By Bernard J. Wolfson and Zinnia Finn
[Editor’s note: KHN, which produces California Healthline, is not affiliated with Kaiser Permanente.]
California law that went into effect in July requires health plans to provide timely follow-up appointments for mental health and addiction patients. It is the subject of unrestricted strikes by Permanente’s clinicians, and understaffing plagues them with stifling workloads that make it impossible to provide adequate care.
KP says it is making every effort to increase staff, but is hampered by a shortage of staff. Therapists and the National Federation of Health Professionals who represent them counter that the managed-care giant is struggling to attract clinicians because mental health services have a bad reputation.
The controversy erupted at a time when mental health care was in high demand. During the COVID-19 pandemic, the percentage of US adults with symptoms of depression and anxiety nearly quadrupled.
A new law requires state-regulated health plans to offer reschedules within 10 days of the last mental health or substance use session, unless the patient’s therapist approves less frequent visits. increase.
The union-sponsored bill was signed into law by Gov. Gavin Newsom in October and included a grace period for health plans to comply.
Kaiser Permanente didn’t comply, said Sal Rosselli, president of the medical workers union, which represents more than 2,000 KP mental health clinicians in Northern California and 4,000 statewide. there is,” he said. “Thousands of people are not getting the treatment that clinicians need.”
According to unions and their members, patients often have to wait up to two months for follow-up appointments.
Kaiser Permanente said in an online statement that HMO compliance with the new law is “on track.”
KP said it has strengthened its mental health care capacity by adding approximately 200 clinicians, expanding virtual appointments and offering more mental health services through primary care providers from January 2021 onwards. said Deb Catsavas, senior vice president of human resources for KP’s Northern California division. In addition, KP launched his $500,000 recruitment campaign, saying it will invest $30 million to “build a pipeline for new, culturally diverse mental health professionals across California.” .
But the picketing clinicians, who started the strike on August 15, said they face regular job stumbling blocks due to ongoing staffing shortages.
Alicia Moore, a KP psychologist at Vallejo who leads group therapy sessions in an intensive outpatient program, says her patients have to wait for follow-up appointments, which can make it difficult to maintain progress after the program ends. says there is. “Our program is very good at helping people in crisis right away, but there are no treatment appointments to discharge,” said KP’s Auckland Medical Center on Aug. 16. “When I search for reservations, it’s months away.”
Not only are therapists exhausted, but many potential new providers don’t want to work at KP. If it’s known as a really hard place to do good work, I think it’s very difficult for Kaiser to fill that position.We don’t have reservations to serve patients,” Moore said.
The union said KP also had a staffing problem.
Mickey Fitzpatrick, a psychologist who has worked at Kaiser Permanente for 11 years, said, “This year, I was unable to care for my patients in the way that I was trained in graduate school and in a way that matched my passion for psychotherapy. I resigned,” he said. How to Facilitate Healing. ”
The union claims KP has the money to fix the problem if it wants to, noting that it recorded a net income of $8.1 billion last year and has nearly $55 billion in cash and investments. did.
The two sides also disagree about how much time clinicians should be allowed to work on patient cases outside of treatment sessions.
Catsavas said unions are demanding that clinicians spend less time with patients to allow more time for administrative tasks than KP provides. She said the request runs counter to the union’s “unique efforts to improve access to mental health care.”
According to unions, clinicians are less administrative, such as communicating with parents, school officials, and social services agencies about minor patients and responding to emails and phone calls from anxious adults. say they need to devote time to tasks that are an integral part of their care. Appointments may be 6-8 weeks in advance.
Strikes “will only reduce our access to care at a time of unprecedented demand,” Catsavas said. “This has created a challenge for Kaiser Permanente and mental health care providers everywhere.”
In an Aug. 15 statement, the California Department of Managed Health Care reminded KP that timely access and clinical standards must be respected even when clinicians are on the picket line. “DMHC is closely monitoring Kaiser Permanente’s legal compliance during the strike,” the statement said.
Agency spokesperson Rachel Arezola said the state has received 10 complaints so far related to the new law — all against Kaiser Permanente.
Catsavas said more than 30 percent of KP clinicians continued to care for patients during the strike, and KP psychiatrists, clinical managers, and outside mental health providers stepped in to help.
KP’s mental health issues go back many years. The organization fined him $4 million in 2013 for failing to provide timely mental health treatment. He has since been cited twice for failing to resolve the issue and is currently being investigated by regulators. Regulators have seen a 20% increase in mental health complaints against KP over the last year.
Barbara McDonald of Emeryville said she sought help at KP for her 19-year-old daughter who was exhibiting self-destructive behavior. After numerous attempts over the past few years with Kaiser Permanente, unable to get the help my daughter needed, McDonald spent tens of thousands of dollars to get her diagnosed and treated elsewhere. She has bipolar and borderline personality disorder, as well as attention deficit/hyperactivity disorder, McDonald said.
McDonald said at one point his daughter cut her throat and spent three days in KP hospital.
“Ironically, leaving mental health issues untreated can eventually lead to physical problems as well,” she said. It cannot be said to be less expensive than the treatment of
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. KHN is one of the three main operating programs of KFF (Kaiser Family Foundation), along with policy analysis and polls. KFF is a donated non-profit organization that provides information on health issues to the public. n
