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"content": "\u003cp>\u003cspan style=\"font-weight: 400\">The health care industry has often been slow to adopt new technology — but not when it comes to AI. And as Kaiser Permanente’s mental health clinicians in Northern California negotiate their latest contract with the company, they’re looking for reassurance that AI isn’t coming for their jobs.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Links:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003ca href=\"https://www.kqed.org/science/1999553/will-ai-replace-your-therapist-kaiser-wont-say-no\">Will AI Replace Your Therapist? Kaiser Won’t Say No\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm?e=KQINC3808554854\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">Some members of the KQED podcast team are represented by The Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco-Northern California Local.\u003c/span>\u003c/i>\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:00:00] I’m Ericka Cruz Guevarra and welcome to The Bay, local news to keep you rooted. So I went to the doctor’s the other day, and as expected, the nurse asked some pretty basic questions. How tall am I? Do I exercise? Any history of cancer in the family? Then, when the doctor walked in, she asked a pretty surprising question. Would it be okay if they used some sort of automated transcriber to take notes on my visit? An automated transcriber, as in AI, I asked. Turns out AI is everywhere, including in the doctor’s office. Some in the healthcare industry say AI is making their lives easier. But others, like the mental healthcare workers at Kaiser are also worried that it could replace them entirely.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:01:05] A lot of our members are afraid that it’s going to shift into full-blown therapy, right? That there are going to be new technologies that allow Kaiser to provide, you know, chat-based mental health care.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:01:20] Today, will AI replace your therapist? And why the debate at Kaiser is worth watching.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:01:38] Health care is an industry that is usually pretty slow to adopt new technology, but the experts that I talk to say that AI is different.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:01:49] April Dembosky is a healthcare correspondent for KQED.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:01:52] Health systems are really excited about the potential that AI has primarily in this moment to improve diagnostics, but also to cut down on paperwork and administrative tasks. So if you go see a medical doctor at Sutter or Kaiser right now, very likely you have been or very soon will be asked if it’s okay for the doctor to use an AI note taker where they will use their cell phone. To record the interaction and then the AI will summarize and write notes for your medical chart.\u003c/p>\n\u003cp>\u003cstrong>The Pitt \u003c/strong>[00:02:29] I have an app on my phone that can listen to our conversation and the details of my physical exam and write it all up in your medical record. Wow.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:02:39] If folks out there are watching The Pitt, this actually came up in episode two. So the episode that just came out last week. So there’s a new doctor in the ER and she’s introducing the residents to the concept of AI note takers.\u003c/p>\n\u003cp>\u003cstrong>Doctor (The Pitt) \u003c/strong>[00:02:55] What do you think?\u003c/p>\n\u003cp>\u003cstrong>Medical Student (The Pitt) \u003c/strong>[00:02:56] Well, I don’t think it’s a cardiac.\u003c/p>\n\u003cp>\u003cstrong>Doctor (The Pitt) \u003c/strong>[00:02:58] I mean, what do you think of the app?\u003c/p>\n\u003cp>\u003cstrong>Medical Student (The Pitt) \u003c/strong>00:03:00] I mean, it’s hard to say without seeing the full thing.\u003c/p>\n\u003cp>\u003cstrong>Doctor (The Pitt)\u003c/strong> [00:03:02] Take a look.\u003c/p>\n\u003cp>\u003cstrong>Medical Student (The Pitt) \u003c/strong>[00:03:04] Oh my God, do you know how much time this will save?\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:03:07] And so she takes out her cell phone in the exam room and tells a patient, you know, it’s going to record their interaction. And afterward they walk out, they walk over to a computer and the AI has already written a summary of the exam in the patient’s chart.\u003c/p>\n\u003cp>\u003cstrong>Medical Student (The Pitt) \u003c/strong>[00:03:24] Well, excuse me, it says here she takes risperdol and antipsychotics. She takes restoril when needed for sleep, so is that, um…\u003c/p>\n\u003cp>\u003cstrong>Medical Student (The Pitt) \u003c/strong>[00:03:31] AI, almost intelligent.\u003c/p>\n\u003cp>\u003cstrong>Doctor (The Pitt)\u003c/strong> [00:03:34] You must always carefully proofread and correct the minor errors. It’s excellent, but not perfect.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:03:44] That’s one of the ways that AI is most present in our healthcare right now. I mean, I have friends in the Bay Area who work in healthcare who, you know, I saw some for dinner a little while ago and you know they said, I am here tonight because of the AI note taker. You know, like because the AI notetaker like did my charting for me, I am able to be here and hanging out with you.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:04:12] Wow, that is so interesting. And yeah, I mean, we’re wrestling with the role of AI in our healthcare and popular culture, but also in real life right now. I know this is a big, big question that is especially relevant for mental healthcare workers in Northern California right now, specifically at Kaiser. Can you explain? April, why this is such a relevant conversation among mental health care workers right now in particular.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:04:44] Sure, so mental health clinicians at Kaiser are in contract negotiations right now. They’ve actually been in bargaining for this next contract for about six months now. So it’s been kind of dragging along. And one of the sticking points is actually around AI. So, mental health workers, they know that AI is here to stay in health care, but when it comes to mental health care they want some simple guardrails. They want to make sure that they are part of seeing that AI is rolled out responsibly in a way that protects patients’ privacy, but also in a ways that protects their own jobs. And so one of the things that they’ve asked for in their contract is language that says specifically any introduction of new AI tools will be used only to assist therapists, but it will not be used to replace them. To them, I think this sounds like a really reasonable ask, but they were really surprised when Kaiser said no.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:06:00] So again, they want flexibility to increase their use of AI.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:06:06] I talked to Ilana Marcucci-Morris. She’s a clinical social worker at Kaiser. She works in the intake department, and she’s a member of the union that is bargaining this contract. It’s called the National Union of Health Care Workers, NUHW.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:06:22] When we ask that AI not replace us, they will not put that language in.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:06:28] And when I talk to her, she says, I’m a millennial, I love gadgets, I love tools, you know, I get it. We just want some simple protections here.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:06:37] A lot of our members are afraid that it’s going to shift into full blown therapy, right? That there are going to be new technologies that allow Kaiser to not just skip the licensed triage, but to provide, you know, chat based mental health care.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:06:54] One of the reasons they’re surprised is because their sister union in Southern California had asked for the same language and Kaiser agreed to it. And that contract was signed last May. And so basically, you know, a month or so after signing a contract that included this language, Kaiser was backing off saying, we don’t wanna commit to that anymore.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:07:20] I mean, they’ll say, no, that’s not our intention. But when we say, hey, can you put that it’s not your intention in the contract? Well, we can’t predict the future. We need to maintain flexibility.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:07:38] So it sounds like these mental health care workers are afraid for their jobs, but some of this technology is already being used. What is it about these tools that they are so concerned about?\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:07:54] Basically, Kaiser is excited about getting clinicians to use this note-taking software so that it will free them up to see more patients in a day. But clinicians are really worried about this. I think they’re worried about the privacy and data security, where are these recordings going, how long are they kept, how well are they protected, who else can see them. But specifically, I think they’re also really concerned about how this technology could influence the patient interaction.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:08:27] I wouldn’t want a recording of my disagreements with a family member or my trauma.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:08:34] And so what Ilana says is talking to your doctor about a fever or a skin condition, it’s really different from talking to your therapist about really vulnerable, really emotional things that are going on in your life. And they’re concerned that patients, if they know they’re being recorded, that it might cause them to hold back.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:09:00] A big part of our work is that human connection and rapport.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:09:08] So Kaiser clinicians are basically saying, look, you know, right now this technology is optional for us to use, but we’re really worried that Kaiser is going to, you know, try to force us to use it, perhaps even in clinical situations where we think it could be harmful.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:09:27] Having a human being in your court that is trained and is a professional giving you warmth and encouragement and evidence-based direction is something that technology just can’t replace.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:09:44] AI has already taken roles that people used to have at Kaiser, like doing intake for mental health care. Patients now have the option of doing an e-visit through the app, where you click through a series of questions and the algorithm comes up with a score and recommends where you go next. So far, there isn’t a Kaiser therapist chatbot. Though it hasn’t stopped a lot of people from seeking help for their problems outside of the healthcare system altogether. And April, we’re also in an environment where many people are seeking out mental health help through chatbots, including teenagers. Are patient preferences around this changing as well? And how do mental health experts respond to that?