Report shows violations remain uncorrected more than a year after a record fine and more than five months into the longest mental health strike in California history
Striking Kaiser workers are continuing protests this week with actions today in Pasadena and Thursday in Bakersfield
As Kaiser Permanente’s Southern California mental health strike barrels into its sixth month, the state’s main health plan oversight and enforcement agency has found that Kaiser still has not fixed long-standing deficiencies in its mental health services that for years have forced patients to wait far too long for therapy appointments in violation of state law.
The 88-page report released this week by the Department of Managed Health Care (DMHC) revealed that Kaiser has so far failed to remedy 19 of the 20 violations found in a 2022 “non-routine survey,” one of two separate investigations that led to a $200 million penalty including a $50 million fine against Kaiser in 2023, the largest such penalty in state history.
Violations cited in the report include making one patient wait 16 weeks for an initial intake appointment and forcing other patients to wait “upwards of four months” for autism services.
“This report shows why Kaiser Permanente mental health workers remain on strike,” said Sal Rosselli, president emeritus of the National Union of Healthcare Workers. “Kaiser keeps saying everything is fine when its workers know that patients can’t get the care they need because Kaiser’s services are understaffed and underfunded. Kaiser has never given mental health care the focus and funding it gives to other health services, and it’s never going to stop shortchanging patients and workers until we give it no choice but to make things better.”
The report was released Monday, during the 24th week of a strike by nearly 2,400 Kaiser mental health therapists, psychiatric nurses, social workers and psychologists, who serve 4.8 million Kaiser members in Southern California, from San Diego to Bakersfield.
With Kaiser still denying its Southern California mental health workers sufficient time for critical patient care duties, as well as salary increases and retirement benefits in line with those provided to nearly all other Kaiser employees, workers this week are staging fresh protests against the healthcare giant. After a rally in San Diego on Tuesday, workers will protest outside Kaiser Southern California headquarters in Pasadena today, and will march in Bakersfield on Thursday.
Kaiser mental health professionals, members of the National Union of Healthcare Workers, have been pressing Kaiser to fix its broken mental health care system for more than a decade, helping trigger investigations that resulted in a $4 million fine in 2013 as well as the $200 million penalty in 2023.
The new report shows that despite the record penalty, Kaiser has not corrected deficiencies that violate state mental health laws, leaving patients with substandard care both before and during the strike that began in Southern California last October, as well as during and after the Los Angeles wildfires earlier this year.
In Southern California, investigators with the agency found that Kaiser has failed to correct all but one of the violations that were found in 2022, including:
- Failing to ensure that non-urgent mental health or substance use disorder appointments are offered within 10 days after the initial request.
- Failing to promptly reschedule appointments in a manner appropriate for the enrollee’s health care needs.
- Failing to ensure that patients are offered urgent care appointments within 48 hours.
Investigators found that in a random sample of patient records, Kaiser “failed to demonstrate intake appointments were offered within 10 business days of the initial request” in 85 percent of the cases reviewed. Meanwhile, in 63 percent of cases in which patients’ appointments were canceled or missed, Kaiser “fail[ed] to promptly reschedule appointments in a manner appropriate for the enrollee’s health care needs and ensure continuity of care consistent with good professional practice.”
In Northern California, investigators also found that Kaiser has failed to correct violations that result in patients not receiving urgent or nonurgent mental health or substance use disorder appointments within required time frames, and also found that autism spectrum disorder services were not provided in a timely manner.
The ”non-routine survey,” which was triggered by double digit increases in patient complaints about Kaiser’s behavioral health services, was initiated in May 2022 and completed with field audits conducted in November of 2022. Last September, the agency issued Kaiser a preliminary report outlining each deficiency and asked Kaiser to respond. After receiving Kaiser’s responses, the agency determined that all but one of the deficiencies had not been corrected. The agency issued its final report in February, but only released it on Monday.
“These violations have been going on for years, yet with workers on strike and horrific wildfires afflicting Southern California, Kaiser Permanente continues to insist that everything is fine,” Rosselli said. “We appreciate the work that went into this report, but it won’t make a difference if regulators can’t move faster and more aggressively against violators like Kaiser. This report confirms that Kaiser has been violating mental health laws both before and during our strike, and sanctioning Kaiser three years from now won’t get patients the help they need. Care delayed is care denied, and Kaiser patients are paying the price.”
