Therapists say system routinely results in patients at risk of suicide not getting immediate and appropriate care
Striking Kaiser therapists are continuing a five-day hunger strike today in Los Angeles
When a Kaiser patient in Southern California needs medical attention, they can call an advice nurse, who’s trained to connect them with appropriate care. But when it comes to mental health care, Kaiser connects patients with an unlicensed clerical worker who determines their treatment needs by asking a series of “Yes or No” questions and running the answers through a computer algorithm — in violation of state law.
In a complaint filed today, the National Union of Healthcare Workers, which represents 2,400 Kaiser mental healthcare workers now in their sixth month of a strike in Southern California, is requesting that the California Department of Managed Health Care order Kaiser to immediately stop the practice in Southern California and impose further penalties against the giant HMO.
The complaint is based on structural changes implemented by Kaiser as well as feedback from Kaiser therapists who report routinely being assigned patients whose conditions are far too severe for their clinical programs, including patients who are at risk of suicide.
“It is a frighteningly common occurrence to be assigned a patient and quickly realize that their conditions are far too severe to be in our program and that they should have received immediate services,” said Zhane Sandoval, a psychiatric counselor in Kaiser’s ADAPT Program, which provides 25-minute telehealth therapy sessions for patients with mild-to-moderate mental health conditions.
“As therapists, we see how Kaiser doesn’t view mental health care as equally important to medical care, and that’s why we’re so determined to win this strike, and make Kaiser do right by all of its patients,” added Sandoval, who is one of eight therapists participating in a five-day hunger strike this week outside of Kaiser’s Los Angeles Medical Center.
The complaint comes just two weeks after the California Department of Managed Health Care issued an 88-page report finding that Kaiser has so far failed to correct 19 of 20 deficiencies in its mental health services dating back to a 2022 investigation, which contributed to a record $50 million fine.
One of Kaiser’s uncorrected violations in Southern California is connected to its deficient triaging of patients who call for help with mental health conditions. The agency found that Kaiser lacks “sufficient level of oversight to ensure enrollees receive suicide risk screening, assessment, and treatment consistent with professionally recognized standards of practice.”
Although Kaiser has not been directly cited by state authorities for using unlicensed clerical workers and algorithms to triage mental health patients, there is little ambiguity that it is a violation of state law.
California’s Health and Safety Code states that health plans must provide for 24/7 triage (screening) services by telephone, which is defined as “communication with a physician, registered nurse, or other qualified health professional acting within their scope of practice and who is trained to screen or triage an enrollee who may need for the purpose of determining the urgency of the enrollee’s need for care.”
An unlicensed staff person may handle calls to ask questions on behalf of a licensed staff person to help ascertain the condition of the patient seeking care. However, California law states that “an unlicensed staff person shall not, under any circumstances, use the answers to those questions in an attempt to assess, evaluate, advise or make a decision regarding the condition of an enrollee or determine when an enrollee needs to be seen by a licensed medical professional.”
“This is yet another example of Kaiser Permanente putting patients at risk by refusing to provide the same level of care to those with mental health conditions as it does to those with medical conditions,” NUHW President Emeritus Sal Rosselli said. “Kaiser can’t claim it’s providing parity for mental health care when somebody with a fever gets to talk to a nurse, but somebody having thoughts of ending their life is directed to a clerical worker feeding an algorithm. Instead of working with us to improve care, Kaiser looks for shortcuts to save money and deny patients the services they’re paying to receive.”
Hunger Strike Continues Tuesday in Los Angeles
With Kaiser mental health therapists, psychiatric nurses, social workers and psychologists now in the 25th week of an open-ended strike, the focus is squarely on Kaiser’s Los Angeles Medical Center where eight strikers are holding a 5-day hunger strike. The workers on the hunger strike will be visited by supporters every day this week and are available to speak with reporters.
- Today; Wednesday, April 9; and Thursday, April 10 from 10 a.m. to 6 p.m.
- Friday, April 11 from 8 a.m. to 6 p.m.
WHERE: Kaiser Permanente Los Angeles Medical Center, 4867 W. Sunset Boulevard, Los Angeles
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The National Union of Healthcare Workers is a member-led movement that represents 19,000 healthcare workers in California and Hawai’i, including more than 4,700 Kaiser mental health professionals.