\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:10:40] In the last few years, we’ve seen a huge rise of consumer facing chatbots and these are not therapists to be clear, but people are starting to use them as therapists. This is a trend that is already taken off because they are available immediately. You can tell them how to interact with you and they are always there. There are clinical psychologists who have. You know, been working on a verified evidence-based, widely tested kind of AI chat bot for therapy for at least six years now. And what they will tell you is it takes a really, really long time to develop a proven product like that, that, you know actually conforms to the standards of delivering therapy.\u003c/p>\n\u003cp>\u003cstrong>Jodi Halpern \u003c/strong>[00:11:33] We cannot institute any of this on a large scale population level without studying it first and making sure it’s safe.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:11:42] Jodi Halpern is a bioethics professor at UC Berkeley. Jodi Helpern talks about the potential that chatbots have in cognitive behavioral therapy, which is a particular kind of therapy that tends to be a little bit more formal, a little more formulaic, but she’s very circumspect when it comes to relational therapy.\u003c/p>\n\u003cp>\u003cstrong>Jodi Halpern \u003c/strong>[00:12:04] In the meeting with an empathic human face-to-face, there is the possibility for the patient really to develop trust. And that’s actually a powerful element in improving health outcomes.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:12:20] Chatbots are not very good at this, especially consumer-facing chatbots are designed to be affirmative. Sycophantic is the word that experts use. They’re just designed to validate everything you say.\u003c/p>\n\u003cp>\u003cstrong>Jodi Halpern \u003c/strong>[00:12:40] We need more skillful human workforce in the mental health area to meet our unmet needs. We need AI to unburden the skillful human force through ambient medical records and other forms that don’t have to be intrusive or overly privacy invading, but they can take the workload off clinicians.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:13:06] Coming back to Kaiser, April, many of their employees are already using AI. No Kaiser AI therapists as of now, although many of the workers like Alana are worried that there could be. Has Kaiser had any response to this story or any thoughts on AI or contract negotiations that they’ve shared with you?\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:13:28] Kaiser has not had a lot to say about this. I’ve interacted with them a fair amount asking for interviews multiple times, and they have not been willing to sit down and talk about this, they shared a statement. It says in part that artificial intelligence tools at Kaiser don’t make medical decisions. Our physicians and care teams are always at the center of decision-making with our patients. AI does not replace human assessment and care, but they do see artificial intelligence holding, as they say, significant potential to benefit healthcare by supporting better diagnostics, enhancing patient-clinician relationships, optimizing clinicians’ time, and ensuring fairness in care experiences and health outcomes by addressing individual needs.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:14:23] And I mean, it does seem like consumer trends around AI are one thing, April, but it also seems like these sort of large healthcare systems like Kaiser have a really big role to play in terms of the role that AI could play in the future as well. I mean why do you think it’s important to watch what Kaiser does from here?\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:14:48] Kaiser is a large healthcare institution. It has power. It can influence how quickly and how broadly new technologies are adopted in a way that could have impact on the industry as a whole. And it’s also one of the very few systems that has a mental health union that’s trying to influence that process. So I think that those things put together just make it a really interesting health system to watch. For the way that that influence works on how patients access healthcare and how mental health clinicians do their jobs.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">The health care industry has often been slow to adopt new technology — but not when it comes to AI. And as Kaiser Permanente’s mental health clinicians in Northern California negotiate their latest contract with the company, they’re looking for reassurance that AI isn’t coming for their jobs.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Links:\u003c/span>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003ca href=\"https://www.kqed.org/science/1999553/will-ai-replace-your-therapist-kaiser-wont-say-no\">Will AI Replace Your Therapist? Kaiser Won’t Say No\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm?e=KQINC3808554854\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">Some members of the KQED podcast team are represented by The Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco-Northern California Local.\u003c/span>\u003c/i>\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:00:00] I’m Ericka Cruz Guevarra and welcome to The Bay, local news to keep you rooted. So I went to the doctor’s the other day, and as expected, the nurse asked some pretty basic questions. How tall am I? Do I exercise? Any history of cancer in the family? Then, when the doctor walked in, she asked a pretty surprising question. Would it be okay if they used some sort of automated transcriber to take notes on my visit? An automated transcriber, as in AI, I asked. Turns out AI is everywhere, including in the doctor’s office. Some in the healthcare industry say AI is making their lives easier. But others, like the mental healthcare workers at Kaiser are also worried that it could replace them entirely.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:01:05] A lot of our members are afraid that it’s going to shift into full-blown therapy, right? That there are going to be new technologies that allow Kaiser to provide, you know, chat-based mental health care.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:01:20] Today, will AI replace your therapist? And why the debate at Kaiser is worth watching.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:01:38] Health care is an industry that is usually pretty slow to adopt new technology, but the experts that I talk to say that AI is different.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:01:49] April Dembosky is a healthcare correspondent for KQED.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:01:52] Health systems are really excited about the potential that AI has primarily in this moment to improve diagnostics, but also to cut down on paperwork and administrative tasks. So if you go see a medical doctor at Sutter or Kaiser right now, very likely you have been or very soon will be asked if it’s okay for the doctor to use an AI note taker where they will use their cell phone. To record the interaction and then the AI will summarize and write notes for your medical chart.\u003c/p>\n\u003cp>\u003cstrong>The Pitt \u003c/strong>[00:02:29] I have an app on my phone that can listen to our conversation and the details of my physical exam and write it all up in your medical record. Wow.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:02:39] If folks out there are watching The Pitt, this actually came up in episode two. So the episode that just came out last week. So there’s a new doctor in the ER and she’s introducing the residents to the concept of AI note takers.\u003c/p>\n\u003cp>\u003cstrong>Doctor (The Pitt) \u003c/strong>[00:02:55] What do you think?\u003c/p>\n\u003cp>\u003cstrong>Medical Student (The Pitt) \u003c/strong>[00:02:56] Well, I don’t think it’s a cardiac.\u003c/p>\n\u003cp>\u003cstrong>Doctor (The Pitt) \u003c/strong>[00:02:58] I mean, what do you think of the app?\u003c/p>\n\u003cp>\u003cstrong>Medical Student (The Pitt) \u003c/strong>00:03:00] I mean, it’s hard to say without seeing the full thing.\u003c/p>\n\u003cp>\u003cstrong>Doctor (The Pitt)\u003c/strong> [00:03:02] Take a look.\u003c/p>\n\u003cp>\u003cstrong>Medical Student (The Pitt) \u003c/strong>[00:03:04] Oh my God, do you know how much time this will save?\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:03:07] And so she takes out her cell phone in the exam room and tells a patient, you know, it’s going to record their interaction. And afterward they walk out, they walk over to a computer and the AI has already written a summary of the exam in the patient’s chart.\u003c/p>\n\u003cp>\u003cstrong>Medical Student (The Pitt) \u003c/strong>[00:03:24] Well, excuse me, it says here she takes risperdol and antipsychotics. She takes restoril when needed for sleep, so is that, um…\u003c/p>\n\u003cp>\u003cstrong>Medical Student (The Pitt) \u003c/strong>[00:03:31] AI, almost intelligent.\u003c/p>\n\u003cp>\u003cstrong>Doctor (The Pitt)\u003c/strong> [00:03:34] You must always carefully proofread and correct the minor errors. It’s excellent, but not perfect.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:03:44] That’s one of the ways that AI is most present in our healthcare right now. I mean, I have friends in the Bay Area who work in healthcare who, you know, I saw some for dinner a little while ago and you know they said, I am here tonight because of the AI note taker. You know, like because the AI notetaker like did my charting for me, I am able to be here and hanging out with you.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:04:12] Wow, that is so interesting. And yeah, I mean, we’re wrestling with the role of AI in our healthcare and popular culture, but also in real life right now. I know this is a big, big question that is especially relevant for mental healthcare workers in Northern California right now, specifically at Kaiser. Can you explain? April, why this is such a relevant conversation among mental health care workers right now in particular.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:04:44] Sure, so mental health clinicians at Kaiser are in contract negotiations right now. They’ve actually been in bargaining for this next contract for about six months now. So it’s been kind of dragging along. And one of the sticking points is actually around AI. So, mental health workers, they know that AI is here to stay in health care, but when it comes to mental health care they want some simple guardrails. They want to make sure that they are part of seeing that AI is rolled out responsibly in a way that protects patients’ privacy, but also in a ways that protects their own jobs. And so one of the things that they’ve asked for in their contract is language that says specifically any introduction of new AI tools will be used only to assist therapists, but it will not be used to replace them. To them, I think this sounds like a really reasonable ask, but they were really surprised when Kaiser said no.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:06:00] So again, they want flexibility to increase their use of AI.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:06:06] I talked to Ilana Marcucci-Morris. She’s a clinical social worker at Kaiser. She works in the intake department, and she’s a member of the union that is bargaining this contract. It’s called the National Union of Health Care Workers, NUHW.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:06:22] When we ask that AI not replace us, they will not put that language in.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:06:28] And when I talk to her, she says, I’m a millennial, I love gadgets, I love tools, you know, I get it. We just want some simple protections here.