Kaiser canceling California mental health appointments as strike looms, union leaders say

Cathie Anderson

Kaiser Permanente is canceling appointments for patients as a strike by its 2,000 behavioral health clinicians looms Monday, a union representing the workers reported in a complaint to the California Department of Managed Health Care.

The Oakland-based health care giant stopped booking clients in a number of behavioral health services, said Fred Seavey, the research director for the National Union of Health Care Workers, in the complaint.

In one example, Seavey pointed to an internal message from a San Leandro area manager who said the company is not scheduling patients for intensive outpatient treatment; individual or group psychotherapy, and medication management that occurs over three or more days a week for several hours a day.

Seavey also showed a message from a Walnut Creek manager who said that all patient groups, including those for patients with serious mental illness, would be canceled a day ahead of scheduled appointments.

“Per California law, if Kaiser doesn’t have sufficient in-network clinicians to provide timely and geographically accessible care to its enrollees, it must arrange for its enrollees to receive such care from out-of-network providers at no additional cost,” Seavey wrote.

Kaiser in a written statement called union allegations “not true.”

“Kaiser Permanente will prioritize ensuring availability of urgent appointments but will seek to keep as many appointments as possible. Some non-urgent appointments may need to be rescheduled for another day or with another provider,” spokesman Kerri Leedy said in a statement to The Sacramento Bee.

In the complaint, Seavey supplied the Department of Managed Health Care with a photo of messages from Dr. Andrew S. Corso, the manager of Kaiser’s Intensive Outpatient Program in the San Leandro and Union City area, which stated that even Kaiser members recently discharged from psychiatric hospitals and those at risk of hospitalization due to their conditions could experience treatment delays or cancellations.

Corso cited one patient he was trying to help, saying the individual had a slightly elevated risk of suicide and qualified for intensive outpatient treatment but “given the circumstances we don’t have intake availability.” He said he could put the patient in a crisis group instead and consider the intensive outpatient program when the strike ended.

Kaiser for months has faced scrutiny over its behavioral health services. Department of Managed Health Care Director Mary Watanabe in May announced a surprise probe into Kaiser’s behavioral health services after an increase in consumer complaints.

California hearing on mental health care

The investigation raised concerns for state senators on the Select Committee on Mental Health and Addiction last week, who wanted to know whether Kaiser and other health plans were meeting mandates of a new law, Senate Bill 221, that requires insurers to schedule follow-up appointments for mental health services within 10 business days if a therapist recommends it.

Sen. Richard Pan, D-Sacramento, asked Watanabe whether the strike would exacerbate patient waits, and what the state agency could do about it.

“You have a system, which as you noted, is actually not performing to the standard,” Pan said, “and now they might have further obstruction because of a strike.”

Watanabe replied: “Strike or no strike, as the regulator, we’re gonna hold them accountable to following the law and the timely access standards that we have in place. ... There’s no allowance in the law during the strike that you get to extend those time periods.”

She urged consumers to call the health department’s help center at 888-466-2219 to complain if Kaiser or other health plans delay their therapy beyond what a mental health clinician has prescribed. The agency also has posted a message in large print at the top of its website homepage.

In addition to the state probe into Kaiser’s mental health operations, Watanabe said she sent a letter to Kaiser requesting information on their strike contingency plans “and how they will respond to ensure that there’s not a disruption in care and that consumers are accessing care, including how they will arrange for care out of network, if needed.”

It is the plan’s responsibility to find the appropriate care and connect the patient to it, Watanabe said, stressing that no health plan should be giving patients a list of providers to call.

Providers at the hearing shared internal documents showing that patients were waiting as long as three months or more for follow-up appointments.

A parent and a patient advocate told the lawmakers that Kaiser personnel had chided members for their parenting, saying children wouldn’t need the care they were demanding if they were better parents, and in some cases, Kaiser personnel tried to keep them from learning that the company offered pricey mental health services that their loved ones needed.

Kaiser strike to begin Monday

Heidi Strunk, the chief executive officer of Mental Health California, told legislators that even with all her experience, she has found the process exhausting and infuriating when she has tried to help her own family and friends.

“Unfortunately for most or all these people, the process is intimidating and/or they don’t have time or energy to fight for their entitled services,” 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 sites. In the Sacramento region, NUHW members will be setting up picket lines at alternate sites — Roseville Medical Center, 1600 Eureka Road, and South Sacramento Medical Center, 6600 Bruceville Road — on some days.

In interviews with The Bee, NUHW leaders said members plan to remain on strike until the company makes changes that will assure it can provide timely access to care that meets the standard of care for their practice.

In the statement, Kaiser leaders 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 move forward with this strike, we have a comprehensive contingency plan in place to ensure that our members receive the care they need.”