Kaiser Therapists Take Key Step Toward 1-Day Strike

Mental health clinicians at Kaiser locations throughout Northern California are voting through Saturday to decide whether to hold a one-day strike this spring over proposed changes to care protocols they say will diminish their working conditions or harm patients.

About 2,400 therapists and social workers, represented by the National Union of Health Care Workers, have been negotiating their next contract since June, with talks reaching an impasse in recent months.

“We all find ourselves confronting a Kaiser that no longer seeks input from its caregivers,” said Shay Loftus, a psychologist at Kaiser in Fairfield. “Kaiser management wants us to be cogs in their machine, but that’s not how health care, especially mental health care, works best for patients.”

The small but mighty union has a track record of forcing improvements to working conditions and patient care through its advocacy. This has included backing laws that mandate shorter wait times for individual therapy at Kaiser and going on strike for 10 weeks in 2022 to secure more time in their schedules for administrative work, like calling patients or reviewing charts.

They say Kaiser is now trying to claw back both of those wins in the current contract, in addition to setting the stage for laying off therapists or replacing them with artificial intelligence.

But the union’s top complaint centers on a new system Kaiser rolled out for triaging mental health patients in 2024 that replaces intake clinicians with unlicensed phone operators or an e-visit, where an algorithm determines the level of care based on questions the patient answers in an app or online.

Therapists say patients are funneled into non-urgent therapy when they should have been directed to intensive services or the hospital.

“Telephone service reps book people in completely inappropriate slots,” said Molly Parsons, an individual and couples therapist at Kaiser’s Pleasanton clinic. “It delays care and potentially harms patients who need immediate interventions.”

The two sides are not yet aligned on wage increases, which are typically negotiated last, but the union said this strike is about seeking agreement on the non-economic issues first. A spokesperson said the union is still engaged in sporadic bargaining sessions with Kaiser and is set to meet with the company for another session next week.

In a statement, Kaiser said that AI tools are designed to “support — not replace — human judgment and care,” and that technology is evaluated for performance, safety, clinical usability, accuracy, equitability and satisfaction.

“We believe AI has the potential to help clinicians and employees spend more time focused on patient care, improve the patient experience, and enhance fairness and quality in health outcomes,” spokesperson Lena Howland said via email. “Human assessment and clinical expertise always guide care delivery.”

The union will finalize voting to authorize the strike over the weekend and said as of Thursday, about 70% of the membership had cast votes.

If it garners member support, the union plans to schedule the work stoppage for later in March. They must give 10 days’ advance notice.

After striking for 10 weeks without pay over their last contract, then seeing their sister union in Southern California call an open-ended strike that lasted more than six months, appetite for anything more than a one-day walkout was low this time around.

“It doesn’t seem like members are that jazzed about an ongoing, open-ended strike,” Parsons said. “There’s a fear, not only for how that would impact us as clinicians, but a fear of how it would impact our clients and patient care. And so, a one-day strike, we’re hoping to get more people involved.”

That will have less negative impact on patients, she added, “but it will show Kaiser that we’re serious about this.”

KQED’s Katie DeBenedetti contributed to this report.