More than 2,000 Kaiser Permanente mental health workers, including unionized psychologists in Marin, are threatening to strike indefinitely beginning August 15.
The National Union of Health Workers, which represents employees in ongoing contract negotiations, says doctors voted in June to authorize their first indefinite strike. The union says doctors want to force Kaiser to address a lack of adequate staff to meet patients’ needs.
Kaiser Northern California mental health workers, including psychologists, therapists, chemical dependency counselors and social workers, have held six short-term strikes in the last four years. This strike would be the first to have no set end date.
“Patients are being ripped off while Kaiser’s coffers are overflowing,” said Sal Rosselli, union president. “Our members plan to use the tools of a union to get their patients the care they deserve and the parity required by law.”
Deb Catsavas, Kaiser’s senior vice president of human resources, said the company has been negotiating with the National Union of Health Care Workers (NUHW) since the union’s 2,000-member contract expired in September.
“We understand that NUHW has unfortunately announced strike plans, a bargaining tactic this union has used every time it has negotiated a new contract with Kaiser Permanente, for the last 12 years of its existence,” Catsavas said. “It is puzzling that NUHW leaders chose to strike when we were close to a deal.”
Catsavas did not respond to the union’s claim that it is not hiring enough mental health workers to meet the needs of its members.
According to the union, Kaiser has approximately one full-time equivalent mental health physician for every 2,600 members. The union says that as a result, patients who should have therapy every week or two wait months just to start their therapy and four to eight weeks between appointments.
Alexis Petrakis, a Kaiser psychologist in Petaluma who treats patients in both Petaluma and San Rafael, said she’s prepared to strike if that’s what it takes for Kaiser to hire more mental health workers.
“I hope we don’t have to take that step,” Petrakis said, “but we really have reached a point where patients can’t wait another day. The urgency cannot be stressed enough. We need a change ASAP. That is why I am standing with my union.”
Petrakis said the standard of care for patients deemed to need individual therapy is an appointment at least every four weeks.
“Right now, my time slot is booked for six weeks,” he said.
The union says Kaiser is flouting a new law, SB 221, that requires patients to receive follow-up mental health therapy appointments within 10 business days of being initially seen.
Petrakis said Kaiser has complied with a previous law that requires insurers to provide initial mental health appointments within 10 days by charging providers with more patients than they can handle.
“We see hundreds and hundreds of people without any kind of containment,” Petrakis said, “so we can’t focus on our existing patients and try to help them through their treatment.”
Petrakis said the overload makes it difficult for Kaiser to retain doctors.
“We are losing really good, really skilled, really passionate therapists on a regular basis,” he said. “Two doctors from the children’s team just left this week.”
According to the union, 377 Northern California-based Kaiser doctors quit their jobs between June 2021 and May 2022, more than double the 186 who left the year before.
To make matters worse, Petrakis said, Kaiser’s reputation among psychologists makes it more difficult to fill vacancies.
“We have 16 open positions throughout the department,” he said. “I would not recommend any open position to anyone in my network.”
Robert Lasser, a psychologist who operates a private practice in Kentfield and occasionally treats Kaiser patients who are authorized to see outside therapists, said he would not consider working for Kaiser.
“I know from many years of experience that they will see a patient a couple of times and then they will either make them wait for weeks or put them in group therapy,” Lasser said.
The state Department of Managed Health Care fined Kaiser $4 million in 2013 for failing to provide timely mental health treatment and again in 2017 for failing to disclose Medicaid data. The department opened a new investigation of Kaiser’s behavioral health services in May following patient complaints.
Regarding compliance with SB 221, Kaiser spokeswoman Adriann McCall wrote in an email, “While the mental health physician shortage continues to challenge all California health care organizations, the implementation of SB 221 in Kaiser Permanente’s mental health and addictions care and services model is well underway.”
“We know that training and hiring more therapists will not be enough to meet the complex and growing mental health needs of our population,” McCall added. “We also need to look for new and innovative approaches to providing care.”
Responding to questions about Kaiser’s plans to care for mental health patients if a strike occurs, McCall said, “Our mental health physicians who choose to continue providing care to our patients, psychiatrists, clinical managers, contingency professionals and through from an expansion of our network of high-quality third-party providers in the community, all supported by our integrated teams of physicians and clinicians.”
The statement went on to say that “urgent and emergency care will continue to be prioritized. Some non-urgent appointments may need to be rescheduled for another day or with another doctor.”
Talks between the union and Kaiser continued on Friday without reaching an agreement. More trading sessions are scheduled for Wednesday and August 12.