Kaiser and state officials reach settlement agreement over deficiencies in mental health care

Kaiser Permanente and the California Department of Managed Health Care announced this week a settlement agreement aimed at resolving “deficiencies” in the HMO’s oversight and access to its mental health services, DMHC officials said.

The agreement, which acknowledges significant steps taken by Kaiser to improve access to and monitoring of mental health services, lays out a number of steps the HMO must take within a specified time frame. Failure to do so could result in fines, officials said.

It’s in response to an “enforcement action” taken against Kaiser by DMHC in 2013.

“If the plan doesn’t meet the benchmarks and deliverables outlined in the settlement agreement, it may be subject to financial consequences up to $1 million,” said DMHC spokesman Rodger Butler.

News of the agreement comes a little more than a week before Kaiser is scheduled to launch a significant expansion of mental health services in Santa Rosa. On July 31, Kaiser will see the first patients at its new mental health and wellness offices in southwest Santa Rosa.

The new medical office complex, which takes up the second floor of the building at 2235 Mercury Way, will feature 60 new mental health provider offices and six group therapy and counseling offices. Both adult and pediatric mental health services will be offered at the new site.

For years, DMHC officials have been pressuring Kaiser to improve timely access to mental health services, better inform patients about available services and improve its monitoring and tracking of patient appointments.

In summer 2013, the state levied a $4 million administrative fine against Kaiser for continuing practices identified in a routine survey DMHC conducted in 2013. Two years later, DMHC issued a follow-up survey report that identified remaining “deficiencies” related to access and monitoring of mental health care appointments.

The follow-up report also found that in some cases Kaiser continued to disseminate “inaccurate and misleading health education information to enrollees regarding the scope of their coverage for behavioral health services.”

In a statement released by the HMO, Dr. Patrick Courneya, executive vice president and chief medical officer of Kaiser Foundation Hospitals and the health plan, said Kaiser continues to make improvements to its mental health services and the ways that it measures treatment outcomes. The number of Kaiser’s therapists, psychiatrists and other mental health workers has grown by 50 percent in the past five years, despite national shortages in these fields, Courneya said.

No other health plan in the state “can offer anything close,” he said. Three distinct groups comprise the Kaiser organization: Kaiser Foundation Health Plan, Kaiser Foundation Hospitals and the physician-led Permanente Medical Groups.

The settlement highlighted some of the steps Kaiser has taken in recent years to improve both access to mental health and Kaiser’s ability to track and monitor patient care.

From 2012 to May 2017, Kaiser has hired across the state about 850 behavioral health providers and 188 behavioral health physicians. The settlement agreement also pointed out that Kaiser has made significant “capital investments” to accommodate the new hires.

In an email, Courneya said Kaiser has been “building, leasing, and remodeling treatment space so that our growing team of clinicians has places to treat more patients ... The new Santa Rosa mental health offices are an example of this growth.”

While the settlement agreement resolved issues related to DMHC’s 2015 follow-up survey report, it does not cover problems outlined in a subsequent routine survey outlined in a June 2017 report.

Among other findings, the 2017 survey report found that Kaiser did not adequately track the “availability and timelines” of follow-up mental health appointments, nor does it take effective and timely action when it finds problems.

Butler said DMHC officials will conduct a follow-up survey within 18 months to determine whether Kaiser has corrected those problems identified in the 2017 survey that have not yet been referred to ?DMHC’s enforcement branch.

Kaiser officials have said they are confident the follow-up survey to the 2017 report will find no deficiencies.

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.