‘Unethical’ conditions at Kaiser trigger massive NorCal strike

Two thousand Kaiser Permanente therapists across Northern California went on an indefinite strike this morning, protesting “unethical” working conditions that providers and patients say put vulnerable people at risk.

“It is no longer tolerable for me to tell a young person and their family that their child has to wait four to eight weeks before they are seen for major depression, trauma or serious anxiety disorders,” Michael said. Torres, child psychologist. at San Leandro Medical Center, SFGATE told SFGATE. “I’ve been apologizing to people for 20 years, and nothing has improved at Kaiser.”

In January 2020 letterthe American Psychological Association accused Kaiser – which reported a net profit of $8.1 billion last year – of causing “extreme wait times” for follow-up appointments that resulted in a “worrying” lack of care for patients. Internal documents shared with SFGATE reveal that some Northern California patients seeking mental health care did not get follow-up appointments for three months.

SFGATE previously reported that between June 2021 and May 2022, 377 clinicians based in Northern California left their jobs at Kaiser, more than double the attrition rate from the previous year. As a result, Torres said, the few remaining therapists are caving in under the weight of increasing workloads and long hours. He told SFGATE he felt too stretched to provide the care his teenage patients really needed.

While a new law, Senate Bill 221, states that patients must receive a follow-up appointment with health care providers within 10 days of their request, which is impossible given the current level of staffing, Torres said. As her teenage patients wait months for their next appointment, their symptoms only get worse. And many give up care altogether.

The 2,000 workers currently on strike are directly employed by Kaiser. The HMO also contracts with outside networks of mental health care providers, including the third-party insurance company Beacon, to which patients are often referred. But patients who are referred to these external providers report facing equally endless waiting lists and gridlocks.

Deb Catsavas, senior vice president of human resources at Kaiser, told SFGATE in a written statement that the tactics of the National Union of Health Care Workers, which represents striking therapists, are “unethical” and ” counter-productive”.

“It is especially disappointing that NUHW is asking our dedicated and compassionate employees to walk away from their patients when they need us most,” she wrote. Nonetheless, she adds that Kaiser is “committed to negotiating in good faith to reach a fair and equitable agreement” that benefits both therapists and patients.

Kristi, a Brentwood resident who asked to use only her first name, told SFGATE that during a crisis period from June 2021 to around May 2022, she was only able to see a Kaiser staff therapist every five to seven weeks. Even those sessions got shorter over time, she said, with 45-minute sessions rapidly decreasing to 30 and 25 minutes.

“During that time, my mental health declined,” she said. “Gradually, but quickly towards the end.”

When Kaiser provided her with a referral to the Beacon Network, she received a list of 30 therapists. Only one called her back, but said they couldn’t see her. In the meantime, his mental health deteriorated.

“I was suicidal,” she adds. “I needed a high level of care that Kaiser was unable to provide.”

Amid a mental health crisis in June, she said she called Kaiser and begged to speak to her therapist or anyone available. But the receptionist told her she would have to wait until July 18 for her appointment. Eventually, after filing a grievance against Kaiser, as well as complaints against her social worker, Kristi began receiving weekly appointments with a Kaiser therapist.

This pattern is common, according to Torres. “The external network is overwhelmed,” he told SFGATE. “There is no place.” As a result, patients often spend two months trying to find a provider outside of the HMO, only to return to Kaiser Clinic because no one could fit them in.

Bay Area mother Barbara McDonald told SFGATE that Kaiser’s mental health care has been unnavigable and “unreliable” since her daughter began having life-threatening mental health issues. ‘It seems completely negligent,’ she said, explaining that she had spent around $45,000 on outpatient mental health services for her daughter, thanks to the endless delays and cancellations they faced trying to access to Kaiser’s own programs.

“I feel like I need therapy and there are so many people who need it more than me. And I know the well is dry over there,” she said. , through the tears.

This is not the first time Kaiser has faced such allegations. In 2021, the San Diego City Attorney for follow-up Kaiser Permanente, alleging that more than 30% of the listings in their mental health directory were inaccurate.

“These inaccurate directories, known as ‘ghost networks’, misrepresent the extent of an insurer’s network of providers, promising consumers access to health care that, in reality, is not available in under the regime,” said the complaint Lily. “…These consumers are frustrated by fruitless hours spent trying to find an in-network provider taking on new patients, and haunted by out-of-network provider fees. Some consumers will delay care or even forgo care entirely because of phantom networks. »

Even with therapists on strike, the state will still require Kaiser to provide patients with mental health appointments, according to Mary Watanabe, director of the Department of Managed Health Care, which regulates the HMO. Watanabe spoke about the issue on Thursday during a state Senate hearing held in response to last week’s strike announcement.

According to a complaint filed Thursday by the National Union of Health Care Workers, Kaiser illegally canceled thousands of appointments ahead of the strike.

“We expect Kaiser to fully comply with access standards in a timely manner. Strike or no strike, as regulators we will hold them accountable,” Watanabe said during the hearing. Department of Managed Healthcare Audited Kaiser Since May in response to complaints that the HMO violated Senate Bill 221.

The committee also heard from patients and therapists, many of whom spoke of the stress and emotional turmoil caused by understaffing and long wait times.

“We will never tolerate what we heard today and what we hear regularly in terms of denial of care if someone presented with cancer or a broken arm,” said Senator Scott Wiener, according to Courthouse News.

Torres, for his part, said he was taking part in the strike because he was tired of not being able to donate the resources needed to treat patients. It also deters postgraduate residents from becoming staff. “They recognize this unethical care,” he told SFGATE. And there’s little incentive to stay in a system that underpays and overworks its employees when “they can, in the Bay Area, start making $220 an hour in the private sector,” Torres said.

But the community is not just losing staff members.

“We are losing patients,” Torres said. “The symptoms are not improving and, in fact, are increasing.”

Beacon Health Options has not responded to SFGATE’s request for comment at the time of this writing.

If you are in distress, call the 24-hour National Suicide Prevention Hotline at 800-273-8255, or visit suicidepreventionlifeline.org for more resources.

Amanda Bartlett contributed to this report.

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