The health care provider canceled patient appointments during a 2022 strike. State regulators say they are making sure the company does not break the law during the current strike in Southern California.

By Mark Kreidler, Capital & Main

This story is produced by the award-winning journalism nonprofit Capital & Main and co-published here with permission.

With negotiations going nowhere between Kaiser Permanente and roughly 2,400 striking mental health care professionals in Southern California, state officials are turning to a connected concern: making sure history does not repeat itself.

The Department of Managed Health Care (DMHC) announced last week that it will monitor Kaiser patients’ access to mental and behavioral services during the open-ended work stoppage that began Oct. 21, to be sure the health giant continues to provide adequate care, which it conspicuously failed to do when it canceled more than 100,000 appointments during a 2022 strike.

“Health plans must continue to comply with the law during a labor strike,” Mary Watanabe, the director of the Department of Managed Health Care, said in the DMHC’s announcement. Watanabe said such compliance includes “meeting timely access standards and providing appropriate mental health and substance use disorder care to members.”

In a media statement emailed Oct. 25 to Capital & Main, Kaiser officials said they had contacted almost all of their members who had mental or behavioral care appointments scheduled for the coming week, “providing appointments to everyone who wanted one.” The company added that hundreds of mental health professionals who are not part of the strike were continuing to provide care.

The state department’s active oversight recalls Kaiser’s abysmal performance during a similar situation in Northern California in 2022. That year, about 2,000 mental health care professionals staged a grinding, 10-week strike in an effort to force Kaiser to upgrade its patient services, including hiring more therapists and giving them more time each week to study their patients’ cases and outline treatment plans.

But the Department of Managed Health Care later found that despite assurances from Kaiser that its Northern California mental health patients would continue to have adequate access to services during the strike, the company ultimately canceled at least 111,000 such appointments. State law requires health providers to continue offering full access during a labor stoppage, including outsourcing appointments to non-Kaiser therapists if necessary.

That finding, among others, was part of the reason for Kaiser’s $200 million settlement with the state last year, in which the care provider acknowledged deep deficiencies in its mental and behavioral care services, paid a record $50 million fine and agreed to undertake extensive corrective action to provide adequate mental health care to its members.

“Given Kaiser’s documented track record, we are concerned that Kaiser intends to respond to the [strike] by employing the same unlawful methods it has used during previous work stoppages,” Fred Seavey, of the striking National Union of Healthcare Workers, wrote to the state in requesting oversight in Southern California by the department. (Disclosure: The NUHW is a financial supporter of Capital & Main.)

Kaiser has a history of providing inadequate mental health care services to its 9.4 million members in California. The company paid a $4 million fine to the state in 2013 for deficient access to such services, and four years later it agreed to redress similar failures. Yet Kaiser has consistently left patients without follow-up mental health appointments for weeks, sometimes months, state officials and critics have said.

The National Union of Healthcare Workers’ 2022 strike in Northern California resulted in higher wages, a commitment by Kaiser to hire more therapists and an expansion to about seven hours per work week for therapists to spend on things like responding to patients’ emails and voicemails, tailoring their treatment plans and charting appointments.

The Southern California strike hinges on similar issues. The union says that staffing problems there are severe, with one therapist for about every 3,000 Kaiser members in that region compared with one per 2,000 members in Northern California. The union is also bargaining for the same seven hours per week of non-appointment work time for its therapists, while Kaiser is offering four hours per week to Southern California workers. And the union wants pension benefits restored to its mental health care workers; Kaiser stopped offering them a decade ago, even though most other employees in the company receive pensions.

Kaiser officials have accused the union of slow-walking negotiations and pre-planning the current strike. They also said the company is offering 18% in raises spread over four years, and that its Southern California therapists are already paid 18% more than peers in “other organizations.” (A Kaiser spokesperson did not respond to questions from Capital & Main about how the company calculated that figure.)

The union, whose most recent ask was for a 28% wage increase over three years, said on Monday that contract talks had broken off completely. No new bargaining sessions are scheduled.

“We remain ready to resume negotiations when Kaiser gets serious about reaching an agreement,” said Jim Clifford, a licensed clinical counselor for Kaiser in San Diego. “Everything we’ve proposed, Kaiser already provides to nearly all of its employees in California. Kaiser can’t meet its obligation to transform its mental health care system unless it starts treating its mental health professionals as equal to the rest of its workforce.” 

For the health giant’s mental and behavioral health care patients, the question remains whether they’ll be able to get the appointments they need. The Department of Managed Health Care’s statement that it is monitoring the situation was issued in order “to inform [Kaiser’s] members of their rights and how to get help if they encounter an issue,” spokesperson Rachel Arrezola said in an email. Kaiser members facing access issues can contact the DMHC Help Center at 888-466-2219 or via the department’s website, www.DMHC.ca.gov.

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