The strike announcement comes exactly one year after California’s top health regulator fined Kaiser a record $50 million for numerous mental health deficiencies including understaffing its mental health services
Daily picket lines and rallies will be held outside Kaiser facilities throughout Los Angeles, San Diego, Bakersfield, Orange County, and the Inland Empire.
GLENDALE, CALIFORNIA — Nearly 2,400 unionized mental health workers in Southern California are poised to start an open-ended strike, Monday, October 21, to demand that the nation’s largest non-profit HMO fix its behavioral health system that it has acknowledged to state officials forces patients to wait too long for care because it lacks sufficient staffing.
The mental health professionals, who include psychologists, social workers, psychiatric nurses, addiction medicine counselors, licensed clinical counselors and marriage and family therapists, provide behavioral health care for Kaiser’s 4.8 million members in hospitals, clinics and medical offices from San Diego to Bakersfield. Negotiations began in late July and are scheduled to continue Tuesday and Thursday of next week. Their contract expired on September 30.
“We want to be with our patients, but we can’t keep working in a system that doesn’t meet their needs and treats us like assembly line workers trying to meet a quota,” said Lisa Delgadillo, a licensed clinical social worker for Kaiser in Fontana. “We’ve been fighting Kaiser for so long, and the only action that has had an impact is an open-ended strike.”
Two years ago, Kaiser mental health therapists in Northern California, who are also represented by the National Union of Healthcare Workers, struck for ten weeks, securing a four-year contract with significantly more time for patient care duties that can’t be done during appointments and winning provisions that forced Kaiser to increase staffing and provide more services at its mental health clinics.
However, Kaiser management has refused to extend those gains to Southern California, creating in essence a two-tiered mental health system where patients in Northern California have better access to care and mental health workers have more time to meet the needs of their patients.
Currently, Kaiser staffs approximately 40 percent fewer mental health workers who provide therapy sessions 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.
Overall, Kaiser staffs approximately one therapist for every 3,000 members in Southern California compared to one therapist for every 2,000 members in Northern 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.
Kaiser therapists in Southern California are also guaranteed only two hours per week for important tasks such as responding to patient calls and emails, preparing for appointments, devising treatment plans and making notes in patient charts. In Northern California, therapists are guaranteed seven hours per week for those duties, which is much more in line with industry standards.
“I’m back-to-back all day in appointments,” said Kassaundra 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 mental health professionals who were hired by Kaiser’s Southern California region between January 2021 and September 2024 have left their positions. Of the 367 departed workers, 64 percent left Kaiser within 12 months of their hire date.
The strike announcement comes exactly 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. Kaiser was cited both for under-staffing its mental health services and for canceling 111,803 individual and group therapy appointments during the ten-week strike in Northern California.
In accepting the fine, Kaiser acknowledged that the “lack of clinical staff has resulted in excessive wait times for enrollee individual therapy appointments.” State investigators found that in 2022, less than half of follow-up therapy appointments with Kaiser therapists were completed within ten days of the prior appointment as required by state law. A union survey of Kaiser therapists in Southern California conducted this summer found that appointment wait times have actually gotten longer over the past year.
In addition to paying the fine and being forced to spend an additional $150 million to support statewide mental health programs, Kaiser was required to produce a Corrective Action Plan and “undertake a systemic overhaul and transformational change” of its mental health delivery services. However, 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’s corrective action plan won’t be worth the paper it’s printed on as long as it insists on denying us enough time to do our work, and paying us less than our peers who don’t work in mental health,” said Gena Porter, a psychiatric nurse for Kaiser in Riverside. “What we’re proposing is necessary for Kaiser to have the staffing and resources to fix its mental healthcare system, and Kaiser’s refusal to consider it shows they aren’t serious about improving care.”
Kaiser refused to start contract negotiations until July 31, and so far has rejected the workers’ three main contract planks aimed at reducing turnover and improving care:
- The same provision that Kaiser has agreed to in Northern California, which provides therapists seven hours per week for critical patient care duties as opposed to guaranteeing only two hours in Southern California.
- Fair pay that reflects the importance of mental health care. 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. This contributes to high turnover rates and undermines Kaiser’s mental health pipeline program because Kaiser employees who want to transition into mental health would lose their pension. Kaiser 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.”
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The National Union of Healthcare Workers is a member-led movement that represents 19,000 healthcare workers in California and Hawaii, including more than 4,700 Kaiser mental health professionals.
