Are behavioral health patients getting sufficient care during the Kaiser strike?

Nearly 2,400 Kaiser mental health workers are heading into the fourth week of an ongoing strike with little to no progress made at the bargaining table.

What’s more, the National Union of Healthcare Workers and Kaiser disagree on whether patients are getting the proper care as the work stoppage rolls on.

The union said it’s concerned that Kaiser’s plan for patient care during the strike isn’t good enough.

But in a statement to LAist, Kaiser Permanente said its plan was “working well.”

“Intense and careful attention to detail has gone into every aspect of our preparation for this work stoppage,” Kaiser said.

Thousands of Southern California Kaiser mental health workers are demanding more time outside of therapeutic appointments to handle patient charts and other duties, better pay and pensions.

Fred Seavey, a researcher with the National Union of Healthcare Workers, told LAist there is a disconnect between Kaiser’s message to regulators that it has “comprehensive plans in place to minimize potential disruptions” and what he’s hearing from patients and Kaiser employees as the strike goes on.

Seavey said he's aware of some problems, including at least one patient whose appointment was canceled without immediate follow up from Kaiser, and another patient who logged into a virtual therapy appointment, but the therapist didn't show up.

In October, Kaiser provided a three-page plan to a regulatory body that oversees managed health care plans. The plan laid out the company’s strategy for communication, appointment rescheduling and oversight during the strike.

The plan says Kaiser will notify patients about how they can receive behavioral health care during the strike, but it does not list details like what networks might be available to members, or how many therapists are available.

Kaiser stated at the end of the document that it would amend the filing the week of Oct. 21.

On Nov. 1, the Department of Managed Health Care said in an email to LAist that it had “not received a more detailed or updated version of the strike plan to date.”

That was not good enough, Seavey said, especially because Kaiser’s mental health system has a “massive” scope of work.

“There’s no complexity to this plan... The brevity of this thing is quite striking in my mind,” Seavey told LAist.

Issues with patient care

Jeremy Simpkin, a Licensed Marriage and Family Therapist who works in the South Bay as a case manager for Kaiser, said he was concerned that some of the most acute patients living with serious mental illness, like schizophrenia, would fall through the cracks.

Simpkin said he’s worried that patients who might be given an option between a new therapist or waiting for their current therapist will opt to wait, even if they need immediate follow up.

“These are not people who can wait 30 days,” Simpkin said. “They’re people who need assertive, active outreach.”

He also said he’s concerned that follow-up after a patient is hospitalized will not happen fast enough.

“The possibility is that they could die. So this is very, very serious,” Simpkin said.

In a statement to LAist this week, Kaiser said the claims about the contingency plan were “grossly inaccurate.”

The company agreed that some Kaiser members are choosing to wait for their providers to return from the strike. But, Kaiser said those who choose to wait are placed on a list for follow-up scheduling.

“We are contacting members with higher acuity within 10 days to monitor their well-being and again offer a rescheduled appointment with an external therapist,” the company said.

Kaiser added that about 60% of its patients who are receiving mental health and addiction medicine care currently work with providers who are not participating in the strike.

“We are pleased that since this strike began more than two weeks ago, there has been only a handful of issues that were quickly resolved, and we continue to meticulously monitor our care delivery to ensure that track record remains intact,” the company said.

The Southern California mental health care worker strike comes about a year after state regulators hit Kaiser with a $50 million fine for failing to provide timely access to mental health care and other problems.

As part of that settlement agreement, Kaiser committed to investing an additional $150 million over five years to expand and improve behavioral health care for members.

Voices from the picket lines

Speaking from the picket line outside Kaiser’s Panorama City Medical Center, medical social worker Martha Mejia waved at drivers honking in support of picketers. She said she’s worked at Kaiser for nearly two decades.

Mejia said she regularly helps patients get connected with mental health care during her shifts on the weekend. That could mean helping patients who just learned they cannot return home or others who are just learning of life-changing diagnoses.

Mejia said, for some of those patients, getting an urgent therapy appointment is difficult.

“The reason they can’t get appointments is that they [Kaiser] don’t have enough workers. And the workers they do have are completely overworked,” Mejia said. “It just feels like we’re working in an unethical, unsafe system that doesn’t care anymore."

Deborah Gallo, a developmental psychologist with Kaiser, echoed Mejia’s frustrations from the picket line. She said for patients living with autism, waitlists for appointments can be up to six months.

“We don’t have enough staff, when we’re working, to get people in in a timely fashion,” Gallo said.

In a statement, Kaiser said it was “laser-focused” on making sure members' needs were met, adding that crisis clinicians are available 24/7.

Viral video

Wearing a blue and gray Dodgers jersey, Kaiser member Lulu Favela joined striking workers at the Panorama City picket line last Friday.

Favela recently posted a video on TikTok in support of her striking therapist, Roxana. Favela stopped by to show her support in person before going to the Dodgers World Series parade.

The video has more than 3 million views and has made Favela a bit of a celebrity among striking workers.

“To be quite honest with you, it took a lot for me to build a relationship and honestly to even start therapy. Especially being Latina, there’s a whole bunch of taboo surrounding it,” Favela said.

She said she had no idea the video would go viral, but she was grateful it was bringing attention to the strike.

“It’s not fair to Roxana and it's not fair to myself either that she can’t do her job because she’s overworked, underpaid and undervalued,” Favela said.

Worker demands

Kaiser mental health workers said they are regularly seeing 10 or more patients a day and are not getting enough time to manage their duties outside of client appointments.

They said they want the HMO to provide workers seven hours of guaranteed time per week to handle things like sending emails, filling out patient charts and other duties.

Union members who spoke with LAist said therapists are regularly staying at work hours after their shifts have ended in order to keep up with the workload.

Kaiser said in a statement that the union’s proposal would lead to too much time spent away from patients.

The union members are also demanding the HMO restore pensions and agree to better pay.

Kaiser said it’s offering an 18% wage increase for therapists over four years.

What’s next

According to the National Union of Healthcare workers, there are no bargaining sessions scheduled for next week.

In an email, the Department of Managed Health Care said it had received nine calls since Oct. 21 regarding the strike.

The regulator said Kaiser members who experience issues with receiving appropriate care should contact the plan directly, or the DMHC Help Center for further assistance at (888) 466-2219, or DMHC.ca.gov.”