Caregivers in Southern California approved strike authorization after Kaiser rejected proposals to address staffing shortages and provide more time for critical patient care responsibilities
GLENDALE, CALIFORNIA — Kaiser Permanente psychologists, social workers, psychiatric nurses, addiction medicine counselors and marriage and family therapists in Southern California have voted overwhelmingly to authorize a strike in response to Kaiser’s refusal to address severe inequities in its behavioral healthcare system that leave patients struggling to access care that meets their needs.
The caregivers, whose contract expired on September 30, have not submitted a formal strike notice to Kaiser, and no strike date has been set as contract negotiations continue through next week. More than 80 percent of the caregivers signed the strike authorization petition.
The strike authorization by nearly 2,400 professionals who provide behavioral health care for Kaiser’s 4.8 million members in hospitals, clinics and medical offices from San Diego to Bakersfield comes nearly one year after the California Department of Managed Health Care fined Kaiser $50 million — the largest fine in state history for violating mental health parity laws.
In addition to paying the fine, Kaiser was required to produce a Corrective Action Plan and “undertake a systemic overhaul and transformational change” of its mental health delivery services. However, nearly one year later, Kaiser still has not produced a state-approved plan, while continuing to underfund and understaff its mental health system, especially in Southern California.
“Kaiser hasn’t come to the bargaining table with meaningful solutions to the massive problems we have,” said Kassaundra Gutierrez-Thompson, a Kaiser therapist based in Los Angeles, “It feels impossible to stay a good therapist in this system, so I’m ready to strike for my patients and myself.”
Kaiser has the resources to fix its mental health system. Since 2018, the HMO has reported $31 billion in profits. Yet, in a recent survey of Kaiser mental health therapists in Southern California conducted by their union, the National Union of Healthcare Workers (NUHW):
- 65 percent reported that their departments lacked enough staff to provide timely and appropriate care to patients.
- 81 percent responded that they don’t have enough time in the day for critical patient care duties that can’t be done during therapy sessions.
- 68 percent reported that weekly individual therapy appointments at their clinic were not available to those who needed it.
- 58 percent reported that they can’t see their patients every two weeks as required by state law.
Although Kaiser underfunds and understaffs its behavioral healthcare system statewide, the situation is not as bad in Kaiser’s Northern California region, where in 2022, therapists, also represented by NUHW, waged a 10-week strike that forced Kaiser to increase staffing and provide therapists more time for critical patient care tasks that can’t be done during therapy sessions.
Currently, Kaiser staffs approximately 40 percent fewer therapists in its Southern California region, which stretches from San Diego to Bakersfield than its Northern California region which includes the Central Valley, Bay Area and Sacramento – even though Kaiser has about 200,000 more members in Southern California. The shortfall forces many Southern California patients to try to find care through outside provider networks, denying them the benefits of Kaiser’s integrated care model.
Also, Kaiser therapists in Southern California get only about half as much time as their counterparts in Northern California for important tasks such as responding to patient calls and emails, preparing for appointments, devising treatment plans and making notes in patient charts.
“I’m back-to-back all day in appointments,” said Gutierrez-Thompson, who works in a Kaiser program where therapy appointments last less than 30 minutes. “I have about three minutes to look at my patients’ charts. That’s not enough. Patients are getting burned out therapists who end up leaving because this isn’t what therapy is supposed to be.”
According to Kaiser data, one-quarter of the 1,508 therapists who were hired by Kaiser’s Southern California region between January 2021 and September 2024 have left their positions. Of the 367 departed therapists, 64 percent left Kaiser within 12 months of their hire date.
Kaiser refused to start contract negotiations until July 31, and so far has rejected the caregivers three main contract planks aimed at reducing turnover and improving care:
- Equal time for patient care duties that can’t be done during appointments. While therapists in Northern California have 7 hours per week for these responsibilities without exception, their counterparts in Southern California only receive 2-4 hours.
- Fair pay. Currently, Kaiser pays its mental health professionals up to 40 percent less than non-mental health caregivers, whose jobs require less education and fewer licensing requirements.
- Restoration of pensions. Other than a small group of pharmacists, mental health professionals in Southern California hired after 2014 are Kaiser’s only employees in California, who don’t get a pension, which contributes to high turnover rates. The mental health professionals who don’t have pensions are twice as likely to leave Kaiser as those who do, union data shows.
“Everything we’re proposing in negotiations, Kaiser is already providing to the vast majority of its workforce,” said Adriana Webb, a medical social worker with Kaiser who specializes in serving patients with HIV. “If Kaiser is serious about transforming its mental health care system, it has to start by ending the inequities that harm us and our patients.”
