- The California Department of Managed Health Care has launched a targeted enforcement investigation into whether Kaiser Permanente health plans are providing patients with timely access to appointments, as required by law, during a strike by mental health clinicians at the system's facilities, a DMHC spokeswoman confirmed in an email to Healthcare Dive on Sunday.
- The probe follows a complaint earlier this month by the National Union of Healthcare Workers to the DMHC that accused Kaiser Foundation Health Plan of illegally canceling behavioral health services for thousands of enrollees in Northern California in response to the impending strike by non-physician clinicians. The strike by DMHC-represented clinicians began on Aug. 15.
- Kaiser Permanente, in an emailed statement, told Healthcare Dive that it is using every resource available to ensure it meets members' mental health needs. "We welcome the opportunity to review the steps we have taken to prepare for and manage through the union’s efforts to disrupt mental health care," spokesman Marc Brown said.
The more than 2,000 mental health therapists on strike will remain off the job until Kaiser increases staffing at its clinics and ends "dangerously long" wait times for therapy sessions, according to the NUHW. The union contends Kaiser is breaking California law and violating clinical standards by making patients wait months to start therapy and four to eight weeks between appointments.
California law requires health plans to arrange for care to be provided out of network if timely access to mental health services is unavailable from in-network providers.
DMHC spokeswoman Rachel Arrezola said the department notified Kaiser on Aug. 22 that it had opened an enforcement investigation. The DMHC will continue to monitor the plan closely during the strike to ensure it is in compliance with the law, she said.
"The DMHC is concerned about the potential for immediate harm to enrollees based on the very serious nature of allegations that the plan is not providing timely appointments to enrollees required by the law," Arrezola said.
Brown said 40% of Kaiser's clinicians are caring for members instead of striking, "with more returning each day." In addition, Kaiser Permanente psychiatrists, clinical managers and other licensed clinicians have stepped in to meet with people needing care. Kaiser is also working toward agreements with hundreds of community-based mental health providers to open their schedules for at least two months to be able to treat more of Kaiser's patients, he said.
"We appreciate the DMHC’s interest and accountability in understanding how we are working to deliver clinically appropriate mental health care during NUHW’s unnecessary strike," Brown said.
Kaiser Permanente mental health clinicians in Hawaii were planning to begin a strike Monday, joining California therapists in calling for the system to address access-to-care issues.