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:06:37] A lot of our members are afraid that it’s going to shift into full blown therapy, right? That there are going to be new technologies that allow Kaiser to not just skip the licensed triage, but to provide, you know, chat based mental health care.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:06:54] One of the reasons they’re surprised is because their sister union in Southern California had asked for the same language and Kaiser agreed to it. And that contract was signed last May. And so basically, you know, a month or so after signing a contract that included this language, Kaiser was backing off saying, we don’t wanna commit to that anymore.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:07:20] I mean, they’ll say, no, that’s not our intention. But when we say, hey, can you put that it’s not your intention in the contract? Well, we can’t predict the future. We need to maintain flexibility.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:07:38] So it sounds like these mental health care workers are afraid for their jobs, but some of this technology is already being used. What is it about these tools that they are so concerned about?\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:07:54] Basically, Kaiser is excited about getting clinicians to use this note-taking software so that it will free them up to see more patients in a day. But clinicians are really worried about this. I think they’re worried about the privacy and data security, where are these recordings going, how long are they kept, how well are they protected, who else can see them. But specifically, I think they’re also really concerned about how this technology could influence the patient interaction.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:08:27] I wouldn’t want a recording of my disagreements with a family member or my trauma.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:08:34] And so what Ilana says is talking to your doctor about a fever or a skin condition, it’s really different from talking to your therapist about really vulnerable, really emotional things that are going on in your life. And they’re concerned that patients, if they know they’re being recorded, that it might cause them to hold back.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:09:00] A big part of our work is that human connection and rapport.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:09:08] So Kaiser clinicians are basically saying, look, you know, right now this technology is optional for us to use, but we’re really worried that Kaiser is going to, you know, try to force us to use it, perhaps even in clinical situations where we think it could be harmful.\u003c/p>\n\u003cp>\u003cstrong>Ilana Marcucci-Morris \u003c/strong>[00:09:27] Having a human being in your court that is trained and is a professional giving you warmth and encouragement and evidence-based direction is something that technology just can’t replace.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:09:44] AI has already taken roles that people used to have at Kaiser, like doing intake for mental health care. Patients now have the option of doing an e-visit through the app, where you click through a series of questions and the algorithm comes up with a score and recommends where you go next. So far, there isn’t a Kaiser therapist chatbot. Though it hasn’t stopped a lot of people from seeking help for their problems outside of the healthcare system altogether. And April, we’re also in an environment where many people are seeking out mental health help through chatbots, including teenagers. Are patient preferences around this changing as well? And how do mental health experts respond to that?\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:10:40] In the last few years, we’ve seen a huge rise of consumer facing chatbots and these are not therapists to be clear, but people are starting to use them as therapists. This is a trend that is already taken off because they are available immediately. You can tell them how to interact with you and they are always there. There are clinical psychologists who have. You know, been working on a verified evidence-based, widely tested kind of AI chat bot for therapy for at least six years now. And what they will tell you is it takes a really, really long time to develop a proven product like that, that, you know actually conforms to the standards of delivering therapy.\u003c/p>\n\u003cp>\u003cstrong>Jodi Halpern \u003c/strong>[00:11:33] We cannot institute any of this on a large scale population level without studying it first and making sure it’s safe.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:11:42] Jodi Halpern is a bioethics professor at UC Berkeley. Jodi Helpern talks about the potential that chatbots have in cognitive behavioral therapy, which is a particular kind of therapy that tends to be a little bit more formal, a little more formulaic, but she’s very circumspect when it comes to relational therapy.\u003c/p>\n\u003cp>\u003cstrong>Jodi Halpern \u003c/strong>[00:12:04] In the meeting with an empathic human face-to-face, there is the possibility for the patient really to develop trust. And that’s actually a powerful element in improving health outcomes.\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:12:20] Chatbots are not very good at this, especially consumer-facing chatbots are designed to be affirmative. Sycophantic is the word that experts use. They’re just designed to validate everything you say.\u003c/p>\n\u003cp>\u003cstrong>Jodi Halpern \u003c/strong>[00:12:40] We need more skillful human workforce in the mental health area to meet our unmet needs. We need AI to unburden the skillful human force through ambient medical records and other forms that don’t have to be intrusive or overly privacy invading, but they can take the workload off clinicians.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:13:06] Coming back to Kaiser, April, many of their employees are already using AI. No Kaiser AI therapists as of now, although many of the workers like Alana are worried that there could be. Has Kaiser had any response to this story or any thoughts on AI or contract negotiations that they’ve shared with you?\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:13:28] Kaiser has not had a lot to say about this. I’ve interacted with them a fair amount asking for interviews multiple times, and they have not been willing to sit down and talk about this, they shared a statement. It says in part that artificial intelligence tools at Kaiser don’t make medical decisions. Our physicians and care teams are always at the center of decision-making with our patients. AI does not replace human assessment and care, but they do see artificial intelligence holding, as they say, significant potential to benefit healthcare by supporting better diagnostics, enhancing patient-clinician relationships, optimizing clinicians’ time, and ensuring fairness in care experiences and health outcomes by addressing individual needs.\u003c/p>\n\u003cp>\u003cstrong>Ericka Cruz Guevarra \u003c/strong>[00:14:23] And I mean, it does seem like consumer trends around AI are one thing, April, but it also seems like these sort of large healthcare systems like Kaiser have a really big role to play in terms of the role that AI could play in the future as well. I mean why do you think it’s important to watch what Kaiser does from here?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>April Dembosky \u003c/strong>[00:14:48] Kaiser is a large healthcare institution. It has power. It can influence how quickly and how broadly new technologies are adopted in a way that could have impact on the industry as a whole. And it’s also one of the very few systems that has a mental health union that’s trying to influence that process. So I think that those things put together just make it a really interesting health system to watch. For the way that that influence works on how patients access healthcare and how mental health clinicians do their jobs.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>More than 2,400 Kaiser Permanente mental health care workers in Southern California began a strike this morning and established picket lines at locations from Los Angeles to San Diego, marking the second strike among Kaiser therapists in a little more than two years.\u003c/p>\n\u003cp>Mental health workers represented by the National Union of Healthcare Workers prepared for the strike over the weekend after declining Kaiser’s terms on Friday.\u003c/p>\n\u003cp>Kaiser, in a written statement, said it is notifying patients whose appointments could be affected by the strike. “Patients will have the opportunity to be seen by another professional in our extensive network of highly qualified, licensed therapists if their regular provider is engaged in a strike,” the statement read.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2022/08/kaiser-mental-health-worker-strike/\" target=\"_blank\" rel=\"noreferrer noopener\">The previous strike in 2022\u003c/a> among mental health clinicians in Northern California lasted 10 weeks and led to a commitment from \u003ca href=\"https://nuhw.org/northern-california-kaiser-therapists-win-major-gains-as-strike-concludes/\" target=\"_blank\" rel=\"noreferrer noopener\">Kaiser to hire more therapists\u003c/a> and to give employees specific work hours away from face-to-face patient care.\u003c/p>\n\u003cp>Southern California Kaiser workers are now requesting more time between appointments to prepare for patients. They also want a wage increase and a pension benefit that the company provides to its Northern California clinicians.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s pretty simple,” said psychological social worker William Johnson, a union steward who serves on the bargaining committee. “We’re looking for the same three top priorities that Kaiser already said ‘Yes’ to for our Northern California mental healthcare workers.”\u003c/p>\n\u003cp>Johnson said his current workload includes seeing 32 to 35 patients a week in one-hour sessions.\u003c/p>\n\u003cp>Kaiser released a statement in response to the union’s plans to strike, saying, “Unfortunately, this comes as no surprise, as this seems to have been their intention all along.”\u003c/p>\n\u003cp>The company has offered wage increases amounting to 18% over four years and a number of other perks, according to the statement. Kaiser representatives said they have invested more than a billion dollars in expanding mental health capabilities in California and increased the number of licensed mental health clinicians in Southern California by 30% over the past four years.\u003c/p>\n\u003cp>However, union members say \u003ca href=\"https://calmatters.org/health/2024/10/kaiser-permanente-strike-mental-health/\" target=\"_blank\" rel=\"noreferrer noopener\">turnover has been a problem\u003c/a>, with a quarter of therapists hired between January 2021 and August 2024 leaving their jobs. [aside postID=\"news_11964377,news_11964043,news_11923034\" label=\"Related Stories\"]\u003c/p>\n\u003cp>“Kaiser leadership has consistently been dismissive whenever we voice our concerns or experiences,” Johnson said. “They like to tell us things like, ‘We get that it’s not ideal,’ and they also add, ‘But it works for us.’”\u003c/p>\n\u003cp>Jared Garcia, another union steward on the bargaining committee, said he’s hoping the strike lasts less than a month, but he’s prepared to see it go on as long as it takes.\u003c/p>\n\u003cp>“Scabs aren’t going to work,” Garcia said. “Kaiser knows the limitations of finding mental health professionals — let alone to replace 2,400 of our union members at this time.