Kaiser, mental health workers avert strike

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The tentative contract settlement that narrowly averted a strike by Kaiser Permanente mental health workers on Monday could reduce patients’ wait times for follow-up care and increase their access to one-on-one therapy sessions, union leaders and HMO officials said.

The 11th hour agreement creates a trigger mechanism that would require Kaiser to hire more mental health therapists if it experiences an increase in patients seeking follow-up treatment sessions, according to the National Union of Healthcare Workers, which represents about 75 psychologists, therapists and social workers in Sonoma County and 1,400 in Northern California.

Specifically, it requires therapists to see four returning patients for every new patient, NUHW President Sal Rosselli said. If therapists do not consistently meet the explicit ratio, Kaiser agreed to hire more therapists, he said.

“That’s extraordinary. It’s unprecedented to my knowledge,” he said.

The tentative agreement gives Kaiser some flexibility for dealing with prolonged spikes in demand or staffing issues caused by such things as leaves of absence, Rosselli said.

Kaiser officials would not elaborate on the agreement but, in a written statement to the press, only vaguely described a new expectation “that therapists will meet an increased standard for the amount of time spent seeing patients in individual appointments.” Kaiser did not comment on the possibility of hiring more therapists if the ratio is not met.

“The agreement demonstrates that Kaiser Permanente and our mental health professionals have a shared commitment to our members,” said Don Mordecai, regional director of mental health and chemical dependency services for Kaiser in Northern California.

Allegations that Kaiser does not have sufficient mental health staff to meet the needs of its members has dogged the popular health care provider for several years.

In 2012, state regulators conducting a routine survey 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.

The state Department of Managed Health Care fined Kaiser $4 million in 2013 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.

Kaiser’s critics, including some of its own therapists, said the HMO shifted resources away from follow-up therapy in order to schedule more timely initial appointments in response to the fine. That led to a backlog of follow-up appointments, where some patients reported waiting as many as eight weeks for appointment.

By setting a 1-to-4 ratio of new-to-return patients, the contract agreement will help Kaiser patients obtain much more timely return visits, the union said. Clement Papazian, a Kaiser social worker and president of the Integrated Behavioral Health Services Chapter of NUHW, said Kaiser therapists had been averaging about two return appointments for every one initial appointment.

“People just couldn’t get back in and we were seeing greater and greater wait times,” Papazian said.

Both Rosselli and Kaiser credited former state Senate President Pro Tem Darrell Steinberg with last-minute mediation that brought the two sides to an agreement over the weekend. The tentative agreement was announced late Sunday.

The agreement, which will be voted on by NUHW members in the coming weeks, also calls for a 15 percent wage increase over the next three years. Kaiser’s prior offer was for a 12 percent increase over that period. Union officials said they got Kaiser to back off a plan to create a two-tier pension plan, where new hires would have been given a 401(k) plan instead the current defined benefit pension plan.

Kaiser said the agreement calls for a “joint committee” that would review pension benefits and “explore alternative retirement income programs to control costs and liabilities for new employees.”

Kaiser also said the agreement calls for employee contributions to employee and retiree medical benefits.

“This tentative agreement reflects that after prolonged negotiations with NUHW we have been able to work through our disagreements, and ultimately agree on common goals that are in the best interests of our members, employees and our entire organization,” Mordecai said.

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

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