It is an old trope of the unionbusting culture in American business to claim that workers join unions and strike over greed, i.e. better pay and benefits. The fact is that workers stand together primarily for better working conditions and in the case of health care workers better patient care standards. It is in that spirit that members of the National Union of Health Care Workers scheduled a work stoppage to bring Kaiser to their position.
Kaiser agreed to better patient care announcing an agreement acceding to their caregivers demands in a statement:
Kaiser Permanente mental health clinicians represented by the National Union of Healthcare Workers have called off the strike scheduled to begin Monday, November 16. With former California State Senate President pro Tempore Darrell Steinberg acting as mediator, clinicians have reached a tentative agreement with Kaiser on a three-year contract, including agreements on the two central issues in the dispute.
Under the agreement, Kaiser clinicians — psychologists, psychiatric social workers, and marriage and family therapists — will be free to advocate for their patients and meet their treatment needs without threat of discipline or discharge. The union and Kaiser have also reached an unprecedented agreement on a 1:4 ratio of new-to-return patients to ensure timely access to ongoing mental health care for Kaiser members. Kaiser has also agreed to rescind its proposed cuts to pension benefits.
“Kaiser has opened the door to a positive working relationship with us with the goal of providing timely, quality care to our patients by hiring hundreds more mental health professionals,” said Clement Papazian, a psychiatric social worker at Kaiser Oakland and the elected president of NUHW’s Northern California chapter of Kaiser mental health clinicians. “It’s a positive first step.”
Kaiser’s mental health clinicians released a video, No More Kaiser Suicides, along with a comprehensive fact sheet outlining the need for improved care for Kaiser’s mental health patient community. The statement made it clear that their priority was patient care and safety while Kaiser resisted ostensibly in the name of profit and control.
The statement speaks for itself:
Mental health clinicians at Kaiser health facilities in Northern California — 1,500 psychologists, therapists, and psychiatric social workers, all members of the National Union of Healthcare Workers — have voted to strike until the giant HMO agrees to hire enough workers to adequately staff its psychiatric departments and ends its retaliation against whistleblowers. An overwhelming 88 percent majority of caregivers voted in support of an open-ended job action to protect their patients.
Lengthy Delays Continue Despite State Fines and Reprimands
California’s Department of Managed Health Care has raised alarms and imposed penalties on Kaiser for “serious” and “systemic” violations of state laws governing mental health care. “Despite penalties from state regulators, Kaiser has done nothing but stonewall its patients and retaliate against caregivers who dare to advocate for them,” said Clement Papazian, a psychiatric social worker at Kaiser in Oakland and president of NUHW’s Northern California chapter of Kaiser mental health clinicians. “It’s time to hold Kaiser accountable.”
The DMHC has investigated and cited Kaiser twice in two years and forced the HMO to pay a $4 million fine for violating mental health parity laws, for providing misleading information to patients and subscribers, and for falsifying records to conceal illegal appointment delays. In its second investigative report, released in February 2015, just a month after Kaiser clinicians held a weeklong statewide strike to protest Kaiser’s legal and ethical violations, the DMHC found that Kaiser’s violations continue and that the HMO failed to deliver timely care to 22 percent of its Northern California mental health patients. “That is not a good performance,” DMHC Director Shelley Rouillard told the Los Angeles Times. “Fundamentally it comes down to there are not enough providers in the Kaiser system to serve everyone who needs mental health services.”
Profits before Patients
These violations have occurred during a time of unprecedented profits for “nonprofit” Kaiser. California’s largest HMO, with more than seven million members, has made $16.6 billion since 2009, including $3.1 billion in 2014, and has a reserve of $23 billion. Enrollment has exploded since the Affordable Care Act was implemented in January 2015, boosting the HMO’s revenues while dramatically increasing demand for its mental health services.
Meanwhile, Kaiser’s mental health clinics remain vastly understaffed. Kaiser’s recent claims of staffing increases did not take into account its greatly expanded enrollment, staff attrition as clinicians buckle under ever-growing caseloads, or looming retirements — nearly 30 percent of Kaiser’s California clinicians are at or approaching retirement age.
“Kaiser’s recent hiring doesn’t even keep pace with enrollment much less address the staffing deficits we’ve been saddled with for years,” said Papazian. “It’s just the latest in a string of PR blitzes Kaiser has launched to avoid dealing with the problem while pocketing billions in profits.”
Retaliation against Clinicians and Whistleblowers
Kaiser clinicians throughout the state have been working without a contract for four years because the HMO refuses to agree to common-sense staffing levels and patient protections. Furthermore, Kaiser has retaliated against its clinicians and doctors for blowing the whistle on the company’s illegal and unethical delays of care. Among those singled out was Fremont psychologist Alex Wang who was terminated for noting “patient needs to be seen sooner” in a patient’s chart. Kaiser has also denied mental health clinicians the raises and benefits it has given to 100,000 other employees.
“Kaiser’s retaliation against its mental health clinicians for their patient advocacy is outrageous,” said NUHW President Sal Rosselli. “They’ve harassed and fired respected psychologists, withheld standard pay increases given to 100,000 other Kaiser employees, and are trying to drastically cut their retirement benefits. Kaiser is trying to intimidate and silence the caregivers who are responsible for bringing Kaiser’s failures to light, and whose criticisms have been fully affirmed and vindicated by state regulators.”
The agreement for a three-year contract will go to members for a vote in the coming weeks.