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Kaiser Clinicians in California Warn of Strike

EMERYVILLE, Calif. (CN) - Kaiser Permanente's 2,600 California mental health clinicians will strike statewide on Monday, Jan. 12, to protest what they call Kaiser's chronic failure to provide patients with timely, quality mental-health care.

The National Union of Healthcare Workers notified Kaiser of its intent to strike on New Year's Eve.

The union said the strike by psychologists, therapists and social workers will last a week, at more than 35 Kaiser outlets throughout California.

If it happens, it will be the nation's largest-ever mental health workers' strike.

Kaiser, a nonprofit, has reported more than $14 billion in profits since 2009, the union said in a harshly worded statement. It said that Kaiser's 2014 profits of $3 billion were 40 percent higher than the record profits it reported in 2013.

Despite these glowing numbers, the union said, "Kaiser Permanente does not staff its psychiatry departments with enough clinicians to treat the ever-growing number of patients seeking mental health care. Kaiser's systemic understaffing forces patients to endure lengthy waits for treatment - weeks and even months - in violation of California law and industry standards."

Kaiser said in a statement that it has contingency plans in place for the strike and was "disappointed" to receive the strike notice.

"A strike so soon after returning to the bargaining table is irresponsible and communicates that the union is more interested in disrupting care for thousands of members and patients and continuing its campaign to spread misinformation and disparage Kaiser Permanente's mental-health care than it is interested in bargaining constructively," Kaiser said in the statement.

Kaiser has retaliated against workers who complained of inadequate patient care, the union said in an undated report called " Kaiser's Mental Health Care Crisis ."

"Kaiser has aggressively retaliated against mental health clinicians for reporting illegal practices that jeopardize the care and safety of their patients," the union said in the report. "Kaiser has attempted to intimidate and silence clinicians by targeting them with investigations, disciplinary actions, and illegal terminations. NUHW has filed two complaints with the California attorney general regarding Kaiser's violations of the state's whistleblower protection laws."

California's Department of Managed Health Care in 2013 fined Kaiser $4 million for delaying appointment for mental health patients, understaffing its psychiatry departments and falsifying patients' appointment records to conceal the long wait times, the union said.

"It seems that Kaiser's primary way of generating income in psychiatry is to save on the labor costs," Clement Papazian, a licensed clinical social worker at Kaiser's Oakland facility and president of the NUHW's Northern California chapter of mental health clinicians told Courthouse News.

"It's just gotten to the point where it's unsustainable in almost every way. And with the national conversation almost daily being focused on mental health care services, we simply can't stand by and allow Kaiser to continue in their policies."

Paul Shaw, a licensed clinical social worker in San Francisco, said in an interview that the strike has been "a long time in coming."

"We've been in negotiations about this for over three years, and we haven't seen anything that would amount to a real solving of problems for patients," Shaw said.

"This is how we can get our message across, since they don't listen to logic and in some cases don't even listen to the Department of Managed Health Care."

During contract negotiations in December, Kaiser's mental health clinicians sought clinician-management committees in each facility who could collaborate to determine adequate staffing levels and outsourcing needs, with a third-party expert on standby to step in if the two sides came to an impasse.

Kaiser did not accommodate the request, the union says, which triggered the strike.

"We feel like they're not working with us in any kind of shared governmental fashion," Papazian said. "Historically, we've had a seat at the table, but we've essentially had no veto power.

"We want providers to have a more active role in how these services are staffed and delivered. It's a very commonsense proposal that has been done many other places, but Kaiser is extremely resistant to anything like it."

Kaiser said it's the union that's being unreasonable.

"It is troubling that following just one bargaining session - and before we have even have had the chance to meet again - the union has announced a week-long strike," Kaiser said in its statement.

Kaiser said it will meet with union officers again on Tuesday, Jan. 6.

Kaiser has 9.3 million members, making it the nation's largest HMO. Its California enrollment increased by nearly 350,000 since passage of the Affordable Care Act, and its mental health care services have become responsible for 97,000 more patients as a result of the Medi-Cal carve-in, which reduced payments for Medi-Cal care, according to the union.

Congress first addressed mental health insurance coverage in the Mental Health Parity Act of 1996, which required that group health plans' dollar limits on insurance coverage for mental health be no less than coverage for other medical procedures.

This was amended and to some extent superseded by the Mental Health Parity and Addiction Equity Act of 2008.

But mental health coverage continues to be a radioactive topic for insurers.

Since the discovery or invention in the 1980s of anti-depressant drugs that affect brain chemistry, insurers, and HMOs, by and large, have tried to shelve classic "talk therapy" for mental problems, in favor of pills.

One, because of talk therapy's long billing hours;

Two, because of talk therapy's indeterminate length - possibly lifelong;

Three, because of the impossibility of measuring its benefits; but primarily,

Four, because pills are so much cheaper.

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