Two thousand Kaiser Permanente therapists in Northern California began an indefinite strike this morning, protesting “unethical” working conditions that providers and patients say put vulnerable people at risk.
“It is no longer tolerable for me to tell a young person and their family that their child must wait four to eight weeks to be seen for major depression, trauma or severe anxiety disorders,” Michael Torres, child psychologist. at San Leandro Medical Center, he told SFGATE. “I’ve been apologizing to people for 20 years and nothing has improved at Kaiser.”
In a January 2020 letter, the American Psychological Association accused Kaiser, which posted a net profit of $8.1 billion last year, of causing “extreme wait times” for follow-up appointments that they caused a “disturbing” lack of care for patients. Internal documents shared with SFGATE reveal that some Northern California patients seeking mental health care did not receive follow-up appointments for three months.
SFGATE previously reported that between June 2021 and May 2022, 377 Northern California-based physicians left Kaiser, more than double the attrition rate from the previous year. As a result, Torres said, the few remaining therapists are buckling under the weight of growing caseloads and long hours. He told SFGATE that he feels stretched too thin to provide the care his teenage patients really need.
Although a new law, Senate Bill 221, states that patients must receive a follow-up appointment from health care providers within 10 days of the request, that is impossible given the current staffing level, Torres said. As his teenage patients wait months for their next appointment, their symptoms only get worse. And many give up attention altogether.
The 2,000 workers now on strike are employed directly by Kaiser. The HMO also contracts with outside networks of mental health providers, including the third-party insurance company Beacon, to which patients are often referred. But patients referred to these third-party providers report facing equally endless waiting lists and dead ends.
Deb Catsavas, Kaiser’s senior vice president of human resources, told SFGATE in a written statement that the tactics of the National Health Workers Union, which represents the striking therapists, are “unethical” and “counterproductive.”
“It is especially disappointing that NUHW is asking our dedicated and compassionate employees to walk away from their patients when they need us most,” he wrote. However, he adds that Kaiser is “committed to negotiating in good faith to reach a fair and equitable settlement” that benefits both therapists and patients.
Kristi, a Brentwood resident who asked to use only her first name, told SFGATE that during a crisis period from June 2021 to May 2022, she was only able to see one Kaiser staff therapist out of every five or seven weeks. Even those sessions got shorter over time, he said, with 45-minute sessions soon shrinking to 30 and 25 minutes.
“During that period of time, my mental health declined,” he said. “Slowly, but then quickly toward the end.”
When Kaiser provided her with a referral to the Beacon Network, she was provided with a list of 30 therapists. Only one called her, but said they couldn’t see her. Meanwhile, his mental health spiraled.
“I killed myself,” he adds. “He needed a high level of care that Kaiser couldn’t provide.”
In the midst of a mental health crisis in June, she said she called Kaiser and begged him to talk to her therapist or whoever was available. But the receptionist told her she would have to wait until July 18 for her appointment. Eventually, after filing a complaint against Kaiser, as well as complaints against her claims worker, Kristi began receiving weekly appointments with a Kaiser therapist.
This pattern is common, according to Torres. “The external network is overwhelmed,” he told SFGATE. “There is no room.” As a result, patients often spend two months trying to find a provider outside the HMO, only to return to the Kaiser clinic because no one could fit them.
Bay Area mother Barbara McDonald told SFGATE that Kaiser’s mental health care has been impossible to navigate and “unreliable” in the years since her daughter began experiencing health problems mental that threaten life. “It feels completely negligent,” she said, explaining that she has spent about $45,000 on outside mental health services for her daughter, thanks to the endless delays and cancellations they faced trying to access Kaiser programs.
“I feel like I need therapy and there are a lot of people who need it more than I do. And I know the well is dry there,” she said through tears.
This is not the first time Kaiser has faced such accusations. In 2021, the San Diego City Attorney sued Kaiser Permanente, alleging that more than 30% of its mental health directory listings were inaccurate.
“These inaccurate directories, known as ‘ghost networks,’ misrepresent the breadth of an insurer’s network of providers, promising consumers access to health care that is not actually available under the plan ” the complaint said. “…These consumers are left exasperated by fruitless hours spent trying to find an in-network provider who takes on new patients and bewitched by out-of-network provider charges. Some consumers will delay care or even give up completely in the spotlight because of ghost networks.”
Even with therapists on strike, the state will still require Kaiser to provide patients with mental health appointments, according to Mary Watanabe, director of the Department of Managed Health Care, which regulates the HMO. Watanabe spoke on the issue Thursday at a state Senate hearing held in response to last week’s strike announcement.
According to a complaint filed Thursday by the National Union of Health Care Workers, Kaiser has illegally canceled thousands of appointments ahead of the strike.
“We expect Kaiser to fully comply with appropriate access standards. Strike or no strike, as a regulator we will hold them accountable,” Watanabe told the audience. The Department of Managed Health Care has been auditing Kaiser since May in response to complaints that the HMO has been violating Senate Bill 221.
The committee also heard testimony from patients and therapists, several of whom spoke of the stress and emotional turmoil caused by understaffing and long wait times.
“We would never tolerate what we heard today and what we hear on a regular basis in terms of denial of care if someone came in with cancer or a broken arm,” state Sen. Scott Wiener responded, according to Courthouse News.
Torres, for example, said he is participating in the strike because he is tired of not being able to provide adequate resources to care for patients. It is also discouraging postdoctoral residents from becoming staff members. “They recognize this unethical care,” he told SFGATE. And there’s little incentive to stay within a system that underpays and overburdens its employees when “they can, in the Bay Area, start making $220 an hour in the private sector,” Torres said .
But the community isn’t just losing staff members.
“We’re losing patients,” Torres said. “Symptoms are not improving and are actually increasing.”
Beacon Health Options did not respond to SFGATE’s request for comment at the time of writing.
If you’re having trouble, call the 24-hour Suicide Prevention Lifeline at 800-273-8255 or visit suicidepreventionlifeline.org for more resources.
Amanda Bartlett contributed to this report.