Mental health care providers, represented by the National Union of Healthcare Workers (NUHW), of the Oakland-based Health Maintenance Organization (HMO) Kaiser Permanente, are demanding better care for their patients and better pay and benefits for themselves. They met with Kaiser representatives on January 10 and will be meeting with them again on January 15. This follows their five-day strike in December.
Kaiser’s mental patients often wait weeks or even months to receive mental health care. Kaiser does not have enough mental health care providers on staff to keep patients from waiting for so long for an appointment. Kaiser’s mental health care providers are backlogged, so Kaiser refers patients seeking a mental health care appointment to external providers.
Miranda Buxton, a Kaiser therapist and a member of the bargaining committee for Kaiser’s mental health care providers’ contract, said that from what she has personally observed, many patients cannot obtain an external appointment because external providers are backlogged. The patients then try to schedule an appointment with Kaiser again, only to find Kaiser still backlogged.
Buxton said that due to spending weeks or even months without treatment, patients’ conditions can worsen. This means that they ultimately need more mental health care and more appointments, which worsens the backlog.
Buxton emphasized that the focus of the strike is better patient care. “That’s been the biggest issue for a long time,” said Matthew Artz, the spokesperson for the NUHW. However, Buxton said that their demands for better pay and benefits were “only fair” given the cost of living in the Bay Area. She said that Kaiser pays its mental health care providers less than external providers.
“[Access to mental health care appointments] has been a long-standing issue at Kaiser, and in fact many of the therapists that are part of this union … filed a complaint with the … California Department of Managed Healthcare [CDMH] … back in 2011 … saying Kaiser is not providing required access for mental health services, and in 2013, after investigation, the Department found that that was the case … and actually fined Kaiser four million dollars,” said Artz.
He said that this is not a lot to Kaiser, but was one of the largest fines ever levied against an HMO in California at the time. “What the state really came down hard on Kaiser for in 2013 was access to initial appointments,” he said. Under California’s “timely access” law, patients of an HMO are entitled to an intake appointment with a mental health care provider within ten business days of scheduling the appointment. Regulations on follow-up appointments are less clear.
According to Artz, after the fine, Kaiser started prioritizing the intake appointments. It became easier for Kaiser patients to obtain an intake appointment, but harder to obtain a follow-up appointment.
He referred to this as “Better access to less care.” The CDMH found in a 2015 survey of Kaiser that it provided its patients with inadequate access to both intake and follow-up appointments.
Berkeley City Council voted to rezone a section of Berkeley to allow Kaiser to build a facility there. One of the three Councilmembers who opposed the bill, Cheryl Davila, said she was not sure how the strike impacted the zoning decision.
When representatives were asked to explain the reason why Kaiser had indicated intent to build a new facility in Berkeley, Vice President Mark J. Tortorich offered a statement: “As our membership in the Bay Area continues to grow, we are exploring possibilities for expanding access to our high quality, integrated care.” No Kaiser representatives responded to the Jacket when asked questions about the strike and where money for the fine was cut from.