Mental healthcare workers across northern California have been on strike for over a month, pushing Kaiser Permanente to staff up, relieving overworked employees and improving care for patients.
On Aug. 15, over 2,000 Kaiser employees represented by the National Union of Healthcare Workers (NUHW) started an open-ended strike. About 100 of the workers are located in Sonoma County. The union has said that Kaiser patients around the state seeking follow-up therapy appointments routinely face one to three month delays, potentially in violation of a new state law.
The Department of Managed Health Care (DMHC), the state agency which regulates healthcare providers, is investigating complaints about illegal service delays at Kaiser after receiving complaints before and after the strike began.
Workers picketing outside of Kaiser’s Bicentennial Way hospital in Santa Rosa last week said that understaffing is their main concern.
“We’re frequently told by Kaiser that they’re urgently and really intently trying to hire more people, but that expression never really reflects what we see in our clinics,” said Ray Messinger, a four-year Kaiser employee. “Understaffing is really bad right now; it’s worse than I think it’s ever been.”
“Being understaffed creates a return ratio that is really not adequate for psychological treatment. As a child psychologist, my patients are seen every six weeks,” said Daniela De Vasques, who has worked for Kaiser since October 2015.
“Kaiser members are paying for premiums to receive psychological services, and they are receiving the first appointment. So, they are getting in the system, but they are not adequately maintained in the system. That’s the main reason I am standing here,” De Vasques added.
In Sonoma County, wildfires and the pandemic-fueled growth of telehealth have increased the workload even more, according to Nohemi Lopez-Klinck, who has worked as a child psychologist at Kaiser since 2018.
“Every year, usually around September or October, you have an influx of patients who come back because they are experiencing PTSD from the fires,” Lopez-Klinck said.
In a statement, Kaiser claimed the union had “deliberately tried to create a crisis in access to mental health care for Kaiser Permanente and its members” by going on strike when the two sides were “very close to reaching an agreement in bargaining.” The company added that it has “a track record of successfully and steadily hiring” new therapists at the Santa Rosa facilities despite a “relatively small” applicant pool in Sonoma County.
“All communities and health care providers, not only Kaiser Permanente, are massively affected by the crisis created by the surge in demand for mental health care in our county and across the country, combined with workforce shortages,” the statement said.
For now, there’s no end in sight for the disagreement. On Sept. 15, Kaiser reportedly left the bargaining table with no plans to return.
According to a report by KQED, the company agreed to pay increases, but would not consider other union proposals, including increased staffing levels, giving employees more time for administrative work, and caseload caps.
These complaints about levels of service and workers’ strikes are nothing new for the healthcare giant. In 2014, Kaiser agreed to pay a $4 million fine levied by California’s DMHC for failing to meet state regulations on scheduling times.
State lawmakers are trying to address follow-up appointment delays at Kaiser and other healthcare providers.
Last October, Gov. Gavin Newsom signed Senate Bill 221, which requires health insurers to provide return therapy appointments within 10 business days of an initial visit, unless their therapist determines a longer delay would not impact a patient’s care. However, at a June 30 press conference, NUHW officials said that Kaiser had not prepared for the new requirements, which went into effect the next day.
“This law has the potential to help so many Californians, and that’s why it’s so disappointing that Kaiser, as the provider for more than a third of all insured Califorians, has not taken any concrete steps to comply with it [SB 221],” NUHW president Sal Rosselli said.
The union disputes Kaiser’s worker shortage claims and says that clinicians, citing unsustainable workloads, are leaving the company faster than it is replacing them. Between June 2021 and May 2022, 668 clinicians left Kaiser statewide, a rate nearly double the 335 who left the year before, according to the union.
Kaiser’s statement to the Bohemian did not directly address compliance with SB 221, but did state that practitioners not involved in the strike and outside mental health providers are helping to meet patients’ needs during the strike.
An outside observer may weigh in soon. In May, the DMHC, the state agency in charge of regulating Kaiser and other health care providers, announced it was conducting a “non-routine survey” to ensure Kaiser was offering patients adequate services. In August, DMHC said it is continuing to monitor Kaiser’s service levels during the strike.
NUHW in early September raised specific concerns about the emergency care services being offered at Kaiser’s Santa Rosa Medical Center. The union filed a complaint with the state alleging that Kaiser had “ceased providing emergency psychiatric services to enrollees seeking care in the hospital’s Emergency Department” from midnight to 6am “due to the inadequacy of Kaiser’s provider network.”
Last week, the Press Democrat reported that an anonymous employee said that two patients had attempted suicide at Kaiser’s Santa Rosa hospital during those early-morning hours.
Kaiser said in its statement that officials from the California Department of Public Health recently spent a day reviewing the Santa Rosa Emergency Department’s processes, deeming them “thorough and compliant.” The state agency will complete a final report in 30-60 days, according to Kaiser.
The company no doubt doesn’t like the bad press it’s receiving, but union officials claim that, historically, the company has seemed willing to pay fines and weather strikes rather than invest in staffing to deal with structural issues.
“Fines for violations have not been increased since the ’70s so, unfortunately, organizations like Kaiser Permanente see the fines as the cost of doing business,” Rosselli said at the June press conference.
Kaiser, with facilities in eight states, reported a record $8.1 billion in net profits in 2021, a figure that certainly makes multi-million dollar fines seem insignificant.
A new California bill would increase the penalty for violating scheduling regulations. In August, the state legislature passed Senate Bill 858, which would increase the current fines healthcare providers face for failing to comply with scheduling requirements and other regulations from $2,500 to $25,000. Gov. Newsom reportedly has until Sept. 30 to sign the bill.