and other insurers also pay a lot less than either Medicare or Medi-Cal does, Hansen said, but in pitches being sent to out-of-network providers this week, Kaiser has offered rates at 110% of Medicare payments.
Therapist Michelle Deely, who has a private practice in San Francisco, sent Albert and other professionals an email, strongly urging them to decline Kaiser’s offer: “This strike is an important way for clinicians to force KP to do what is right — put the same money, resources and energy into offering mental health care that they put into physical health care offerings.”
Prior to the strike, whistleblowers had shared internal documents showing that Kaiser members in the Sacramento region were waiting as long as two months for follow-up appointments with a therapist, after having an initial intake session. A new California law that went into effect in July requires health plans to schedule follow-up sessions within 10 business days if recommended by a therapist.
‘Normal’ tactic for U.S. companies in strikes
Jane McAlevey, a policy fellow at the UC Berkeley Labor Center, said any strike is intended to create a crisis for a company, a tactic that rank-and-file workers employ to focus public attention on a systemic problem.
McAlevey described Kaiser’s incentives for contract therapists as a “normal” union busting strategy in the United States. In Germany, where she regularly does consulting work with unions, she said, the constitution forbids companies from replacing workers in this way.
In the U.S., though, “employers are suddenly willing to shell out outrageous premium pay to striker replacement workers instead of investing these funds ... where the workers on strike are demanding it, in this case, to help patients get better care,” McAlevey said.
In its statement, Kaiser said that it was close to an agreement with union negotiators but that the NUHW proceeded with the strike on Aug. 15 anyway. Union members, interviewed while picketing at Sacramento-area hospitals, said Kaiser had not come close to what they felt was needed to improve working conditions enough to reduce staff turnover rates.
They noted that 20% of Kaiser therapist have left the company since June 2021. Kaiser leaders said the figure was not much different than the national turnover rate in the overall health care industry.
This story was originally published August 26, 2022 at 5:25 AM.
CORRECTION: In a previous version of this article, a quote urging independent mental health providers to decline Kaiser Permanente’s contracting offer was incorrectly attributed to therapist Sally Levy Albert. San Francisco-based therapist Michelle Deely sent the message to Albert and other professionals.
