After walking picket lines for more than six months in what became the longest health strike by mental health workers in U.S. history, NUHW-represented mental health workers 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 final vote was 1,937 to 31 in favor of ratification. The settlement was covered by numerous news outlets including: Capital & Main, ABC10, KPBS, San Diego Union-Tribune, The EastsiderLA, Times of San Diego, Silicon Valley, Healthcare Dive, LAist, Courthouse News.
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 it’s 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 were twice as likely to leave Kaiser as those who still had one.
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 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.”
