Kaiser Permanente is canceling patient appointments as a strike by its 2,000 behavioral health clinicians looms Monday, a union representing workers said in a complaint to the California Department of Managed Health Care.
The Oakland-based healthcare giant stopped booking clients at a number of behavioral health services, Fred Seavey, director of research for the National Union of Health Care Workers, said in the complaint.
In one example, Seavey pointed to an internal message from a San Leandro regional manager who said the company was not scheduling patients for intensive outpatient treatment; individual or group psychotherapy and medication management that take place over three or more days a week for several hours a day.
Seavey also showed a message from a Walnut Creek official who said all patient groups, including those for patients with severe mental illness, would be canceled one day before scheduled appointments.
“Per California law, if Kaiser does not have enough in-network clinicians to provide timely and geographically accessible care to its enrollees, it must arrange for its enrollees to receive that care from out-of-network providers without extra charge,” Seavey wrote.
Kaiser in a written statement called the union allegations “false”.
“Kaiser Permanente will prioritize the availability of urgent appointments, but will seek to keep as many appointments as possible. Some non-emergency appointments may need to be rescheduled to another day or with another provider,” spokesperson Kerri Leedy said in a statement to The Sacramento Bee.
In the complaint, Seavey provided the Department of Managed Health Care with a picture of messages from Dr. Andrew S. Corso, director of Kaiser’s intensive outpatient program in the San Leandro and Union City area, who said even members from Kaiser have recently been discharged from psychiatric hospitals and those at risk of hospitalization due to their condition may face treatment delays or cancellations.
Corso cited a patient he was trying to help, saying the individual had a slightly elevated risk of suicide and was qualified for intensive outpatient treatment, but “given the circumstances, we have no admission availability”. He said he might instead place the patient in a crisis group and consider the intensive outpatient program when the strike ends.
For months, Kaiser has come under intense scrutiny over its behavioral health services. Managed Health Care Department Director Mary Watanabe announced a surprise investigation into Kaiser’s behavioral health services in May after an increase in consumer complaints.
California hearing on mental health care
The investigation raised concerns among state senators on the Special Committee on Mental Health and Addiction last week, who wanted to know whether Kaiser and other health plans were meeting the mandates of a new law, the Senate Bill 221, which requires insurers to schedule follow-up appointments. for mental health services within 10 working days if recommended by a therapist.
Sen. Richard Pan, D-Sacramento, asked Watanabe whether the strike would raise patient expectations and what the state agency could do about it.
“You have a system that, as you noted, is not working to the norm,” Pan said, “and now they might have an additional filibuster because of a strike.”
Watanabe replied, “Strike or no strike, as regulators we are going to hold them accountable for complying with the law and the timely access standards that we have in place. … There is no authorization in the law during the strike that allows you to extend these periods.
She urged consumers to call the health department help center at 888-466-2219 to complain if Kaiser or other health plans are delaying their therapy beyond what a mental health clinician has prescribed. The agency also posted a large-print message at the top of its website’s homepage.
In addition to the state’s investigation into Kaiser’s mental health operations, Watanabe said she sent a letter to Kaiser requesting information about their strike contingency plans “and how they will respond to ensure there is no disruption to care and that consumers have access to care, including how they will arrange out-of-network care, if needed.”
It’s up to the plan to find the right care and connect the patient to it, Watanabe said, stressing that no health plan should give patients a list of providers to call.
Providers at the hearing shared internal documents showing patients were waiting up to three months or more for follow-up appointments.
A parent and patient advocate told lawmakers that Kaiser staff chastised members for their parenting, saying children wouldn’t need the care they were asking for if they were better parents, and in in some cases, Kaiser staff tried to prevent them from learning that the company was offering expensive mental health services that their loved ones needed.
Kaiser’s strike will begin on Monday
Heidi Strunk, executive director of Mental Health California, told lawmakers that even with all of her experience, she found the process exhausting and infuriating when trying to help her own family and friends.
“Unfortunately for most or all of these people, the process is daunting and/or they don’t have the time or energy to fight for the services they are entitled to,” Strunk said. “They just want help.”
Picket lines will go up Monday starting at 6 a.m. at Sacramento Medical Center, 2025 Morse Ave., Fresno Medical Center, 7300 N. Fresno St. and other Northern California locations. In the Sacramento area, NUHW members will set up picket lines at alternate sites — Roseville Medical Center, 1600 Eureka Road and South Sacramento Medical Center, 6600 Bruceville Road — on select days.
In interviews with The Bee, NUHW executives said members plan to remain on strike until the company makes changes that will allow it to provide timely access to standard-of-care care. for their practice.
In the statement, Kaiser executives said they continue to negotiate with the union and “believe the bargaining table is the best place to resolve our differences.” However, should the union go ahead with this strike, we have a comprehensive contingency plan in place to ensure our members receive the care they need.