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A year ago, Kaiser entered into a \u003ca href=\"https://calmatters.org/health/2023/10/kaiser-permanente-california-behavioral-health-settlement/\" target=\"_blank\" rel=\"noreferrer noopener\">$200 million settlement agreement \u003c/a>with the state of California, agreeing to pay a $50 million fine and invest another $150 million over five years to address delays in behavioral health appointments.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>More than 2,400 Kaiser Permanente mental health care workers in Southern California began a strike this morning and established picket lines at locations from Los Angeles to San Diego, marking the second strike among Kaiser therapists in a little more than two years.\u003c/p>\n\u003cp>Mental health workers represented by the National Union of Healthcare Workers prepared for the strike over the weekend after declining Kaiser’s terms on Friday.\u003c/p>\n\u003cp>Kaiser, in a written statement, said it is notifying patients whose appointments could be affected by the strike. “Patients will have the opportunity to be seen by another professional in our extensive network of highly qualified, licensed therapists if their regular provider is engaged in a strike,” the statement read.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2022/08/kaiser-mental-health-worker-strike/\" target=\"_blank\" rel=\"noreferrer noopener\">The previous strike in 2022\u003c/a> among mental health clinicians in Northern California lasted 10 weeks and led to a commitment from \u003ca href=\"https://nuhw.org/northern-california-kaiser-therapists-win-major-gains-as-strike-concludes/\" target=\"_blank\" rel=\"noreferrer noopener\">Kaiser to hire more therapists\u003c/a> and to give employees specific work hours away from face-to-face patient care.\u003c/p>\n\u003cp>Southern California Kaiser workers are now requesting more time between appointments to prepare for patients. They also want a wage increase and a pension benefit that the company provides to its Northern California clinicians.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s pretty simple,” said psychological social worker William Johnson, a union steward who serves on the bargaining committee. “We’re looking for the same three top priorities that Kaiser already said ‘Yes’ to for our Northern California mental healthcare workers.”\u003c/p>\n\u003cp>Johnson said his current workload includes seeing 32 to 35 patients a week in one-hour sessions.\u003c/p>\n\u003cp>Kaiser released a statement in response to the union’s plans to strike, saying, “Unfortunately, this comes as no surprise, as this seems to have been their intention all along.”\u003c/p>\n\u003cp>The company has offered wage increases amounting to 18% over four years and a number of other perks, according to the statement. Kaiser representatives said they have invested more than a billion dollars in expanding mental health capabilities in California and increased the number of licensed mental health clinicians in Southern California by 30% over the past four years.\u003c/p>\n\u003cp>However, union members say \u003ca href=\"https://calmatters.org/health/2024/10/kaiser-permanente-strike-mental-health/\" target=\"_blank\" rel=\"noreferrer noopener\">turnover has been a problem\u003c/a>, with a quarter of therapists hired between January 2021 and August 2024 leaving their jobs. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Kaiser leadership has consistently been dismissive whenever we voice our concerns or experiences,” Johnson said. “They like to tell us things like, ‘We get that it’s not ideal,’ and they also add, ‘But it works for us.’”\u003c/p>\n\u003cp>Jared Garcia, another union steward on the bargaining committee, said he’s hoping the strike lasts less than a month, but he’s prepared to see it go on as long as it takes.\u003c/p>\n\u003cp>“Scabs aren’t going to work,” Garcia said. “Kaiser knows the limitations of finding mental health professionals — let alone to replace 2,400 of our union members at this time.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A year ago, Kaiser entered into a \u003ca href=\"https://calmatters.org/health/2023/10/kaiser-permanente-california-behavioral-health-settlement/\" target=\"_blank\" rel=\"noreferrer noopener\">$200 million settlement agreement \u003c/a>with the state of California, agreeing to pay a $50 million fine and invest another $150 million over five years to address delays in behavioral health appointments.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Three years ago, California leaders passed legislation that promised \u003ca href=\"https://calmatters.org/health/2020/08/california-leader-mental-health/\">the most dramatic expansion \u003c/a>of mental health and addiction care coverage in decades.\u003c/p>\n\u003cp>As the state’s residents struggled with the stress and trauma of a raging pandemic and a record wildfire season, mental health advocates used words like “groundbreaking” to describe the new law. Finally, they said, California was poised to become a national leader in mental health.\u003c/p>\n\u003cp>Their optimism about that law, Senate Bill 855, has been fraying ever since. Advocates say health plans routinely fail to ensure enough mental health providers accept their coverage, making patients wait too long before being seen.\u003c/p>\n\u003cp>Case in point: Last week, the Department of Managed Health Care unveiled news of a historic $200 million settlement with Kaiser Permanente for failing to provide patients with\u003ca href=\"https://calmatters.org/health/2023/10/kaiser-permanente-california-behavioral-health-settlement/\"> timely mental health appointments\u003c/a>, among other issues.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Such issues will take center stage on Wednesday at a \u003ca href=\"https://www.senate.ca.gov/mental-health-and-addiction\">special oversight hearing\u003c/a> of the Senate Select Committee on Mental Health and Addiction.\u003c/p>\n\u003cp>Democratic state Sen. Scott Wiener of San Francisco, chair of the committee and author of the California Mental Health Parity Act, says he shares many of the mental health advocates’ concerns. [pullquote size=\"medium\" align=\"right\" citation=\"Sen. Scott Wiener, D-San Francisco\"]‘We know the plans have a long history of finding ways not to cover mental health treatment. The whole purpose of this law is to put an end to that.’[/pullquote] “We know the plans have a long history of finding ways not to cover mental health treatment,” he told CalMatters. “The whole purpose of this law is to put an end to that.”\u003c/p>\n\u003cp>Before the passage of the 2020 law, the state only required health plans to cover medically necessary treatment of nine serious mental illnesses. For years, mental health advocates have tried and failed to \u003ca href=\"https://calmatters.org/projects/california-mental-health-care-parity/\">expand that list\u003c/a>. With Wiener’s law, they were finally triumphant.\u003c/p>\n\u003cp>Beginning in January 2021, the state has required plans to pay for treatment of a much more extensive array of mental health issues, along with substance use disorder and addiction. This state law is separate from a \u003ca href=\"https://www.apa.org/topics/managed-care-insurance/parity-law-resources\">federal mental health parity\u003c/a> law passed in 2008. The concept of “parity” refers to requiring insurers to treat mental and physical health conditions equally.\u003c/p>\n\u003cp>Health plans say they “have been diligently working in good faith” to comply with these laws while facing industry-wide challenges like workforce shortages. They say they are navigating guidelines that are ambiguous and uneven while waiting for the Department of Managed Health Care to finalize regulations.\u003c/p>\n\u003cp>“This creates a situation of moving goalposts for plans, providers, and our enrollees,” said Mary Ellen Grant, spokesperson for the California Association of Health Plans, in an email.\u003c/p>\n\u003ch2>Mental health parity investigations\u003c/h2>\n\u003cp>Mental health advocates have also long criticized the Department of Managed Health Care, which oversees health plans in the state that receive monthly fees to provide health care for their members. And they, too, are concerned that it’s taking so long for the official rules to be decided.\u003c/p>\n\u003cp>This summer, more than a dozen advocacy groups signed a letter of concern to the department, questioning its commitment to enforcing some aspects of\u003ca href=\"https://steinberginstitute.org/wp-content/uploads/2023/08/Comments-to-DMHC-on-BH-Investigations_DRAFT.pdf\"> the new state parity law\u003c/a>. The organizations want the department to publish and publicize its investigations.\u003c/p>\n\u003cp>“It’s still a relatively secret process,” said Lauren Finke, a policy director at The Kennedy Forum, a national organization that cosponsored California’s parity legislation.\u003c/p>\n\u003cfigure id=\"attachment_11964805\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11964805\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1-800x533.jpg\" alt=\"Kaiser workers on strike in front of a building.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kaiser workers strike in front of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 2, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Department of Managed Health Care declined to make anyone available to speak with CalMatters until later this fall. In an email, a representative said the department “is committed to ensuring enrollees have appropriate access to behavioral health care when they need it.”\u003c/p>\n\u003cp>In response to advocates’ critiques that the department isn’t adequately analyzing and publicizing how well plans are complying with state parity law, the department said in a statement that it is evaluating health plans’ compliance in other ways; including that analysis in the behavioral health investigations would slow them down too much, the statement said. [pullquote size=\"medium\" align=\"right\" citation=\"Meiram Bendat, attorney and psychotherapist, Santa Barbara\"]‘The historic network inadequacy around the state and the lack of meaningful fines, that’s a real failure on the part of the department.’[/pullquote] Meiram Bendat, a Santa Barbara attorney and psychotherapist who focuses on mental health parity, says that the three-year-old state law has improved patients’ ability to receive mental health care by creating a uniform definition of what is considered “medically necessary.”\u003c/p>\n\u003cp>But when it comes to ensuring that health plans maintain adequate provider networks, he said, the department is “failing miserably.” Too often, plans offer their members only outdated lists of providers who then prove to be unavailable, Bendat said. The Department of Managed Health Care hasn’t adequately held plans accountable for this and other problematic practices, he said.\u003c/p>\n\u003cp>“The historic network inadequacy around the state and the lack of meaningful fines, that’s a real failure on the part of the department,” he said.\u003c/p>\n\u003ch2>Kaiser mental health settlement\u003c/h2>\n\u003cp>Finke, of The Kennedy Forum, called the Kaiser settlement “long overdue” and “a very important first step in the Department holding plans more accountable for their performance [or lack thereof].” The settlement includes a $50 million fine and corrective action plan as well as a commitment by Kaiser to invest an additional $150 million over five years to improve behavioral health services. [aside label='More on Around California' tag='california-law'] But Finke and others also said the settlement itself provides evidence of the department’s failures to enforce a previous \u003ca href=\"https://wpso.dmhc.ca.gov/enfactions/docs/2895/1500394196511.pdf\">settlement agreement\u003c/a> with Kaiser from 2017.