A 10-week strike among 2,000 mental health clinicians at Kaiser Permanente facilities in Northern California drew to a close last week when the two sides reached a deal, mediated by Sacramento Mayor Darrell Steinberg.
They agreed on new contract terms with measures to help make clinicians’ workloads more manageable and to reduce wait times — union concerns that catalyzed the strike and prompted a state investigation into whether the HMO was giving patients timely access to appointments under state law.
Those who went on strike will get nearly two additional hours per week to perform tasks like responding to patient calls and emails, tailoring treatment plans and communicating with social service agencies under the deal, according to the National Union of Healthcare Workers, which represents them.
That’s the biggest win for Alexis Petrakis, a licensed clinical psychologist in the child and family program at a Bay Area Kaiser hospital, who walked off the job.
“Otherwise then you’re just in a factory of individual sessions,” Petrakis said.
Additional indirect patient care time will allow her to more thoroughly consult with patients’ parents, teachers and other figures, she said. She can also more readily field calls and emails from patients in crisis situations.
“The hardest part of my job is knowing how to help and feeling helpless,” she said.
“Not having the time or capacity to do that really wears away at your ability to sustain in a professional environment,” she said.
Under the deal made Friday, therapists will have 90 minutes to conduct initial assessments on children seeking mental health care, up from 60 minutes previously.
The system also agreed to hire more therapists and expand its crisis services to nearly all of its clinics.
Another key union win is the creation of five separate labor-management committees that will meet over the next six months to make recommendations regarding Kaiser’s service model for its behavioral health operations.
Unlike with previous committees, Kaiser will have to implement and fully fund the recommendations, and stalemates will be broken through meditation from Steinberg.
“We appreciate our therapists’ confidence in this agreement, which addresses the concerns they expressed, while upholding Kaiser Permanente’s commitment that any agreement must protect and enhance access to mental health for our members,” the system said in an email statement.
The committees will focus on getting Kaiser to comply with a state law requiring health insurers to provide patients with timely access to mental healthcare services, according to the union.
Under California law, health plans must make such appointments available within 10 business days of a patient's request, or arrange for out-of-network care. Last year Gov. Gavin Newsom signed a law ensuring that rule covers patients seeking both initial and follow-up visits.
On the week the Kaiser strike began, the HMO canceled about 1,600 follow-up therapy appointments in Northern California.
Two weeks later, the state’s Department of Managed Health Care launched an enforcement investigation into whether Kaiser health plans were providing patients with timely access to appointments amid the work stoppage.
In May, Kaiser faced another state probe into its mental health operations amid complaints from enrollees and providers about long wait times for appointments, which the union highlighted during initial bargaining sessions.
While staffing and workload issues were at the heart of the strike, clinicians also received raises under Friday’s deal.
Raises in the four-year contract mirror those agreed on prior to the strike, at 4% in the first year and 3% in the following years. In the second and fourth years staff will also receive a 1% lump sum bonus.
Bilingual therapists will also get $1.50 cents extra pay an hour, up from $1 previously.
The strike hasn’t ended yet for 50 other Kaiser mental health clinicians in Hawaii, who also walked off the job in the second week of the strike in California.
They’ve also called on Kaiser to address access-to-care issues.
The system won’t provide its Hawaii-based therapists with the same terms it gave its California-based therapist, instead offering wage freezes and retirement benefit cuts, according to NUHW.