But the strikers said the severity of the shortage was specific to Kaiser, and that burnout and poor working conditions contributed to poor retention of existing employees and made it difficult for the company to hire new ones.
“There is no shortage of clinicians. There is just a shortage of clinicians who want to work for Kaiser,” Marcucci-Morris said. “We’re getting into this field to help people, and it’s hard to recruit therapists when Kaiser’s reputation is known to make people wait so long for therapy sessions. This is really, really unethical. And I personally have a handful of colleagues and friends who are therapists with time in their schedules that I have tried to recruit for Kaiser. But the reputation is so bad.”
It is more attractive, the strikers said, for qualified therapists to work in private practice. “Workers just don’t want to work for Kaiser anymore, and that’s the real crisis we’re facing,” Marcucci-Morris said.
The union said the rate at which mental health clinicians are leaving Kaiser has nearly doubled in the past year, with 668 leaving between June 2021 and May 2022, compared to 335 the previous year. In a union survey of 200 of these departing clinicians, 85% said they were leaving because their workload was unbearable or because they felt they did not have enough time to complete the work, and 76% said they were unable to “treat patients in line with standards of care and medical necessity.’
“We need to increase the mental health workforce, there’s no doubt about that,” California state Sen. Scott Weiner told the KQED Forum. “It’s also the case that the shortage isn’t as bad right now as health plans are saying … health plans can take steps to expand their workforce, including better pay, providing better reimbursement to private providers and it’s investments that they have to do what they haven’t done.”
“I don’t think it’s the case that they can just throw up their hands and say we have some workforce challenges and so we’re going to make people wait three months,” he added. “We have a real shortage of physical health care providers, but we don’t tolerate around physical health what we’ve long tolerated about mental health, effectively denying people access to life-saving care.”
Has California passed recent laws to address this shortage?
Senate Bill 221, passed in 2021 and taking effect on July 1, 2022, states that “health plans, including Kaiser, must provide timely access to mental health and addiction treatment,” said the California state senator Scott Weiner on the KQED Forum. “And that means an immediate first visit.”
The law codifies existing regulations from the Department of Managed Health Care and the Department of Insurance that require a health service plan or insurer to ensure that “for an enrollee seeking a non-emergency appointment with a mental health care provider who is not a physician … appointments are offered within 10 business days of the appointment request.” Follow-up visits should take place within two weeks, Weiner added.
Senate Bill 858, which recently passed the California State Assembly and will now go to Gov. Gavin Newsom’s desk, would update the way health insurance companies are fined for violations, something that hasn’t been updated or even adjusted for inflation since 1970, Weiner said. Currently, the maximum possible fine is $2,500 per violation; the bill, if passed, would increase that amount to $25,000.
“We think this will create a much greater incentive to actually comply with the law and to ensure that people have timely and appropriate access to health care,” he said.
What exactly do the strikers want? What is the current status of the negotiations?
In the negotiations leading up to the strike, the National Health Workers Union accepted Kaiser’s offer of a wage increase. But the union is sticking to its demand that nine hours a week – up from the current six hours – be set aside for administrative work. Kaiser rejected this request on the grounds that it would not allow enough time to see patients. The company’s counter offer of an additional 1.2 hours for this work was flatly rejected.
“We wouldn’t be on strike right now if money came first [issue]Marcucci-Morris said, citing overwork, retention issues and poor morale — as well as what the union described as a lack of a clear plan for how the company would meet the requirements set forth by SB 221.
“We’re not going to solve the problems of buying out the therapist and paying us more.” What good is more pay when you’re drowning and can’t get air?”
How is the strike affecting patients in need of care?
Kaiser is legally obligated to continue to care for its members during a labor strike.