\u003c/p>\n\u003cp>“Will DMHC do its job going forward? That’s the big question,” asked Fred Seavey, research director for the National Union of Healthcare Workers. The union represents 2,000 Kaiser mental health workers in Northern California who undertook a 10-week strike last year over heavy clinician workloads and long wait times for appointments.\u003c/p>\n\u003cp>He said he wrote complaints to the Department of Managed Health Care earlier this year, saying that Kaiser in Southern California has been illegally restricting the scope of behavioral health services.\u003c/p>\n\u003cp>Kaiser said, in an emailed statement, that “any accusation that we intentionally limit or restrict needed care is untrue.”\u003c/p>\n\u003cp>Southern California Kaiser members receive a wide range of behavioral health clinical offerings, the statement said. Despite a statewide shortage of clinicians, Kaiser is “doing all that we can” to expand its network of mental health providers.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Three years ago, California leaders passed legislation that promised \u003ca href=\"https://calmatters.org/health/2020/08/california-leader-mental-health/\">the most dramatic expansion \u003c/a>of mental health and addiction care coverage in decades.\u003c/p>\n\u003cp>As the state’s residents struggled with the stress and trauma of a raging pandemic and a record wildfire season, mental health advocates used words like “groundbreaking” to describe the new law. Finally, they said, California was poised to become a national leader in mental health.\u003c/p>\n\u003cp>Their optimism about that law, Senate Bill 855, has been fraying ever since. Advocates say health plans routinely fail to ensure enough mental health providers accept their coverage, making patients wait too long before being seen.\u003c/p>\n\u003cp>Case in point: Last week, the Department of Managed Health Care unveiled news of a historic $200 million settlement with Kaiser Permanente for failing to provide patients with\u003ca href=\"https://calmatters.org/health/2023/10/kaiser-permanente-california-behavioral-health-settlement/\"> timely mental health appointments\u003c/a>, among other issues.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Such issues will take center stage on Wednesday at a \u003ca href=\"https://www.senate.ca.gov/mental-health-and-addiction\">special oversight hearing\u003c/a> of the Senate Select Committee on Mental Health and Addiction.\u003c/p>\n\u003cp>Democratic state Sen. Scott Wiener of San Francisco, chair of the committee and author of the California Mental Health Parity Act, says he shares many of the mental health advocates’ concerns. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> “We know the plans have a long history of finding ways not to cover mental health treatment,” he told CalMatters. “The whole purpose of this law is to put an end to that.”\u003c/p>\n\u003cp>Before the passage of the 2020 law, the state only required health plans to cover medically necessary treatment of nine serious mental illnesses. For years, mental health advocates have tried and failed to \u003ca href=\"https://calmatters.org/projects/california-mental-health-care-parity/\">expand that list\u003c/a>. With Wiener’s law, they were finally triumphant.\u003c/p>\n\u003cp>Beginning in January 2021, the state has required plans to pay for treatment of a much more extensive array of mental health issues, along with substance use disorder and addiction. This state law is separate from a \u003ca href=\"https://www.apa.org/topics/managed-care-insurance/parity-law-resources\">federal mental health parity\u003c/a> law passed in 2008. The concept of “parity” refers to requiring insurers to treat mental and physical health conditions equally.\u003c/p>\n\u003cp>Health plans say they “have been diligently working in good faith” to comply with these laws while facing industry-wide challenges like workforce shortages. They say they are navigating guidelines that are ambiguous and uneven while waiting for the Department of Managed Health Care to finalize regulations.\u003c/p>\n\u003cp>“This creates a situation of moving goalposts for plans, providers, and our enrollees,” said Mary Ellen Grant, spokesperson for the California Association of Health Plans, in an email.\u003c/p>\n\u003ch2>Mental health parity investigations\u003c/h2>\n\u003cp>Mental health advocates have also long criticized the Department of Managed Health Care, which oversees health plans in the state that receive monthly fees to provide health care for their members. And they, too, are concerned that it’s taking so long for the official rules to be decided.\u003c/p>\n\u003cp>This summer, more than a dozen advocacy groups signed a letter of concern to the department, questioning its commitment to enforcing some aspects of\u003ca href=\"https://steinberginstitute.org/wp-content/uploads/2023/08/Comments-to-DMHC-on-BH-Investigations_DRAFT.pdf\"> the new state parity law\u003c/a>. The organizations want the department to publish and publicize its investigations.\u003c/p>\n\u003cp>“It’s still a relatively secret process,” said Lauren Finke, a policy director at The Kennedy Forum, a national organization that cosponsored California’s parity legislation.\u003c/p>\n\u003cfigure id=\"attachment_11964805\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11964805\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1-800x533.jpg\" alt=\"Kaiser workers on strike in front of a building.\" width=\"800\" height=\"533\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-03-qut-1.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Kaiser workers strike in front of the Kaiser Permanente Oakland Medical Center in Oakland on Oct. 2, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The Department of Managed Health Care declined to make anyone available to speak with CalMatters until later this fall. In an email, a representative said the department “is committed to ensuring enrollees have appropriate access to behavioral health care when they need it.”\u003c/p>\n\u003cp>In response to advocates’ critiques that the department isn’t adequately analyzing and publicizing how well plans are complying with state parity law, the department said in a statement that it is evaluating health plans’ compliance in other ways; including that analysis in the behavioral health investigations would slow them down too much, the statement said. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> Meiram Bendat, a Santa Barbara attorney and psychotherapist who focuses on mental health parity, says that the three-year-old state law has improved patients’ ability to receive mental health care by creating a uniform definition of what is considered “medically necessary.”\u003c/p>\n\u003cp>But when it comes to ensuring that health plans maintain adequate provider networks, he said, the department is “failing miserably.” Too often, plans offer their members only outdated lists of providers who then prove to be unavailable, Bendat said. The Department of Managed Health Care hasn’t adequately held plans accountable for this and other problematic practices, he said.\u003c/p>\n\u003cp>“The historic network inadequacy around the state and the lack of meaningful fines, that’s a real failure on the part of the department,” he said.\u003c/p>\n\u003ch2>Kaiser mental health settlement\u003c/h2>\n\u003cp>Finke, of The Kennedy Forum, called the Kaiser settlement “long overdue” and “a very important first step in the Department holding plans more accountable for their performance [or lack thereof].” The settlement includes a $50 million fine and corrective action plan as well as a commitment by Kaiser to invest an additional $150 million over five years to improve behavioral health services. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> But Finke and others also said the settlement itself provides evidence of the department’s failures to enforce a previous \u003ca href=\"https://wpso.dmhc.ca.gov/enfactions/docs/2895/1500394196511.pdf\">settlement agreement\u003c/a> with Kaiser from 2017.\u003c/p>\n\u003cp>“Will DMHC do its job going forward? That’s the big question,” asked Fred Seavey, research director for the National Union of Healthcare Workers. The union represents 2,000 Kaiser mental health workers in Northern California who undertook a 10-week strike last year over heavy clinician workloads and long wait times for appointments.\u003c/p>\n\u003cp>He said he wrote complaints to the Department of Managed Health Care earlier this year, saying that Kaiser in Southern California has been illegally restricting the scope of behavioral health services.\u003c/p>\n\u003cp>Kaiser said, in an emailed statement, that “any accusation that we intentionally limit or restrict needed care is untrue.”\u003c/p>\n\u003cp>Southern California Kaiser members receive a wide range of behavioral health clinical offerings, the statement said. Despite a statewide shortage of clinicians, Kaiser is “doing all that we can” to expand its network of mental health providers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Some 2,000 Kaiser Permanente mental health care employees in Northern California are returning to work after voting almost unanimously to ratify a new contract on Thursday, ending a grueling 10-week standoff over staffing shortages, wages and patient care.\u003c/p>\n\u003cp>The four-year contract gives therapists nearly two hours of additional time per week to respond to patient emails, contact social service agencies and perform other administrative tasks. The deal also includes a commitment from Kaiser to hire more therapists, improve access to treatment for patients and increase initial consultation times for children.\u003c/p>\n\u003cp>“It took much longer than it should have to reach this agreement, but, in the end, we succeeded in securing important improvements in patient care that Kaiser negotiators told us across the bargaining table that they’d never agree to,” Jennifer Browning, a Kaiser social worker who served on the bargaining committee, said in a statement.[aside label=\"related coverage\" tag=\"kaiser-strike\"]The hard-fought deal between the Oakland-based health care giant and the National Union of Healthcare Workers — the union representing Kaiser therapists, social workers, chemical dependency counselors and other mental health staffers in the Bay Area and Central Valley — \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/tentative-agreement-reached-with-nuhw-to-end-strike\">was reached earlier this week\u003c/a> after Sacramento Mayor Darrell Steinberg stepped in to mediate. Thursday’s official approval of the agreement ends the longest strike among mental health care workers in U.S. history, according to the union.\u003c/p>\n\u003cp>In a statement, Kaiser officials said they were “very pleased at the outcome” of the vote. \u003c/p>\n\u003cp>“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 statement said. “We are glad to have all our employees back, caring for their patients.