4,000 California mental health workers reject Kaiser contract offer

The National Union of Healthcare Workers announced Thursday that 4,000 members of the union had soundly rejected Kaiser Permanente's contract offer, saying the proposal failed to remedy the long wait times for California patients seeking mental health treatment.

Kaiser's “proposals didn't offer clinicians meaningful solutions to provide timely, adequate care for patients,” said Clement Papazian, a licensed clinical social worker in Oakland. “We could not support a contract that offered no significant immediate relief for unsustainable caseloads and longer waits than ever for care.”

Negotiators for the union bargaining teams had recommended voting against Kaiser's offer, and Kaiser's John Nelson said that will not postpone improvements that the company and the union already had agreed needed immediate rollout.

“There are several important initiatives where we will not wait any longer,” said Nelson, the company's vice president of communications. “Kaiser Permanente is moving forward with unprecedented investments to further advance our mental health care. These include hiring more than 300 therapists, accelerating our investments of $700 million in mental health facilities and committing more than $50 million in the next three years to increase the number of people entering and remaining in the mental health professions – including $30 million in tuition assistance for our current employees.”

NUHW President Sal Rosselli, in a prepared news release, said Kaiser announced its decision to hire 300 mental health professionals after it became clear that workers would overwhelmingly reject the contract offer.

“While this could be a meaningful step forward, we need more information about these jobs and a commitment from Kaiser to work with clinicians in determining how many new clinicians are needed and how they should be deployed to best meet the needs of patients,” Rosselli said. “That can't happen until Kaiser returns to the bargaining table.”

The union called off an open-ended strike that was set to begin in June, acceding to requests from leaders of the state legislature that management and labor try to continue working toward an agreement. After calling off the strike, the union's bargaining teams decided to put Kaiser's latest offer to members for a vote. They polled workers by ballot at more than 100 Kaiser facilities around the state, said NUHW spokesman Matt Artz, and 88 percent of the workers voted against the contract offer.

Nelson said Kaiser Permanente is committed to meeting the demand for mental health care in the communities it serves, so the company is working to address three challenges – staffing, space and workforce development – that management feels will improve access and enhance the quality of Kaiser's mental health care and service.

“We have hired more than 500 new therapists over the past few years, and we've expanded our work with high-quality community providers to further ensure our members have access to the care they need,” Nelson said. “We have launched an innovative telepsychiatry program and done more than any other organization to integrate mental health care into our primary care and emergency medicine settings.”

Because of a shortage of mental health clinicians, the company is investing $10 million to increase the number of people entering and remaining in the mental health professions. The company expects to open enrollment for this expanded post-graduate program in the next few months, Nelson said, and the goal is to have about 300 individuals in this program statewide.

Kaiser also announced this week that it was opening an inpatient combined medical-psychiatric unit at the Fremont Medical Center, Nelson said, which psychologists and therapists agree is much needed. The company also announced plans to open outpatient mental health centers in San Leandro and Fremont later this year, Nelson said, adding 100 new offices where mental health providers will treat patients. In Southern California, he said, Kaiser has begun work to launch 11 new and updated facilities.

Therapists and psychologists have applauded the new facilities, said Artz, the NUHW spokesman, but they feel that, like Kaiser's contract offers, the new buildings don't get to the heart of their concerns about patient care. While it's important that Kaiser improve and expand its mental health facilities to meet needs, Artz said, members say it doesn't help to add infrastructure but then understaff the number of psychologists and therapists.

At the new outpatient clinic in Fremont, for instance, members have been told that Kaiser plans to move staff over from an existing space in Niles, Artz said. And although facilities in San Leandro will expand, members say Kaiser is merely transferring over staff from Union City to work there. NUHW's therapists and social workers are concerned because Union City is already understaffed and can't meet intake access, Artz said.

Rosselli said: “We're asking for Kaiser to provide the same quality care for patients seeking mental health treatment as it does for patients seeking medical care. That should not be difficult to accomplish for an HMO that reported a $3.2 billion net profit in the first three months of this year.”

State regulators have repeatedly cited Kaiser for failing to provide timely mental health care, Rosselli said, and the company has been under state-ordered outside monitoring of its mental health services for a number of years.

Workers went on a strike for five days in December 2018 , Rosselli said, and since then, wait times for therapy appointments have gotten longer and some clinics now are making patients wait more than three months for return appointments. Kaiser clinicians held a one-day strike in San Francisco on Wednesday to decry chronic understaffing, saying that Kaiser's only clinic has eliminated 70 percent of its group therapy programs and has made children wait four to six weeks for their first face-to-face appointment.

Before the one-day strike had ended, Rosselli said, Kaiser management informed NUHW that it was prepared to work with caregivers to address the staffing shortages in the clinic.