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KaiserPerm Mental Health Workers set to strike today on behalf of patients as well as themselves [1]

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Date: 2022-08-15

A few weeks ago, KP management responded to the possibility of this strike with a release that included mention it had contingency plans in place for continuing to serve mental health patients. (It sounded oddly as if KP actually is capable of providing the services it commits to, and simply doesn’t.) Now...

WORLD SOCIALIST WEB — AUG 14

While Kaiser is rated AA- by the Fitch credit rating agency for its “track record of sound and consistent profitability,” it was rated the worst mental health provider in the country by the American Psychological Association. The health care giant is required by law, Senate Bill 221, to offer an appointment within 48 hours in urgent cases, and 10 business days for non-urgent cases, to be determined by a treating clinician. If Kaiser or any provider cannot guarantee an appointment within that time period, they are required to cover an out-of-network visit with a clinician to meet those timeframes. Instead of working to reschedule care outside of its network during the duration of the planned strike, Kaiser Permanente, the largest health care provider in the state, has responded by canceling mental health therapy appointments ahead of the strike action.

CALIF DEPT OF MANAGED CARE — JAN 27, 2020

The American Psychological Association (APA), American Psychological Association Services, Inc. (APA Services), and the California Psychological Association (CPA)1 would like to offer evidence and expertise in connection with very serious allegations from our members about extreme wait times for follow-up psychotherapy appointments for Kaiser Permanente of California

(Kaiser) subscribers. Our concern is not only that Kaiser’s practices violate California law, but also that Kaiser patients risk being harmed by Kaiser falling far below professional standards of care.



We ask you to consider these serious allegations and to take action to correct the disturbing deficiencies in care, which we have been unable to remedy through informal talks with Kaiser.

We plan to participate in the January 31st meeting scheduled by the Department of Managed Health Care (DMHC) and hope to have additional opportunities to contribute to your consideration of this matter.

___________________________________________________ APA is the leading scientific and professional organization representing psychology in the United States, with

more than 121,000 researchers, educators, clinicians, consultants and students as its members. APA Services is a

legally separate companion organization to APA and supports advocacy and psychologists’ economic and

marketplace interests in ways that APA cannot. CPA is a 501(c)(6) non-profit professional association for licensed

psychologists and others affiliated with the delivery of psychological services. CPA supports its members'

professional interests, promotes and protects the science and practice of psychology, and advocates for the health

and welfare

Despite increased demand for those services amid the COVID-19 pandemic, Kaiser staffs about one full-time equivalent mental health clinician for every 2,600 members in Northern California, according to the union. Some patients have had to wait weeks or even months for mental health services as a result, according to the union and reports from the Sacramento Bee.

KP spokespersons called the strike “sadly” a tactic the unions use every time they bargain for a new contract, and assert that Kaiser is committed to negotiation in good faith to reach fair and equitable agreements good for “our therapists and our patients.”

Despite growing efforts at the state level to enforce mental health parity laws, KP psychologists, social workers, therapists, addiction counselors, and other mental health workers say worsening conditions have forced yet more of their colleagues to leave, causing a crisis point in the struggle to provide adequate and timely care for patients,

A union survey of departing clinicians found 668 clinicians leaving between June 2021 and May 2022, compared to 335 clinicians the previous year. Of 200 departing clinicians responding, 85 percent cited unsustainable workloads precluding adequate time to complete, and 76 percent cited inability to “treat patients in line with standards of care and medical necessity” under existing conditions.

The union has gone on strike for short amounts of times six times in the past 4 years alone. Today’s will be the first open-ended one — no end date established.