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11922524/kaiser-mental-health-workers-in-northern-california-begin-open-ended-strike-over-staffing-shortages\">Workers first walked out on August 15\u003c/a>, amid accounts of widespread burnout, retention issues and unsafe therapist-to-client ratios — sometimes resulting in patients having to wait as long as three months to see a therapist, workers said. \u003c/p>\n\u003cp>Early on in the strike, Ilana Marcucci-Morris, a licensed clinical social worker in Kaiser’s psychiatry department in Oakland, said burnout and poor working conditions were contributing to dismal retention rates among employees, and making it difficult for the company to recruit new ones.\u003c/p>\n\u003cp>“There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser,” Marcucci-Morris \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking\">told KQED’s Forum in August\u003c/a>. “We get 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. It’s really, really not ethical.”\u003c/p>\n\u003cp>Pressure mounted on Kaiser to resolve the impasse, as striking workers garnered support from notable state lawmakers, including Lt. Governor Eleni Kounalakis, state Senate President Pro Tempore Toni Atkins, state Sen. Scott Wiener (D-San Francisco), and Assembly Speaker Anthony Rendon.\u003c/p>\n\u003cp>“The day is going to come where the people of this country … truly have access to behavioral health care and mental health care that they need, that they deserve,” NUHW President Sal Rosselli told striking workers last Friday, speaking from the steps of Kaiser’s downtown Oakland offices, after announcing that Steinberg had agreed to mediate. “And when that day comes, historians are going to point to this strike, this union strike, as the catalyst that made it happen.”\u003c/p>\n\u003cp>Natalie Rogers, a Kaiser therapist in Santa Rosa, was among scores of employees who breathed a collective sigh of relief on Thursday, after not receiving any compensation for 10 weeks.\u003c/p>\n\u003cp>“I think we are all happy that we are going back to work. As you could imagine, it was definitely a financial strain, and an emotional strain,” Rogers said. “But I think that we have formed a unity like no other. I think that we now know … what we are capable of doing if we stick together.”\u003c/p>\n\u003cp>And because of that, she added, morale will be higher. “We will have the support from one another that we need to help push Kaiser to where we feel our patients will get the best care,” she said.\u003c/p>\n\u003cp>\u003ci>This story includes reporting from KQED’s Lesley McClurg.\u003c/i>\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The hard-fought deal between the Oakland-based health care giant and the National Union of Healthcare Workers — the union representing Kaiser therapists, social workers, chemical dependency counselors and other mental health staffers in the Bay Area and Central Valley — \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/tentative-agreement-reached-with-nuhw-to-end-strike\">was reached earlier this week\u003c/a> after Sacramento Mayor Darrell Steinberg stepped in to mediate. Thursday’s official approval of the agreement ends the longest strike among mental health care workers in U.S. history, according to the union.\u003c/p>\n\u003cp>In a statement, Kaiser officials said they were “very pleased at the outcome” of the vote. \u003c/p>\n\u003cp>“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 statement said. “We are glad to have all our employees back, caring for their patients.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11922524/kaiser-mental-health-workers-in-northern-california-begin-open-ended-strike-over-staffing-shortages\">Workers first walked out on August 15\u003c/a>, amid accounts of widespread burnout, retention issues and unsafe therapist-to-client ratios — sometimes resulting in patients having to wait as long as three months to see a therapist, workers said. \u003c/p>\n\u003cp>Early on in the strike, Ilana Marcucci-Morris, a licensed clinical social worker in Kaiser’s psychiatry department in Oakland, said burnout and poor working conditions were contributing to dismal retention rates among employees, and making it difficult for the company to recruit new ones.\u003c/p>\n\u003cp>“There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser,” Marcucci-Morris \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking\">told KQED’s Forum in August\u003c/a>. “We get 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. It’s really, really not ethical.”\u003c/p>\n\u003cp>Pressure mounted on Kaiser to resolve the impasse, as striking workers garnered support from notable state lawmakers, including Lt. Governor Eleni Kounalakis, state Senate President Pro Tempore Toni Atkins, state Sen. Scott Wiener (D-San Francisco), and Assembly Speaker Anthony Rendon.\u003c/p>\n\u003cp>“The day is going to come where the people of this country … truly have access to behavioral health care and mental health care that they need, that they deserve,” NUHW President Sal Rosselli told striking workers last Friday, speaking from the steps of Kaiser’s downtown Oakland offices, after announcing that Steinberg had agreed to mediate. “And when that day comes, historians are going to point to this strike, this union strike, as the catalyst that made it happen.”\u003c/p>\n\u003cp>Natalie Rogers, a Kaiser therapist in Santa Rosa, was among scores of employees who breathed a collective sigh of relief on Thursday, after not receiving any compensation for 10 weeks.\u003c/p>\n\u003cp>“I think we are all happy that we are going back to work. As you could imagine, it was definitely a financial strain, and an emotional strain,” Rogers said. “But I think that we have formed a unity like no other. I think that we now know … what we are capable of doing if we stick together.”\u003c/p>\n\u003cp>And because of that, she added, morale will be higher. “We will have the support from one another that we need to help push Kaiser to where we feel our patients will get the best care,” she said.\u003c/p>\n\u003cp>\u003ci>This story includes reporting from KQED’s Lesley McClurg.\u003c/i>\u003cbr>\n\u003c/p>\u003c/div>",
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"content": "\u003cp>The union representing Kaiser Permanente mental health care workers in Northern California on Tuesday reached a tentative four-year agreement with the health care giant, potentially ending a two-month strike among thousands of workers.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"kaiser-strike\"]The tentative agreement would benefit patients and “drive collaborative efforts aimed at improving access to mental health care, while at the same time recognizing and better supporting mental health therapists” in their work, according to a \u003ca href=\"https://twitter.com/NUHW/status/1582454798242050053\">joint statement by Kaiser and the National Union of Healthcare Workers (NUHW)\u003c/a>.\u003c/p>\n\u003cp>“The day is going to come where the people of this country … truly have access to behavioral health care and mental health care that they need, that they deserve,” NUHW President Sal Rosselli told striking workers on Friday, speaking from the steps of Kaiser’s downtown Oakland offices, where he announced that Sacramento Mayor Darrell Steinberg had agreed to mediate negotiations. “And when that day comes, historians are going to point to this strike, this union strike, as the catalyst that made it happen.”\u003c/p>\n\u003cp>“The day is going to come where the term ‘mental health care’ no longer exists — it’s simply ‘health care,’ because of your sacrifice,” Rosselli added.\u003c/p>\n\u003cp>https://twitter.com/HeterodoxThis/status/1582471048334671872\u003c/p>\n\u003cp>Some 2,000 Kaiser Bay Area and Central Valley mental health workers — including therapists, social workers and chemical dependency counselors — \u003ca href=\"https://www.kqed.org/news/11922524/kaiser-mental-health-workers-in-northern-california-begin-open-ended-strike-over-staffing-shortages\">began their open-ended strike on August 15\u003c/a>, to ask for increased staffing, a wage hike and better health care access for patients. Striking employees described widespread burnout, retention issues and unsafe therapist-to-client ratios that meant patients sometimes had to wait as long as three months to see a therapist.\u003c/p>\n\u003cp>Early on in the strike, Ilana Marcucci-Morris, a licensed clinical social worker in Kaiser’s psychiatry department in Oakland, \u003ca href=\"https://www.kqed.org/news/11923034/were-drowning-why-kaiser-mental-health-workers-are-striking\">told KQED’s Forum\u003c/a> that there were 2,600 patients for every mental health worker in the Northern California Kaiser system. She said burnout and poor working conditions were contributing to dismal retention rates among employees, and making it difficult for the company to recruit new ones.\u003c/p>\n\u003cp>“There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser,” Marcucci-Morris said. “We get 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. It’s really, really not ethical.”\u003c/p>\n\u003cp>Union leaders \u003ca href=\"https://www.kqed.org/news/11925882/one-month-into-grinding-strike-negotiations-break-down-between-kaiser-permanente-and-mental-health-workers\">rejected a previous contract\u003c/a> offer from Kaiser last month that included wage increases, but did not meet the union’s demands for increased staffing and more time allotted for administrative work.\u003c/p>\n\u003cp>The striking workers garnered support over the last two months from notable state lawmakers including Lt. Governor Eleni Kounalakis, state Senate President Pro Tempore Toni Atkins, state Sen. Scott Wiener (D-San Francisco), and Assembly Speaker Anthony Rendon.\u003c/p>\n\u003cp>More details on the tentative agreement are expected to be available after a two-day ratification vote among workers later this week.\u003c/p>\n\u003cp>\u003ci>This story includes reporting from KQED’s Emma Silvers and Matthew Green, and Bay City News.\u003c/i>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cp>Negotiations between Kaiser Permanente and the union representing its mental health care workers collapsed Wednesday night, \u003ca href=\"https://www.kqed.org/news/11922524/kaiser-mental-health-workers-in-northern-california-begin-open-ended-strike-over-staffing-shortages\">one month into a strike\u003c/a> that still has no end in sight.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents some 2,000 Kaiser psychologists, therapists, social workers and chemical dependency counselors in Northern California, said in a statement that Kaiser refused to consider proposals to increase staffing and provide therapists with additional time to complete crucial administrative work. The union has also demanded the company cap caseloads if therapists are unable to see patients as quickly as state law requires.\u003c/p>\n\u003cp>Kaiser declined to schedule future bargaining sessions, leaving workers and their many thousands of patients in an ongoing state of limbo, union officials said.\u003c/p>\n\u003cp>“It’s so frustrating to be on the front lines of a mental health crisis only to have your employer be in complete denial about it,” Matt Hannon, a Kaiser psychologist in South San Francisco, and a member of the union’s bargaining committee, said in a statement. “Kaiser officials showed once again that they have no interest in providing timely mental health care that complies with state law or meets the needs of patients.”\u003c/p>\n\u003cp>Kaiser said in a statement that it has already made extensive compromises, including concessions on pay, and that the union is essentially pushing for its workers to spend less time with patients in need.