Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED)
Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED) (Lisa Aliferis/KQED)

A union of 2,500 mental health clinicians at Kaiser have voted to authorize a strike, just one week after Kaiser’s nurses went on strike for two days.

In September, Kaiser agreed to pay a $4-million fine levied by state regulators. The Department of Managed Health Care found patients were subject to excessively long wait times to get a therapy appointment, or were shuttled into groups when they wanted individual therapy.

Psychiatric social worker Clement Papazian says various fixes, like after-hours appointments, still aren’t meeting demand.

“Kaiser has attempted to make some changes, but they’re woefully inadequate in really addressing the full nature of the problem,” he says. “Our mental health workers are really fed up.”

These complaints are part of a long, drawn-out contract negotiation between Kaiser and its psychologists and therapists. Bargaining has been dragging on for four years with no settlement. And the small, scrappy National Union of Healthcare Workers is eager to make a name for itself.

Union president Sal Rosselli says the threat of a statewide strike will strengthen the union’s position when they return to the table next month.

“We’ve had it,” Rosselli said. “We’re drawing a line in the sand. And we’ll be presenting Kaiser with a final offer to resolve this crisis.”

In a statement, Kaiser was critical of the union’s strike vote:

“After a long hiatus, NUHW has now approached Kaiser Permanente to resume bargaining in Northern California. But for the union to threaten a strike before we even meet, and to resort to clichéd bargaining tactics, makes us concerned about the union’s intentions. We hope the union will join us in seeking solutions to the challenges we face. But whichever way the union chooses to go, we are going to continue to work hard on our own to make progress.”

Kaiser says the union has resisted several of its proposals, like sending some patients to non-Kaiser therapists for treatment. It says increasing access to mental health care is a challenge faced by the entire health care industry, and Kaiser is working hard to make improvements.

  • Bert Barth

    Too bad the relationship has become so adversarial. The MH providers won the right to be represented by NUHW and to leave the stable of SEIU almost 4 years ago, and the company is still committed, Tea Party like, to punishing that gesture of self determination, so as to drive the workers sheepishly back to SEIU, to the slaughterhouse as it were, where their clinical standards and also their compensation will be sold out in a back room.
    Kaiser patients should pay attention to this dispute, because they will be treated to exactly as much respect as the union wins for itself and for them – no more.

  • jmm

    As a kaiser member I agree that the kaiser membership deserves much better mental health services. I would back up the mental health workers absolutely, without hesitation.

  • Adam Front, Ph.D.

    Kaiser is greedy. It is squeezing patients and employees from all sides for greater profit, in spite of its non-profit status. Patient healthcare premiums are being raised, staffing in all medical services (not just mental health) are inadequate to provide the excellent care Kaiser promises in its advertising and which patients expect and deserve. At the same time the organization is in bad faith at the bargaining table. They want to cut employee pensions, cut the amount they pay and the level of coverage provided for both active employees and retirees, and minimize pay increases. They are riding on the wave of public sentiment about pensions that started when government budgets were decimated by the financial collapse from the sub-prime mortgage collapse. Kaiser and other large and very profitable corporations are well able to keep the employee pensions funded (Kaiser’s NET profit for the first 3 quarters of 2014 was 41% higher than the same period in 2013). Executives and physicians are not losing their pensions, which are much more generous than those they are trying to take from front line patient care employees. Yet KP management insists that these are “turbulent times” and we all have to tighten our belts. Kaiser and other healthcare giants spent over $50 million to defeat prop 45 (which would have given the insurance commissioner teeth with which to say no to unreasonable healthcare premium increases) and nearly $100 million to defeat prop 46 (which would have increased the cap on medical malpractice awards). Malpractice cases are likely to be more prevalent when nurses and other care providers are under-staffed. Kaiser posts public messages that blame its employees for the endemic problems that its own corporate practices have caused, and in the same breath pledges that the organization values and cares about its healthcare professionals. Meanwhile, patients are paying more and getting less, employees are working harder due to short-staffing and not getting raises that even keep up with the cost of living. while Kaiser stalls at the bargaining table. Kaiser’s top executives and shareholders (the MDs) walk away with the spoils. The 1% at the top are the only ones to whome Kaiser’s by-line of “Thrive” really applies at this time. Meanwhile the media are leery of strongly reporting these facts, possibly because they make huge amounts of money from Kaiser’s advertising dollars, especially this time of year during open enrollment. The whole thing stinks, and I believe that Henry J. Kaiser, who started the medical program to care for his employees and their families, would agree.

  • Lisa

    Kaiser IS greedy. I completely agree Dr. Front. In 2006, we were repeatedly sent away so our baby could die. Kaiser then witheld an important medical record and sent other records to medical/legal to be scrubbed for a lawsuit. The healthcare was so horrendous back then that I can hardly even believe they are still in business today. To add to this, my baby’s father worked for Kaiser. This is how they treat their own employees. Kaiser is in business only for making a profit. The less care they give, the more money they make.

  • Barb

    Kaiser’s mental health model is one of expediency and bottom-dollar consideration — not of patient care. Only if one is in crisis (as in suicidal) do they even consider what they call “intensive therapy” which is just once a week, outpatient care. In the mental health industry, that’s just standard care. Standard care for Kaiser is once a month, if you’re lucky. They need a complete overhaul in this department.

  • Christy

    Kaiser also has very poor coordination of mental health and substance abuse services. Two years ago, my son was suicidal, drinking and using drugs. Mental illness runs in my family, so I knew mental health treatment would be critical to his recovery. On top of that, research has established that mental health and substance abuse services should be coordinated.

    However, Kaiser’s Mental Health department refused to see him until he had been sober for THREE MONTHS! To be fair the substance abuse program does have some licensed clinicians, but they would not evaluate or treat him for a mental health diagnosis. Since mental illness is often at the root of substance abuse, why insist that people get sober for an extended period of time first? That can be an impossible task and leaves people who need care at great risk.

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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