Kaiser mental health workers hit the picket line (w/video)

About 60 Kaiser Permanente mental health professionals walked off the job in Santa Rosa on Monday, part of a weeklong strike across the state to protest stalled contract negotiations and what union members say is inadequate staffing to serve a growing number of patients.

Local picketers said more mental health workers are needed in Sonoma County to handle thousands of newly insured patients who have recently become part of the Kaiser system through the Covered California health exchange and expansion of Medi-Cal.

At least 2,600 mental health professionals represented by the the National Union of Healthcare Workers are participating in the statewide protests at Kaiser facilities this week.

“It’s great that they’re accepting more Medi-Cal patients, but they don’t have enough therapists and Spanish-speaking therapists,” said Robin Bertoli, a licensed clinical social worker who struck on Monday.

Bertoli, who works in Santa Rosa, said she often sees patients during her breaks and ends up having to do paperwork, such as medical notes, during her off-hours and days off.

“People are not getting served well,” Bertoli said. “The pressure to do more with less .?.?. that’s just always in my head.”

Kaiser officials rejected the union’s claims that the health care giant has not done enough to meet demand. The HMO said it has taken significant steps to improve mental health services and accused the union of using alleged staffing shortages to disguise its demands on wages and benefit.

“With this particular union, that seems to be their strategy,” Kaiser Vice President John Nelson said.

In the past three years, Kaiser membership has grown 8 percent while it has increased mental health department staffing by 25 percent, Nelson said.

Kaiser averages about 2 percent annual growth in membership, he said.

The union countered that Kaiser’s own workforce data states that the recent growth in full-time equivalent, or FTE, mental health clinicians is 11.8 percent, not 25 percent. Also, the union said data from the state Department of Managed Health Care puts Kaiser’s membership growth at 10.3 percent. That’s an additional 694,672 members, including 100,000 Medi-Cal enrollees, the union said.

Kaiser’s mental health programs are currently under scrutiny by the state Department of Managed Health Care. After a routine survey in 2012, state regulators found that Kaiser was not accurately tracking patients’ access to its therapists. The agency said Kaiser was unable to ensure patients were offered timely initial appointments with therapists for non-urgent matters, in violation of state regulations.

In 2011, the union made similar findings in its report, “Care Delayed, Care Denied.” The state later fined Kaiser $4 million for what the agency said were “deficiencies” in Kaiser’s mental health services. Kaiser at first challenged the penalty but last fall opted to pay the fine, though it did not concede to the state’s findings.

“The bottom line is we’ve addressed the issues in the (state’s) survey,” said Nelson. “We’ve continued to make progress on improving quality and access. And we will continue to do so. We would like to the union to join with us and work constructively.”

Donning the red colors of the National Union of Healthcare Workers, protesters staked out the sidewalks on Mendocino and Bicentennial avenues near Kaiser’s Santa Rosa hospital.

Striking mental health workers included psychologists, marriage and family therapists and social workers. Kaiser optical department employees who are also part of NUHW but from a different local also took part in Monday’s walkout.

Some workers said that in response to state scrutiny, Kaiser now “front-loads” its scheduling of mental health patients to ensure that patients are seen in a timely manner for the first and second appointments. Thereafter, however, patients must often wait several weeks for a follow-up appointment, the union said.

“Upper management has turned a blind eye to the access issues, and illegal record-keeping used to conceal it,” said Mark Goldstein, a psychologist for Kaiser in San Rafael and a steward for the union representing workers in Petaluma and San Rafael.

Goldstein said that therapists have between seven to 10 new patients a week, a rate that “leaves inadequate appointments for subsequent visits.” Wait times for follow-up care can be as long as two months, he said.

Nelson denied that Kaiser patients are experiencing such long wait times. He said the union’s decision to walk out was primarily intended to gain leverage in contract negotiations. Kaiser mental health workers have not had a contract with Kaiser since their union, the National Union of Healthcare Workers, first formed in 2009.

“The primary issues are economic: wages, benefits, retirement benefits,” Nelson said. “What we think is inappropriate is now trying to put patients in the middle of this dispute.”

Last week, in the lead up to the strike, Kaiser and the union met several days to negotiate. Those talks broke down over the weekend, with both sides accusing the other of abandoning talks.

Kaiser began taking steps last week to minimize the impact the strike will have on mental health patients, Nelson said. These steps include enlisting the help of psychiatrists, mental health department supervisors and managers who are also therapists.

Psychiatrists who are not members of the union, are on hand to treat emergency mental health cases, said Goldstein, the psychologist and NUHW shop steward.