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"kaiser-permanente\"]“Frustratingly, NUHW leadership continued to refuse to resolve any remaining issues or acknowledge how far Kaiser Permanente has already moved for the sake of reaching agreement,” a spokesperson for the Oakland-based company said.\u003c/p>\n\u003cp>But the union emphasizes that the ongoing fight is about staffing resources, not compensation, noting that it already agreed to Kaiser’s wage-increase offer. It argues that Kaiser has failed to meaningfully address the severe mental health staffing shortages at its facilities that have resulted in massive turnover rates among workers and excessive wait times for patients.\u003c/p>\n\u003cp>The union has also accused the company of not providing its mental health patients timely access to services during the strike, in violation of state law, a claim currently under investigation.\u003c/p>\n\u003cp>The California Department of Managed Health Care said in a statement that it is “concerned about the potential for immediate harm to enrollees based on the very serious nature of allegations that the plan is not providing timely appointments to enrollees required by the law.”\u003c/p>\n\u003cp>As part of their investigation, state regulators are assessing whether Kaiser made sufficient arrangements to provide out-of-network services to patients in anticipation of the strike.\u003c/p>\n\u003cp>When the investigation was announced, the health care giant said it was in the process of reaching agreements with hundreds of community-based mental health care providers to partially fill the void left by striking workers.\u003c/p>\n\u003cp>Kaiser also said it is aggressively working to recruit and hire more therapists.\u003c/p>\n\u003cp>But Fred Seavey, a NUHW research director, told KQED last month that Kaiser has a history of failing to provide timely care, even though it has the resources to do so.\u003c/p>\n\u003cp>“Members are paying their premiums. They deserve to receive the care that they need and they paid for,” Seavey said. “If an HMO doesn’t have enough providers available, then it must arrange for members to get care from out-of-network providers at no additional cost to the member.”\u003c/p>\n\u003cp>Union members say they are determined to keep striking until Kaiser makes more concessions, but as the strike enters its second month, and workers remain unpaid, many are feeling the financial impact of not receiving their paychecks.\u003c/p>\n\u003cp>“It’s been a hard month, but going without a paycheck is nothing compared to what our patients have endured for years at Kaiser waiting months between therapy sessions,” Kimberly Hollingsworth-Hornor, a Kaiser therapist in Fresno and bargaining committee member, said in a statement. “We are going to keep striking until Kaiser stops gambling with patient lives and works with therapists to create a system that provides patients the care they need to get better.”\u003c/p>\n\u003cp>\u003ci>KQED’s Sara Hossaini contributed reporting to this story.\u003c/i>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "The union representing some 2,000 Northern California mental health workers said the heath care giant refused to consider its demands for increased staffing and shorter waiting times for patients. No future talks have been scheduled.",
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"title": "One Month Into Grinding Strike, Negotiations Break Down Between Kaiser Permanente and Mental Health Workers | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Negotiations between Kaiser Permanente and the union representing its mental health care workers collapsed Wednesday night, \u003ca href=\"https://www.kqed.org/news/11922524/kaiser-mental-health-workers-in-northern-california-begin-open-ended-strike-over-staffing-shortages\">one month into a strike\u003c/a> that still has no end in sight.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents some 2,000 Kaiser psychologists, therapists, social workers and chemical dependency counselors in Northern California, said in a statement that Kaiser refused to consider proposals to increase staffing and provide therapists with additional time to complete crucial administrative work. The union has also demanded the company cap caseloads if therapists are unable to see patients as quickly as state law requires.\u003c/p>\n\u003cp>Kaiser declined to schedule future bargaining sessions, leaving workers and their many thousands of patients in an ongoing state of limbo, union officials said.\u003c/p>\n\u003cp>“It’s so frustrating to be on the front lines of a mental health crisis only to have your employer be in complete denial about it,” Matt Hannon, a Kaiser psychologist in South San Francisco, and a member of the union’s bargaining committee, said in a statement. “Kaiser officials showed once again that they have no interest in providing timely mental health care that complies with state law or meets the needs of patients.”\u003c/p>\n\u003cp>Kaiser said in a statement that it has already made extensive compromises, including concessions on pay, and that the union is essentially pushing for its workers to spend less time with patients in need.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“Frustratingly, NUHW leadership continued to refuse to resolve any remaining issues or acknowledge how far Kaiser Permanente has already moved for the sake of reaching agreement,” a spokesperson for the Oakland-based company said.\u003c/p>\n\u003cp>But the union emphasizes that the ongoing fight is about staffing resources, not compensation, noting that it already agreed to Kaiser’s wage-increase offer. It argues that Kaiser has failed to meaningfully address the severe mental health staffing shortages at its facilities that have resulted in massive turnover rates among workers and excessive wait times for patients.\u003c/p>\n\u003cp>The union has also accused the company of not providing its mental health patients timely access to services during the strike, in violation of state law, a claim currently under investigation.\u003c/p>\n\u003cp>The California Department of Managed Health Care said in a statement that it is “concerned about the potential for immediate harm to enrollees based on the very serious nature of allegations that the plan is not providing timely appointments to enrollees required by the law.”\u003c/p>\n\u003cp>As part of their investigation, state regulators are assessing whether Kaiser made sufficient arrangements to provide out-of-network services to patients in anticipation of the strike.\u003c/p>\n\u003cp>When the investigation was announced, the health care giant said it was in the process of reaching agreements with hundreds of community-based mental health care providers to partially fill the void left by striking workers.\u003c/p>\n\u003cp>Kaiser also said it is aggressively working to recruit and hire more therapists.\u003c/p>\n\u003cp>But Fred Seavey, a NUHW research director, told KQED last month that Kaiser has a history of failing to provide timely care, even though it has the resources to do so.\u003c/p>\n\u003cp>“Members are paying their premiums. They deserve to receive the care that they need and they paid for,” Seavey said. “If an HMO doesn’t have enough providers available, then it must arrange for members to get care from out-of-network providers at no additional cost to the member.”\u003c/p>\n\u003cp>Union members say they are determined to keep striking until Kaiser makes more concessions, but as the strike enters its second month, and workers remain unpaid, many are feeling the financial impact of not receiving their paychecks.\u003c/p>\n\u003cp>“It’s been a hard month, but going without a paycheck is nothing compared to what our patients have endured for years at Kaiser waiting months between therapy sessions,” Kimberly Hollingsworth-Hornor, a Kaiser therapist in Fresno and bargaining committee member, said in a statement. “We are going to keep striking until Kaiser stops gambling with patient lives and works with therapists to create a system that provides patients the care they need to get better.”\u003c/p>\n\u003cp>\u003ci>KQED’s Sara Hossaini contributed reporting to this story.\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "'We're Drowning': Why Kaiser Mental Health Workers Are Striking",
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"content": "\u003cp>On Friday, the fifth day of an open-ended strike by Kaiser Permanente mental health workers across Northern California, some 200 employees and supporters marched to the health care giant’s Oakland headquarters, demanding that management increase staffing and resources.\u003c/p>\n\u003cp>They were among the roughly 2,000 Kaiser therapists, social workers and other mental health care staffers across Northern California — represented by the National Union of Healthcare Workers — who formed picket lines outside Kaiser facilities this week, after negotiations with management ended without resolution last weekend. Those striking said employee morale is dangerously low and patient care has become substandard due to long wait times for treatment. [aside label=\"Related Stories\" postID=\"news_11922524,news_11922748,news_11921580\"] Kaiser officials have called the strike unethical to patients and counterproductive, pointing to the shortage of mental health professionals nationwide. A company representative declined to participate in an interview, citing ongoing negotiations.\u003c/p>\n\u003cp class=\"p1\">But in a statement issued Friday, Deb Catsavas, senior vice president of human resources at Kaiser Permanente Northern California, reiterated the company’s stance that the strike and “disruption to patient care” were unnecessary.\u003c/p>\n\u003cp class=\"p1\">“While [the National Union of Healthcare Workers] claims it is fighting for increased access to care, its primary demand is for union members to spend less time seeing patients,” said Catsavas. “Our patients cannot afford a proposal that significantly reduces the time available to care for our patients and their mental health needs.”\u003c/p>\n\u003cp>The strike comes amid what the White House has described as an unprecedented mental health crisis among Americans of all ages.\u003c/p>\n\u003ch2>Why are Kaiser mental health care workers striking?\u003c/h2>\n\u003cp>“We’re striking because it’s demoralizing to work for a company that actively does things to capitalize on burnout,” Naomi Johnson, an associate clinical social worker for Kaiser, told KQED Forum. “We’re really working very hard as clinicians to try to see patients as frequently as we can, and to provide the care that we’re trained [for] and good at providing. And we’re not supported in doing that by the company.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Kaiser tells patients that “if you have any sort of concerns or you want to come to therapy, please reach out,” added Johnson. “And then as providers, we’re told, ‘Only treat people who meet medical necessity.’ So it’s really difficult because we have this huge influx of people trying to seek services, but there aren’t enough of us to actually meet the demand, so we’re just completely overwhelmed. … We’re drowning, as clinicians.”\u003c/p>\n\u003cfigure id=\"attachment_11923078\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923078\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"a protest\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers rally before a march from Oakland Kaiser Medical Center to Kaiser’s corporate headquarters on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>How does understaffing affect patients seeking treatment?