The grinding strike by Kaiser Permanente mental health care professionals in Southern California, now almost two months old, has drawn the attention of the leaders of both chambers of the California State Legislature.
But those leaders, Assembly Speaker Robert Rivas and Senate President pro tempore Mike McGuire, aren’t trying to control the negotiations. They’re worried instead about the ongoing likelihood that Kaiser patients will once again not receive the mental health care they need.
In separate but identically worded letters sent to Kaiser CEO Greg Adams last week, Rivas and McGuire expressed concern with Kaiser’s stated contingency plan for dealing with the work stoppage by nearly 2,400 mental health care professionals. The plan, they wrote, lacks detail on how the health giant would avoid “widespread appointment cancellations without timely and appropriate replacement services.”
In their letters, Rivas and McGuire said they had learned of large numbers of mental health care appointments already being canceled in Southern California, adding that “these reductions in vital services are having adverse impacts on Kaiser patients.”
Each letter concluded by urging Adams to resume good-faith negotiations as soon as possible with the National Union of Healthcare Workers (NUHW), which represents the striking mental health care professionals, and to “agree to the union’s reasonable contract proposals” in order to end the labor dispute and resume full-staffing care of mental health patients. (The union is a financial supporter of Capital & Main.)
Rivas’ letter was co-signed by 40 other assemblymembers and McGuire’s letter by 20 other state senators, meaning that a majority of both chambers was behind the message to Adams.
Adams has been Kaiser’s CEO for five years, taking over after the sudden death of Bernard Tyson in 2019, and has worked for Kaiser in various capacities for a quarter century. He has not publicly responded to the letters from the legislative leaders.
In response to questions from Capital & Main, a Kaiser spokesperson emailed a statement Wednesday imploring the union “to put patients before pickets” and resume negotiations — and flatly disputed that Kaiser members who need mental health services cannot access them.
“Contrary to NUHW’s claims, any Kaiser Permanente member who needs an appointment can get one,” the statement said. “We have an extensive external network of more than 13,000 highly qualified therapists, and hundreds of NUHW-represented employees have returned to work. Notably, more than half of our patients were seeing one of our external providers prior to the strike, and their care has not been disrupted in any way.”
Kaiser said its internal data showed that since the union job action began, “There have been less than 0.3% strike-related grievances” by patients lacking mental health care access.
The union has already filed complaints with the state alleging that Kaiser is using the same tactics that led to more than 100,000 mental health appointment cancellations during a 2022 strike, and that the company has already cancelled group therapy appointments for thousands of enrollees in Southern California this time around.
“Kaiser’s mass cancellation of group psychotherapy constitutes an illegal withholding of covered services from enrollees,” says a union complaint filed Dec. 12 with the state’s Department of Managed Health Care. “By doing so, Kaiser delays enrollees’ recovery, extends suffering, and places enrollees’ health and safety at risk — all while continuing to collect monthly premiums.”
The state agency has affirmed that it is monitoring Kaiser patients’ access to mental health care services during the strike. That’s a nod to the mass cancellations of appointments in 2022, which violates state law and was cited by the agency last year as part of a $200 million settlement in which Kaiser pledged to build out its mental health care services. Those services have been found deficient on multiple occasions going back years.
The National Union of Healthcare Workers began an open-ended strike on Oct. 21 after months of negotiations with Kaiser on a new contract. In addition to seeking pay raises, better staffing and a restoration of pensions that had been discontinued, the therapists want Kaiser to give them more time each week to work on patients’ cases outside of scheduled therapy sessions. That time can be used for things like responding to patients’ emails and voicemails, tailoring their treatment plans and charting appointments.
The 10-week strike by the union’s workers in Northern California in 2022 hinged on similar issues, and it resulted in those workers being guaranteed seven hours a week for such patient care outside of therapy sessions. In the Southern California negotiation, Kaiser is offering only four guaranteed hours, a major sticking point.
The two sides have not held a bargaining session since the strike began. Kaiser officials have described the union’s strike as “entirely unnecessary” and said they are ready to talk about “a mutually beneficial agreement.”
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.
Such violations of care standards were noted in Kaiser’s 2023 settlement with the state, which included a record $50 million fine. Both union representatives and state leaders fear the same scenario may be playing out now in Southern California, with dire consequences for Kaiser patients if they can’t get the mental health care they need.
