Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)
Kaiser had been fighting the fine, levied last year by the California Department of Managed Health Care. (Ted Eytan/Flickr)

Kaiser Permanente agreed to pay a $4 million fine over claims that it did not provide adequate access to mental health care services for its patients.

The state’s Department of Managed Health Care levied the fine last year, citing survey results that indicated patients had to wait excessively long periods between therapy appointments, and that they were effectively dissuaded from seeking individual treatment.

Kaiser had contested the fine, calling it “unwarranted and excessive.” The two parties were scheduled to give opening statements before an administrative law judge on Tuesday in Kaiser’s appeal, but Kaiser faxed a letter to the court Monday evening saying it will pay the full fine, and asked the judge to dismiss the case.

“It’s an admission by Kaiser that it has knowingly violated California mental health laws and shortchanged its patients,” said Clement Papazian, a social worker at Kaiser’s Oakland Medical Center. It’s “a vindication of what Kaiser mental health clinicians have been saying for years.”

Papazian was one of several Kaiser clinicians lined up to testify in the hearings, slated to run through early October. The clinicians have complained that they weren’t able to offer individual therapy appointments in a timely manner to patients with severe depression, anxiety and other conditions, sometimes leading to wait times of up to four weeks or more between appointments. Others say patients were directed to group therapy, even in cases where the patient wasn’t receptive to group therapy and requested individual care.

The National Union of Healthcare Workers, which represents mental health professionals at Kaiser, argued that these wait times and policies led to tragic outcomes, even suicide, in some cases.

“Kaiser simply does not staff its psychiatry departments with enough psychologists, therapists and social workers to handle the caseload,” said Sal Rosselli, the union’s president, adding that the caseload is only increasing as more and more people sign up for Kaiser’s coverage under the Affordable Care Act.

Kaiser issued a lengthy statement saying that even though it agreed to pay the fine, it still disagreed with the penalty and believed it had not violated regulations around timely access.

The health plan vowed to make statewide improvements, including more convenient appointment times and locations, and adding more individual therapy. It says that over the years, it has been “continually analyzing our staffing levels throughout our care delivery system, and hiring appropriate mental health providers to meet growth in membership and our members’ needs.”

The state’s Department of Managed Health Care says it is currently conducting a follow-up survey of Kaiser’s mental health systems, to be completed this fall. Any remaining deficiencies will be addressed through corrective action plans, penalties or even the installation of a monitor.

“I am committed to protecting California’s health plan enrollees and ensuring they get timely access to all medically necessary health and mental health care services,” said Shelley Rouillard, the department director, “and will continue to aggressively monitor and take action against health plans that violate the law.”

  • Bostonbluestocking

    As a Kaiser patient, I can attest to the shoddy care given to those seeking mental health services. Not only are they woefully understaffed, the staff is often inexperienced and negligent even when you do get an appointment. I am in Oakland and have had to request a change of psychiatrist after the brand new doctor gave me medication advice that made me profoundly ill — twice. She should have known that you can’t discontinue certain meds cold turkey without serious consequences. When I made my request, I was interrogated with great hostility and suspicion. Mental illness should not be treated as a second-class disease.

  • Kelly Stars

    This is so true! It’s ridiculous.

Author

April Dembosky

April Dembosky is the health reporter for The California Report and KQED News. She covers health policy and public health, and has reported extensively on the economics of health care, the roll-out of the Affordable Care Act in California, mental health and end-of-life issues.

Her work is regularly rebroadcast on NPR and has been recognized with awards from the Society for Professional Journalists (for sports reporting), and the Association of Health Care Journalists (for a story about pediatric hospice). Her hour-long radio documentary about home funerals won the Best New Artist award from the Third Coast International Audio Festival in 2009.

April occasionally moonlights on the arts beat, covering music and dance. Her story about the first symphony orchestra at Burning Man won the award for Best Use of Sound from the Public Radio News Directors Inc.

Before joining KQED in 2013, April covered technology and Silicon Valley for The Financial Times, and freelanced for Marketplace and The New York Times. She is a graduate of the University of California at Berkeley Graduate School of Journalism and Smith College.

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