Today Marks Week nine of a
strike by Kaiser Permanente
Mental health care providers,
and we've been following this
story since the beginning.
Those on strike say it's not about the money,
but about the time they have to
provide quality care to their patients.
But Kaiser says that the Union's
demands would mean fewer appointments.
Becca Habegger shows us what's
at the heart of all of this.
You're a mess. Are under
attack. What do we do?
Jenny Butera is one of about 2000
psychologists, social workers,
therapists and chemical dependency counselors
in Kaiser's Northern California region,
represented by the National
Union of Health Care Workers.
Since August 15th,
hundreds of these providers have
been on strike demanding 3 main
things they say will lead to
better patient care a caseload cap.
Currently, they say there's no
limit on how many patients a
provider can have at one time,
and the Union calls caseloads unmanageable,
more returning patient appointments
and fewer new patient appointments.
They have more availability
for existing patients and more
time for indirect patient care.
That's the time a provider spends
outside of seeing patients in direct
care is actually.
The tasks that we need to do
to provide for the patient,
oftentimes that might be calling
the sheriff for a welfare check.
I'm doing a 5150 on a suicidal patient,
contacting CPS for a for
reporting a child abuse case.
So a lot of things that are only
possible if you're a licensed therapist,
plus replying to patient emails and
creating treatment plans, the Union says.
But Kaiser Permanente says they've met
the Union halfway at the bargaining.
Label on indirect care time,
only to have their offers rejected.
The unions excessive demand would reduce
the number of appointments we currently
have by more than 2500 every week,
Kaiser Permanente tells ABC 10.
This takes us in the wrong direction.
At a time when the need for mental
healthcare has never been higher,
Kaiser Permanente has been clear
we're not willing to do that.
We have extended all that we can
without jeopardizing the care we bring
to patients in terms of caseload,
Kaiser says.
Our therapists in adult and child mental
health clinics who provide individual.
Psychotherapy see an average
of 5 to 7 patients per day.
In addition,
we have an administrative structure
in place to ensure an appropriate
amount of preparation time and
time to support ongoing education,
Butera says.
It's about quality over quantity.
Patients are suffering.
They will continue to suffer with
our current caseload and our current
schedule the way it's made-up.
Also at the heart of this
is a law called SB-221,
which went into effect in July.
It aims to strengthen Californians timely
access to mental healthcare by requiring.
Health care service plans,
including Kaiser Permanente and
health insurers to provide follow-up
mental health and substance use
disorder therapy appointments
within 10 business days,
unless the therapist decides
the patient can wait longer.
Not all patients need that time or need
that frequent of a session, but many do,
and we just can't get them in.
So we're waiting some.
Some therapists have some
availability in four weeks.
I certainly don't.
My earliest is typically 6 to 8 weeks out.
Union claims Kaiser is violating SB-221,
especially with hundreds of
providers still out on strike.
Kaiser Permanente responded to that
telling ABC 10 the new law aligns
with Kaiser Permanente's longstanding
commitment to provide timely,
high quality mental health care and substance
use disorder treatment to our members.
The implementation of SB-221 is challenging
for all health plans and providers,
not just Kaiser Permanente,
given the overall demand for mental
health care and substance use
disorder services and the documented
shortage of trained professionals
both nationally and in California.
Implementation of SB-221 to Kaiser
Permanente's model of mental health and
addiction care and services is well underway,
and a 10 day rule seems
to be pretty reasonable.
We reached out to Richard Frank,
a senior fellow in economic studies with
the Brookings Institution and director of
the USC Brookings Schaeffer Initiative,
on health policy.
He says the aim of SB-221 is a good one,
trying to make mental healthcare as
accessible as physical healthcare.
And what we're really interested in
is making sure that people can get.
Quality mental health and substance
use disorder services when they
need it at a reasonable.
And Becca is with us right now.
Becca, I think my first question is how
many people is this directly affecting?
Yeah, you know, this is hard to quantify
because at this point, you know,
Kaiser is working with patients.
It says to help connect them
with providers who, you know,
if they're providers on strike,
they do have community contracted providers.