Kaiser has 4.6 million enrollees in Northern California ...though that figure does not reflect how many currently access their mental health benefits. In a letter sent Sunday to the Department of Managed Health Care, which regulates health plans, the union asked the department to ensure that Kaiser continues providing mental health care to patients during the strike, rather than canceling appointments. Amanda Levy, deputy director for health policy and stakeholder relations for the Department of Managed Health Care, said the department is continuing to monitor access to services for patients impacted by the strike [per state law requirements that health plans provide enrollees with medically necessary care within timely access and clinical standards at all times, including during an employee strike.]... ….Kaiser is not the only provider facing a shortage of mental health practitioners. Complaints of shortages also have been raised by counties, school districts and non-profit organizations around the state. ... some Kaiser providers are being recruited to work at telehealth start-ups, where money is good and work-from-home options abound. Others are entering private practice. ...In 2013, the Department of Managed Health Care fined Kaiser $4 million for failure to provide adequate mental health treatment. In a hearing this spring, lawmakers raised concerns about the state’s plans to move an additional 200,000 Medi-Cal members onto Kaiser, given problems with mental health treatment. Democratic Sen. Scott Wiener of San Francisco has introduced a bill to significantly increase fines for health plans that fail to comply with state laws. Another bill of Wiener’s, SB 221, which took effect July 1, is intended to ensure patients don’t face long delays for follow-up treatment through commercial providers like Kaiser. Specifically, the new law, which was sponsored by the union, requires that patients receive follow-up mental health care within 10 business days unless a provider determines that a longer wait will not be detrimental to the patient. At a virtual press conference in late June, Kaiser mental health practitioners said the health giant wasn’t close to meeting those requirements.

______________________________________________________________

HEALTHCAREDIVE.COM - FEB 14, 2022

Nonprofits been heavily criticized (especially over the pandemic) for bringing in huge amounts of income. Last year, Kaiser’s $6.4 billion in net income was among the highest in the U.S., beating out the biggest for-profit operator, HCA Healthcare, and other nonprofit giants like Mayo Clinic. The systems, which receive generous tax breaks in exchange for providing charity care, have also faced concerns that they’re acting increasingly like for-profit corporate entities, including growing activity in venture capital and skyrocketing executive salary.

CAPITAL&MAIN — FEB 9, 2022 sweetheart deal with the largest managed-

care organization in California [and the US] may have some messy implications.

Trust in Gov. Gavin Newsom eroded with an apparent gift to a major political donor, as news broke last week of his administration’s private agreement with Kaiser Permanent

..on a new statewide Medi-Cal contract ... that will allow Kaiser to increase its Medi-Cal participation while largely continuing to hand-pick the patients it wants to take on. The deal was brokered in backrooms, and without Kaiser submitting a bid, as other providers are required to do. This is an agreement with practical consequences for some of the 13 million low-income Californians who use Medi-Cal, the state’s version of Medicaid. Kaiser would retain the ability to choose healthier patients, and local nonprofits worry that their agencies will be left with a greater percentage of the higher-risk, costlier participants in the plan, even as they lose enrollment numbers to Kaiser overall. It could affect their ability to deliver critical health services in their own areas, they say. “Offering a statewide, no-bid contract on a silver platter to a commercial plan undercuts the local public health infrastructure while paving a path for large-scale corporate health plan expansion in Medi-Cal,” said Linnea Koopmans, CEO of Local Health Plans of California, which represents 16 nonprofit health plans that account for about 70% of those in the state who are enrolled in Medi-Cal managed care….

LOS ANGELES TIMES — 30 APRIL 2021 donor-advised funds are a type of charitable account some nonprofit foundations and for-profit investment firms offer that allow greater income tax deductions, and anonymity.

..Last year, Newsom raised $226 million in behested payments, an unprecedented amount spurred by the COVID-19 pandemic and a willingness among companies and philanthropists to help fund government and charitable programs. That money was directed by Newsom to aid programs benefiting Californians during the pandemic, including to address homelessness, and a public safety campaign promoting the importance of wearing masks. State filings appears to show [Facebook as the top 2020 donor giving] $27 million for gift cards … to front-line healthcare workers and for public health ads. But a closer analysis …. by The Times [revealed the actual top donor as] Kaiser Permanente with $34.5 million [including a $9.75-million gift listed under Kaiser’s name and an additional $25 million given on Newsom’s behalf] using donor-advised funds it holds at the California Community Foundation and East Bay Community Foundation. Kaiser and Newsom’s office both promoted the $25-million gift in press releases and news conferences — the donation was directed to the governor’s program helping those experiencing homelessness. When The Times asked Kaiser why the donation was not reflected in state filings, a representative for the healthcare giant pointed The Times to the charitable organizations through which the donation was made...

4 February 2022 KHN via Medscape California Inks Sweetheart Deal With Kaiser Permanente, Jeopardizing Medicaid Reforms

10 October 2020 DK Despite COVID, “non-profit” KaiserPerm NETS $4.5billion AprJune 2020 vs mere $2B AprJun 2019 & "will do fine"

13 November 2019 DK KaiserPermanente Class Action Settlement on Mental Health Patients Forced into Medi-Cal

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