Kaiser mental health workers testify at California Legislature to 'factory-like' system

SACRAMENTO (CN) — As mental health care workers are ratifying an agreement to end more than six months of striking against Kaiser Permanente facilities in Southern California, a parent, a therapist and their union president asked California lawmakers Tuesday to keep pressuring the company to improve their mental health services.

“The root of the problem is the ongoing systemic undervaluation of behavioral health care by Kaiser Permanente. Kaiser simply does not give behavioral health the same priority it does medical surgical care,” Sophia Mendoza, president of National Union of Healthcare Workers, told members of the California State Assembly on Tuesday. “There should be no difference in the priority given behavioral healthcare and medical surgical care. There should just be health care. That’s the whole principle of behavioral health parity which is required by law.”

In October 2024, 2,400 mental health therapists, psychologists, social workers and psychiatric nurses organized with NUHW at Kaiser facilities in Southern California from Bakersfield to Los Angeles and San Diego went on strike.

They demanded the company reinstate pensions and pay increases to make up for a number of years when workers didn’t get cost of living adjustments, to match their pay with other health care workers in similar positions and attract and retain workers by easing staffing issues that affect patients as well.

On Sunday, the union announced they’d reached a tentative agreement to end the strike, but while members vote on whether to agree to it, the California State Assembly’s Committee on Health hosted an informational hearing to learn more about the company’s mental health care system that one in four Californians use.

Kaiser’s model of 30-minute therapy sessions “creates a factory-like setting where both clinicians and patients feel like they’re on a conveyor belt together, rushed and pressured to watch the clock," Kassaundra Gutierrez-Thompson, a licensed clinical social worker at a Kaiser facility in Southern California, and a NUHW member, told legislators.

“This approach is not aligned to clinical standards that most therapy sessions are 45 to 50 minutes long, which provides the needed depth for effective therapy. Kaiser’s compressed format undermines the therapeutic process. Patients get short changed of the healing they deserve,” she added.

Gutierrez-Thompson said therapists often see 14 to 16 patients back-to-back, which means therapists can’t even take bathroom breaks, leading to therapists leaving their positions because of burnout.

When the state investigated Kaiser for over relying on group therapy sessions instead of more effective one-on-one sessions, the company substituted those sessions with live or prerecorded webinars instead, she added.

Milton Brown, a expert in the treatment of suicidal behaviors and an enrollee of Kaiser, testified about his daughter’s attempted suicide and subsequent delayed care.

“The biggest trauma of my adult life was when my daughter almost died by suicide and my secondary trauma was fighting Kaiser to follow the standards of care and follow the law to save my daughter’s life,” he said.

When Brown’s daughter finally received some care, she was undertreated and put into cheaper forms of treatment than what she actually needed, Brown said.

“With that huge delay they were basically willing to let her die. Egregious, egregious, egregious,” he said. “How many people have to die for Kaiser to wake up and do what’s right?”

While the tentative agreement the union has on the table with Kaiser restores employees’ cost of living increases, their wages will still be much lower than employees in Kaiser’s medical and surgical departments, Mendoza said.

“Unfortunately the tentative collective bargaining agreement does not give Southern California caregivers as much patient care time as their Northern California counterparts receive. And it doesn’t yet achieve the full parity of compensation that behavioral health technicians deserve and that is required to recruit and attain the number of clinicals Kaiser needs,” Mendoza said.

The union looked towards a successful 10-week strike of NUHW workers in Northern California in 2022 for similar grievances as a lodestar.

When the union asked why the company treats workers and patients in the northern half of the state differently than the southern half, they were eventually told it’s because of distinctions in “geographic regions,” making staff in Southern California question whether they were being discriminated against because of demographic differences in the two regions, Gutierrez-Thompson said.

To get what workers and patients need, they need to “chart a new course both at the capital and in the workplace,” Mendoza said, including advocating the passage of a bill that would make it much easier for Kaiser patients to get reimbursed for out of pocket expenses for therapy and medication. The workers also look to another bill that aims to improve transparency about wages earned by behavioral health care workers and medical and surgical care workers.

“If we are successful in helping Kaiser embrace and implement true behavioral health parity by valuing behavioral health care as much as it values medical and surgical care and by investing in it accordingly, it will be a game changer not only for these plan members, but for our state’s entire healthcare system,” Mendoza said.

Although Kaiser was invited to the hearing to hear feedback and answer questions from the committee, nobody from the company showed up, said Assemblymember Mia Bonta, the committee chair. Instead, the company sent a letter.

“I can say I’m supremely disappointed. One in four Californians are supposedly served by Kaiser in this very important space of behavioral health care,” Bonta said. “I just want to say for the record, providing a two-page letter to this legislature where we have an opportunity to actually hear directly from them and engage in conversation about their efforts to be able to support Californians is this to me,” she added, crumbling the letter in her hand.

Kaiser didn’t attend the hearing “because it would not have been a productive or balanced discussion given NUHW’s role in the hearing,” the company wrote in an email to Courthouse News.

“We will continue to provide information to the committee and any other interested parties about our ongoing work to deliver high-quality, evidence-based care in a way that is timely, convenient, easy to navigate, and meets or exceeds regulatory requirements,” it added.

In 2023, Kaiser Permanente agreed to a $200 million settlement with California to resolve investigations into its behavioral health system that found patient mental and behavioral health care was on average nine days longer than state law allows.

Mary Watanabe, the director of the state’s Department of Managed Health Care said they’d “have something to say soon” about how Kaiser was spending $150 million dollars it’s supposed to invest in improving mental health care access over five years sometime soon.

“This $150 million is not for Kaiser to fix their systemic issues with behavioral health. We call them community investments because it really is investing in some innovative approaches that support creative and innovative approaches to delivering behavioral health services across the state. I’m hoping these are things that could be scaled and implemented beyond Kaiser,” Watanabe said.