But Kaiser also says 65% of the providers
who initially went on strike are back
in August have since returned to work.
You know, on the other hand,
the Union says patients are affected by,
you know, having to wait weeks to
schedule a follow up appointment.
With their provider and they said this was
an issue even before the strike happened.
The Union says that and it says
this was an issue before the strike.
Yeah, the Union says this was an issue.
These long wait times were an
issue before the strike.
It's just that now SB-221 is that law that
went into effect July 1st of this year,
which makes extending follow-up
appointments beyond 10 business
days in violation of the law.
So you know that's that is the
law of the land right now.
These follow up appointments have
to come within 10 business days.
Union says Kaiser's violating that.
Kaiser says they are working to
implement SB-221 and that they have a
network of community based providers.
So they say they are not in
violation of the law per se.
And Kaiser also mentioned a provider
shortage. Talk about that a little bit.
Yeah, sure. You know,
studies have shown that California has a
shortage of mental health care providers,
but how acutely it's felt really
depends on where in this state you live.
Generally, urban areas are better serviced,
rural areas have a tougher time.
The Union, however, says it's not about.
A provider shortage is about work conditions.
They say providers don't want to work
for Kaiser because of the conditions
that I laid out in the story.
Kaiser on the other hand says it really
comes down to a provider shortage
and they're working with the Union to
try to come to an agreement at this
point though as you've seen they have
been on strike for 9 weeks now and
it looks like a weeks answer isn't
quite yet an agreement isn't quite
yet insight. Alright, Becca, thank you.
And we've also been hearing from you at
home on this issue and Becca is going
to be sticking around because when
we come back we'll share some of what
Kaiser patients who wrote in to us.
Had to say about this issue.
All right, now before the break,
we went in depth into the mental
health worker strike at Kaiser.
That's now entering its 9th week.
Today is world Mental Health Day,
and we wanted to know if you at home have
had trouble accessing mental healthcare.
Now, Beckett,
you've been covering this for a while now.
I want to read some of the viewer
comments that people wrote in to us.
We have Chris.
Sean, she said that you can do an
intake appointment with Kaiser
and the next available appointment
isn't for about four to six weeks
if you get an outside referral.
You can be seen almost as soon as
the next day as your authorization.
Authorization can almost take
about a week as well, she adds.
And then another person told us
that they were with Dignity Health
in Sacramento using a purchased
health insurance plan.
They also say that they've called 8
to 10 therapists who are in network,
and only one of them, Becca,
one of them was accepting patients.
So that person said, quote,
it's shocking how rationed mental
health care is. You've been covering this.
What do you make of those comments?
Yeah. And 1st, I think it's important to
point out that we reached out on a side
note to both of those people just to say,
hey, was this your personal experience?
Do you work for Kaiser?
Is this something that you
heard from a friend second hand,
both of these individuals told us that they
it's a personal experience with Kaiser.
And that second person said it was also
their experience at Kaiser and at dignity.
Dignity. Yeah. But they had long wait times.
Look, my, my impression of this is that
it really squares with what we're hearing
from both sides of the Union at Kaiser,
who's representing the
mental health care workers.
They say there are long waits four
to six weeks to get either an initial
appointment or a follow up appointment.
They say that's an unacceptable wait
time to get mental health care.
On the other hand,
we are hearing from Kaiser Permanente that
they have this list of community based
providers that they can give to people.
People are able to reach out
on their own and say hey,
but reach out on their own,
reach out on their own and say hey,
are you taking new patients or hey,
can I get a follow up appointment if
it's someone that they've seen before.
So in this case it depends on.
Your opinion on this?
Do you want to do the work to reach
out to find someone?
Do you think that your insurer,
your your HMO should be doing this for you?
So again,
both sides have their positions saying
that they're doing what they can,
but the Union maintains that four to
six weeks is an unacceptable amount of
time to wait for a follow up appointment.
And that's what these folks,
these commenters are telling us.
All right, Becca, thank you.
Keep writing into us.
We want to hear from you.