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Kaiser Permanente mental health workers to strike Monday

San Bernardino County Sun (CA) - 1/11/2015

Jan. 11--Most of Kaiser Permanente's 2,600 mental health professionals -- members of the National Union of Healthcare Workers -- are expected to start a weeklong strike at 6 a.m. Monday, where they hope to draw attention to what they call a "chronic failure" to provide members with timely, quality mental health care.

The union alleges that Kaiser Permanente does not staff its behavioral health staff with enough clinicians to treat the growing number of patients -- in violation of state mandates and industry standards.

In its statements, the union likens the situation to last year's Veterans Administration scandal, where long delays in receiving medical care became a national issue.

Responding to the charge, Kaiser Permanente executives said while they are battling a nationwide shortage in behavioral health specialists, they have increased hiring in these specialties last year and plan to continue the trend.

In 2014, a year when California Kaiser Permanente membership ranks swelled 8 percent, KP hired 25 percent more mental health professionals than the previous year, John Nelson, Kaiser Permanente vice president of government relations said last week.

Union officials say the Affordable Care Act has made the staffing situation in behavioral health even worse.

Starting Monday and continuing through Friday, union members will be on 65 picket lines at more than 35 locations throughout the state, including West Los Angeles and Fontana medical centers Monday, West Covina and Ontario Tuesday and Woodland Hills and Fontana medical centers Thursday.

Union ranks include 108 members in Fontana and 56 in Ontario, said Justin DeFreitas, a union spokesman.

Union membership includes psychologists, therapists and social workers.

In 2013, Kaiser Permanente was fined $4 million by the California Department of Managed Health Care, the second largest fine in the history of the agency and the largest fine ever in the behavioral health realm.

Kaiser Permanente considered the fine "excessive" and countered that state allegations that documents were falsified were, in fact, accommodations made by appointment schedulers seeking accommodate patients who did not want to be seen within the 10-day period, Nelson said.

Nelson took a swipe at the striking NUHW, saying that in the five years that this union has existed, Kaiser Permanente has reached contract agreements with more than 30 other bargaining units.

The union has not secured its first collective bargaining agreement with Kaiser Permanente.

"We support the right for employees to choose unions. Unions are in our DNA," he said,

The union maintains that it is only Kaiser's collective bargaining unit to tackle the issue of the quality of care that Kaiser delivers.

Among its allegations is that delays in behavioral health services has resulted in several suicides, a charge Nelson denied.

Marsha Grilli, a Milpitas city councilwoman, saidthat her sister committed suicide while waiting for an appointment to see her psychiatrist.

The doctor would not increase the frequency of the visits -- every six weeks -- even though her sister's mental condition was deteriorating rapidly.

"Nobody felt the urgency we felt," she said.

State regulations require that new non-urgent patients be seen by a health profession within 10 business days.

Nelson said that Kaiser Permanente is now in compliance with the regulations, but union officials say it is not.

Elizabeth White, a licensed clinical social worker in West Los Angeles, said she has a lot of children in her practice and often can't see them on a timely basis.

"Most children bounce back quickly from divorce and domestic violence if they can be seen on a weekly basis," she said.

But often, because of the limitations on when they can see a therapist, they can't get in more than once a month, which, White said, isn't often enough to continue the forward momentum of one-on-one sessions.

And children -- as well as adults -- can benefit from group therapy sessions.

But often there isn't space to hold one.

"There has been no effort to plan space for more groups," said White, who is a member of the union's bargaining committee.

Nelson said that behavioral health lacks the large body of "best practices" which family medicine and other medical specialties involving the body have accumulated over the years.

On its own and with others, KP is seeking to find protocols which bring the most favorable results for behavior health patients.

This process would look at issues of frequency and duration of therapy, among other issues, he said.

During contract talks, the NHWU has proposed the creation of clinician-management committee in each facility that can work together to determine adequate staffing levels and outsourcing needs.

In a statement, Kaiser has said it has implemented "comprehensive contingency plans throughout the region to ensure the continued care, service and safety of our members, patients before, during and after the work stoppage..,"

"Our hope is that the success of this action to deal with mental health will be a catalyst for other providers, and society in general, to treat mental health on the same level of care as physical health," said Sal Rosselli, the NUHW president.

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