Kaiser Mental Health Professionals Vote to Ratify Four-Year Contract
After 196-day strike in Southern California, the new contract includes several improvements, including a defined benefit pension, but does not establish full equity for behavioral health within the Kaiser system
Kaiser criticized for no-showing special State Assembly hearing Tuesday on the state of its behavioral health system
After walking picket lines for more than six months in what became the longest health strike by mental health workers in U.S. history, therapists, psychiatric nurses, social workers and psychologists employed by Kaiser Permanente in Southern California have voted overwhelmingly to ratify a contract that includes important gains for patients as well as clinicians.
The ratification vote by nearly 2,400 workers — members of the National Union of Healthcare Workers — will continue through the end of Thursday, but as of Wednesday, the tally was 1,799 to 24 — well over the simple majority necessary for ratification.
The four-year contract is retroactive to Sept. 2024 and will expire in 2028. It includes gains that should improve the experience of receiving and delivering behavioral health care at Kaiser, but does not establish equity for behavioral health within a Kaiser system that has been cited numerous times for mental health violations over the past two decades.
“These negotiations were like fighting a battle,” said Adriana Webb, a medical social worker at Kaiser and a member of the NUHW bargaining committee. “I’m proud of how we stuck together over more than six very difficult months. We didn’t win everything, but we’re coming back to work more connected than ever and with a greater understanding of the power we have as workers to protect our patients and make sure they get the care they’re entitled to.”
With respect to the three core strike issues of patient care time, wages and restoring the defined benefit pensions that Kaiser had taken away from its Southern California mental health workers a decade earlier, the contract includes:
- Five guaranteed hours per week for full-time therapists to perform critical patient care duties such as responding to patient calls and emails, making appointment notes, devising treatment plans and communicating with social service agencies.
- 20 percent raises over four years and a $2,500 ratification bonus.
- A new Cash Balance Pension Plan that guarantees retirement income unlike a 401k and shifts the financial risk of a market downturn onto the employer instead of the employee.
The terms are substantially better terms than what Kaiser was offering prior to the strike. But the wage increases will still leave mental health therapists at Kaiser making up to 50 percent less than comparable workers on the medical side, such as physical therapists. While the new defined benefit pension plan is more secure than the 401k most of the mental health workers had been receiving, it’s not as lucrative as Kaiser’s standard pension plan that nearly all other Kaiser employees receive.
With respect to patient care time, the guaranteed five-hours per week for full-time therapists is significantly better than the two hours Kaiser was providing in Southern California prior to the strike, but is still less than the seven guaranteed hours Kaiser provides for mental health therapists in Northern California.
“There’s no doubt that Kaiser remains hostile to mental health care, but this is still the best contract we’ve ever won, even though it took us more than six months to win it,” said Jim Clifford, a behavioral health counselor who has worked for Kaiser in San Diego since 2001. “We didn’t just regain a defined benefit pension, we got our biggest raises ever and more than double the amount of guaranteed time for patient care duties.”
There’s a direct correlation between how Kaiser treats its mental health professionals and the care that is available to patients. According to Kaiser’s figures, one in four Southern California therapists hired between January 2021 and August 2024 had already left Kaiser by the start of the strike. Therapists without a defined benefit pension are twice as likely to leave Kaiser as those who still had one, based on recent Kaiser data.
Under the contract, workers will get the following annual raises:
- 5.5 percent upon ratification
- 5.5 percent in October 2025
- 5 percent in October 2026
- 4 percent in October 2027
Workers who speak a second language will get an additional $1.50 per hour – a 50 cent per hour increase over the previous contract.
Workers weren’t seeking anything more than what Kaiser was already providing other employees. Despite the modest requests, negotiations progressed slowly with Kaiser refusing to begin talks until late July and then not
bargaining at all between late October and mid-January. Negotiations finally picked up over the last two weeks, with the help of mediators former California Health Secretary Dr. Mark Ghaly and former Sacramento Mayor Darrell Steinberg, after eight workers held a five-day hunger strike.
“I’m proud that we took a stand for mental health care and made gains for ourselves and patients,” said Lourdes Cortez, a social worker for Kaiser in Bakersfield. “We stood up to a behemoth, and we kept fighting for as long as it took to get a contract we can build upon and make more progress toward full mental health parity moving forward.”
Kaiser criticized in special legislative hearing
The struggle to achieve parity for mental health care at Kaiser is far from over. NUHW is sponsoring two mental health parity bills in the state legislature.
AB 1429, a bill authored by Assemblymember Dr. Jasmeet Bains, D-Delano, would make it much easier for Kaiser patients to get fully reimbursed for out-of-pocket mental health expenses, including therapy and medication, that they couldn’t get directly from Kaiser.
SB 747, a bill authored by State Sen. Scott Wiener, D-San Francisco, is aimed at providing transparency about the disparity in compensation between behavioral health workers and comparable workers who provide medical/surgical care.
On Tuesday, the Assembly Health Committee held a two-hour informational hearing on Kaiser’s mental health services during which several legislators voiced concern about Kaiser not providing timely, appropriate care. Kaiser refused to participate in the hearing, instead providing a two-page letter that Assemblymember Mia Bonta, the committee chairperson, crumpled into a ball, after expressing her disappointment in Kaiser’s absence.
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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.
