Hundreds of NUHW-represented mental health therapists at Kaiser Permanente participated in a two-hour Town Hall earlier this month as they ramp up a campaign to protect patient care improvements they worked hard to accomplish over the past decade.
The last time NUHW’s 2,400 mental health professionals in Northern California were in contract negotiations, they waged a successful 10-week strike that secured significantly more time for patient care duties that can’t be done during therapy appointments and labor-management committees that, at least briefly, improved how Kaiser delivers behavioral health care.
Now, with their contract set to expire on September 30, Kaiser is trying to undo those improvements at the bargaining table under the guise of needing more “operational flexibility.”
Kaiser’s about-face started in 2023 — one year after the strike in Northern California — when it agreed to pay a $200 million penalty for violating California mental health laws. As part of the settlement agreement with state regulators, Kaiser agreed to a record $50 million fine and acknowledged that its clinics were understaffed and that patients were waiting too long for therapy appointments.
Rather than work with its therapists on further improvements, Kaiser abandoned the work of its labor–management committees, and imposed drastic changes in how care is provided. Kaiser recently stopped using licensed therapists to triage patients seeking mental health care in favor of telephone operators, who have no mental health training but must now determine if patients seeking help require immediate interventions.
“We’re seeing more patients with severe mental health conditions who should have gotten more immediate care but didn’t because Kaiser has removed licensed therapists from the triage process,” said Brittany Beard, a therapist at Kaiser in the Bay Area. “It’s alarming to hear Kaiser claim that it’s making improvements in its mental health services when some of the changes appear aimed at saving Kaiser money at the expense of patient care.”
Kaiser is now demanding extreme takeaways at the bargaining table, which would undo a decade of progress. Kaiser’s proposals include:
- Securing the ability to subcontract out entire segments of its mental health services and potentially lay off the in-house clinicians who provide that care. If Kaiser went through with this, it would radically change the nature of Kaiser’s mental health system, disconnecting it entirely from Kaiser’s integrated model of care and making it even more of a second-class service.
- Eviscerating the seven hours per week full-time therapists have for critical patient care duties that can’t be done during therapy sessions by allowing Kaiser to book patients into this time. Therapists went on strike three years ago to have enough time for these tasks that include calling back patients, developing treatment plans, and coordinating care because too many of them were burning out and leaving Kaiser because they couldn’t get their work done.
- Making it harder for patients to get return therapy appointments by eliminating the 1:5 ratio of new appointments to return appointments in therapists’ schedules.
- Preventing clinicians from having any voice in how Kaiser provides mental health care by completely doing away with the joint labor–management Model of Care Committees that Kaiser agreed to in the 2022 contract. Kaiser officials have said in bargaining sessions that they don’t need help from their therapists in adhering to state mental health law despite racking up $54 million in state fines over the past decade.
“If we don’t fight back, our work lives are going to be very different and there will be a degradation of patient care,” Shay Loftus, a psychologist who has been on our last three bargaining committees, told her colleagues during the Town Hall.
Kristi Reimer, a psychologist who is also on the bargaining committee, warned that Kaiser’s proposed takeaways are “unprecedented,” adding that we need to “dig deep to think of creative ways to fight back.”
While Kaiser is seeking to undo a decade’s worth of progress and open the door to laying off its own therapists, NUHW members are seeking modest improvements that would give therapists more control over their schedules to help Kaiser recruit and retain more mental health therapists.
Kaiser employs fewer therapists today than it did a year ago, despite being under state oversight in connection with the 2023 Settlement Agreement.
Therapists will soon be leafleting outside their clinics to inform patients about what’s happening at the bargaining table, with more actions forthcoming. Learn more about contract negotiations at KaiserDontDeny.org.
