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Marin psychologists in Kaiser part of strike threat

Marin Independent Journal - 8/5/2022

Aug. 6—More than 2,000 Kaiser Permanente mental health workers, including unionized psychologists in Marin, are threatening to stage an open-ended strike beginning Aug. 15.

The National Union of Healthcare Workers, which represents the employees in ongoing contract negotiations, says clinicians voted in June to authorize their first-ever open-ended strike. The union says the clinicians want to compel Kaiser to address a lack of adequate staffing to meet patient needs.

Kaiser Northern California's mental health workers — including psychologists, therapists, chemical dependency counselors and social workers — have staged six strikes for short amounts of time over the past four years. This strike would be the first not to have an established end date.

"Patients are getting ripped off while Kaiser's coffers are bulging," said Sal Rosselli, the union's president. "Our members plan to use the tools of a union to achieve for their patients the care they deserve and parity required by law."

Deb Catsavas, Kaiser's senior vice president of human resources, said the company has been bargaining with the National Union of Healthcare Workers (NUHW) since the contract for the union's 2,000 members expired in September.

"We understand that NUHW has announced plans to strike — sadly, a bargaining tactic this union has used every time it has bargained a new contract with Kaiser Permanente, over the past 12 years of its existence," Catsavas said. "It is perplexing that NUHW leaders have chosen to strike when we were close to an agreement."

Catsavas did not respond to the union's assertion that it is failing to hire a sufficient number of mental health workers to meet the needs of its members.

According to the union, Kaiser staffs approximately one full-time equivalent mental health clinician for every 2,600 members. The union says that as a result patients who should receive therapy every week or two weeks are waiting months just to start their therapy and between four to eight weeks between appointments.

Alexis Petrakis, a Kaiser psychologist in Petaluma who treats patients both in Petaluma and San Rafael, said she is prepared to strike if that is what it takes to get Kaiser to hire more mental health workers.

"I hope we don't have to take that step," Petrakis said, "but we've really come to a point where patients cannot wait another day. The urgency can not be underscored enough. We need change as soon as possible. That is why I'm standing with my union."

Petrakis said the standard of care for patients deemed to need individual therapy is an appointment at least every four weeks.

"Right now my schedule is booked out for six weeks," she said.

The union says Kaiser is failing to comply with a new law, SB 221, which requires that patients receive follow-up mental health therapy appointments within 10 business days of being initially seen.

Petrakis said Kaiser has complied with a previous law requiring insurers to provide initial mental health appointments within 10 days by loading providers up with more patients than they can handle.

"We see hundreds and hundreds of people without any sort of containment," Petrakis said, "so we can't focus on our existing patients and try to move them through their treatment."

Petrakis said the overloading is making it hard for Kaiser to retain clinicians.

"We are losing really good, really skilled, really passionate therapists on a regular basis," she said. "Two clinicians on the child team just left this week."

According to the union, 377 Kaiser clinicians based in Northern California quit their jobs between June 2021 and May 2022, more than twice the 186 who left the year before.

To make matters worse, Petrakis said, Kaiser's reputation among psychologists is making it more difficult for it to fill openings.

"We have 16 open positions across the entire department," she said. "I wouldn't recommend any open positions to any of my network."

Robert Lasser, a psychologist who operates a private practice in Kentfield and occasionally treats Kaiser patients who receive authorization to see outside therapists, said he wouldn't consider working for Kaiser.

"I know from many years of experience that they'll see a patient a couple of times and then either make them wait for weeks or put them in group therapy," Lasser said.

The state's Department of Managed Health Care fined Kaiser $4 million in 2013 for failing to provide mental health treatment in a timely manner and again in 2017 for failing to disclose Medicaid data. The department opened a new investigation of Kaiser's behavioral health services in May following complaints from patients.

Regarding compliance with SB 221, Kaiser spokeswoman Adriann McCall wrote in an email, "Although the shortage of mental health clinicians continues to challenge every California health care organization, implementation of SB 221 to Kaiser Permanente's model of mental health and addiction care and services is well underway."

"We know that training and hiring more therapists will not be enough to meet the complex and increasing mental health needs of our population," McCall added. "We must also look to new and innovative approaches to providing care."

Responding to questions regarding Kaiser's plans for caring for mental health patients if a strike occurs, McCall said: "Care will be provided by our mental health clinicians who decide to continue providing care for our patients, psychiatrists, clinical managers, contingency professionals, and through an expansion of our network of high-quality external providers in the community — all supported by our integrated teams of physicians and clinicians."

The statement went on to say that "urgent and emergency care will continue to be prioritized. Some nonurgent appointments may need to be rescheduled for another day or with another clinician."

Talks between the union and Kaiser continued on Friday with no agreement reached. More bargaining sessions are scheduled for Wednesday and Aug.12.

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(c)2022 The Marin Independent Journal (Novato, Calif.)

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