\u003c/h2>\n\u003cp>“There are currently 2,600 Kaiser patients for every mental health worker in (the) Northern California Kaiser system,” Ilana Marcucci-Morris, a licensed clinical social worker in Kaiser’s psychiatry department in Oakland, told Forum. That means the average Kaiser therapist sees between seven and 12 patients per day, while someone in private practice might see between three and six. After a series of initial intake calls, the majority of Kaiser patients calling with a “nonurgent” need wait between two and three months to see a therapist.\u003c/p>\n\u003cp>The National Union of Healthcare Workers points to \u003ca href=\"https://nuhw.org/more-than-2000-kaiser-permanente-mental-health-clinicians-to-start-open-ended-strike-august-15/\">internal Kaiser documents illustrating\u003c/a> that “patients who received an initial mental health assessment on June 13 weren’t scheduled for follow-up appointments for a month in San Francisco, more than two months in Sacramento and three months or more in other parts of Northern California.” That length of time, experts say, does a disservice to those who have already taken the often-difficult first step of seeking support.\u003c/p>\n\u003cp>“The goal is to help people get better and terminate,” said Marcucci-Morris. “But the system within Kaiser does not allow for that. It’s the opposite. People are waiting longer, and deteriorating to where they either give up and pay [for therapy] out of pocket, which sets up a system for folks who have those resources to pay a private practice therapist and get better.” She said people who can’t afford private therapy and insurance premiums aren’t able to get better. “They get worse and they stay in Kaiser and they just stay sick,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11923083\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923083\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"protestors reflected in a bus window\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers and supporters hold signs on the picket line outside Oakland Kaiser Medical Center. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>What is causing the understaffing?\u003c/h2>\n\u003cp>Kaiser administrators point to what they describe as a nationwide staffing shortage. “Across the country, there are not enough mental health care professionals to meet the increased demand for care,” said Kaiser’s Catsavas in an Aug. 15 statement. “This has created challenges for Kaiser Permanente and mental health care providers everywhere.”\u003c/p>\n\u003cp>Company administrators say they have worked to combat the shortage by hiring new mental health clinicians, including nearly 200 new clinicians since January 2021; improving mental health care access through virtual care; and launching a $500,000 initiative to recruit new employees.[pullquote align=\"right\" size=\"medium\" citation=\"Ilana Marcucci-Morris, Kaiser psychiatrist\"]‘There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser.’[/pullquote]But those on strike said the severity of the shortage is specific to Kaiser, and that burnout and poor working conditions are contributing to low retention of existing employees, and making it difficult for the company to recruit new ones.\u003c/p>\n\u003cp>“There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser,” said Marcucci-Morris. “We get 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. It’s really, really not ethical. And I personally have a handful of colleagues and friends who are therapists with time in their schedules who I’ve tried to recruit for Kaiser. But the reputation is just so poor.”\u003c/p>\n\u003cp>It’s more appealing, said those striking, for qualified therapists to work for a private practice. “Workers just don’t want to work for Kaiser anymore, and that’s the real crisis we’re facing,” said Marcucci-Morris.\u003c/p>\n\u003cp>The union said the rate at which mental health clinicians are leaving Kaiser nearly doubled in the past year, with 668 clinicians leaving between June 2021 and May 2022, compared to 335 clinicians the previous year. In a union survey of 200 of those departing clinicians, 85% said they were leaving because their workload was unsustainable 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.”\u003c/p>\n\u003cp>“We need to grow the mental health workforce, there’s no doubt about that,” California state Senator Scott Wiener told KQED Forum. “It is also the case that the shortage is not as severe right now as the health plans say … health plans can take steps to expand their workforce, including paying better, providing better reimbursements to private providers, and those are investments that they should be making that they have not made.”\u003c/p>\n\u003cp>“I don’t think it’s the case that they can just throw up their hands and say, we have some challenges with the workforce, and so therefore, we’re going to make people wait three months,” he added. “We have real shortages of physical health care providers, but we don’t tolerate around physical health what we have long tolerated around mental health, which is effectively denying people access to lifesaving care.”\u003c/p>\n\u003cfigure id=\"attachment_11923080\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923080\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"a baby in a stroller as part of a protest \" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers carry signs on the picket line outside Oakland Kaiser Medical Center on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>Has California passed any recent laws to address this shortage?\u003c/h2>\n\u003cp>\u003ca href=\"https://openstates.org/ca/bills/20212022/SB221/\">Senate Bill 221\u003c/a>, which passed in 2021 and went into effect July 1, 2022, said that “health plans, including Kaiser, must provide timely access to mental health and addiction treatment,” Senator Wiener told Forum. “And that means a prompt first visit.”\u003c/p>\n\u003cp>The law codifies existing regulations from the Department of Managed Health Care and the Department of Insurance that require a health care service plan or an insurer to ensure that “for an enrollee requesting a non-urgent appointment with a non-physician mental health care provider … appointments are offered within 10 business days of the request for an appointment.” Follow-up visits have to happen within two weeks, added Wiener.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billVotesClient.xhtml?bill_id=202120220SB858\" target=\"_blank\" rel=\"noopener noreferrer\">Senate Bill 858\u003c/a>, which recently passed on the California State Assembly floor and will now move 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 the 1970s, said Wiener. Currently, the maximum fine possible stands at $2,500 per violation; the bill, if passed, would increase that amount to $25,000.\u003c/p>\n\u003cp>“We think that will create a much larger incentive to actually follow the law and provide people with timely and appropriate access to health care,” he said.\u003c/p>\n\u003ch2>What exactly are the strikers asking for? What’s the current status of negotiations?\u003c/h2>\n\u003cp>In negotiations that led up to the strike, the National Union of Healthcare Workers accepted Kaiser’s wage-increase offer. But the union held fast on its demand that nine hours per week — up from the current six hours — be allotted for administrative work. Kaiser rejected that demand, arguing it would not leave adequate time to see patients. The company’s counteroffer, of an additional 1.2 hours for that work, was flatly rejected.\u003c/p>\n\u003cp>“We wouldn’t be striking right now if money was the primary [issue],” said Marcucci-Morris, pointing to burnout, retention issues and poor morale — as well as what the union describes as the lack of a clear plan for how the company is going to meet the requirements laid out by SB 221.\u003c/p>\n\u003cp>“It’s not going to fix the problems to buy the therapists out and pay us more,” she said. “What good is more pay when you’re drowning and can’t come up for air?”\u003c/p>\n\u003ch2>How is the strike affecting patients in need of care?\u003c/h2>\n\u003cp>Kaiser is legally obligated to continue providing care for its members during a labor strike.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Beginning this week, our patients will receive care from those mental health clinicians who choose patient needs over the strike, as well as from our psychiatrists, clinical managers, and other licensed professionals,” said Catsavas in a statement on the first day of the strike, while noting that “some nonurgent appointments may need to be rescheduled” and that patients whose appointments might be affected “will be directly contacted prior to the date of the appointment to ensure they receive the care they need.”\u003c/p>\n\n",
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"excerpt": "On the fifth day of an open-ended strike, Kaiser mental health workers gathered in Oakland to protest outside the health care giant's corporate headquarters. Here's what they're marching for.",
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"title": "'We're Drowning': Why Kaiser Mental Health Workers Are Striking | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>On Friday, the fifth day of an open-ended strike by Kaiser Permanente mental health workers across Northern California, some 200 employees and supporters marched to the health care giant’s Oakland headquarters, demanding that management increase staffing and resources.\u003c/p>\n\u003cp>They were among the roughly 2,000 Kaiser therapists, social workers and other mental health care staffers across Northern California — represented by the National Union of Healthcare Workers — who formed picket lines outside Kaiser facilities this week, after negotiations with management ended without resolution last weekend. Those striking said employee morale is dangerously low and patient care has become substandard due to long wait times for treatment. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp> Kaiser officials have called the strike unethical to patients and counterproductive, pointing to the shortage of mental health professionals nationwide. A company representative declined to participate in an interview, citing ongoing negotiations.\u003c/p>\n\u003cp class=\"p1\">But in a statement issued Friday, Deb Catsavas, senior vice president of human resources at Kaiser Permanente Northern California, reiterated the company’s stance that the strike and “disruption to patient care” were unnecessary.\u003c/p>\n\u003cp class=\"p1\">“While [the National Union of Healthcare Workers] claims it is fighting for increased access to care, its primary demand is for union members to spend less time seeing patients,” said Catsavas. “Our patients cannot afford a proposal that significantly reduces the time available to care for our patients and their mental health needs.”\u003c/p>\n\u003cp>The strike comes amid what the White House has described as an unprecedented mental health crisis among Americans of all ages.\u003c/p>\n\u003ch2>Why are Kaiser mental health care workers striking?\u003c/h2>\n\u003cp>“We’re striking because it’s demoralizing to work for a company that actively does things to capitalize on burnout,” Naomi Johnson, an associate clinical social worker for Kaiser, told KQED Forum. “We’re really working very hard as clinicians to try to see patients as frequently as we can, and to provide the care that we’re trained [for] and good at providing. And we’re not supported in doing that by the company.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kaiser tells patients that “if you have any sort of concerns or you want to come to therapy, please reach out,” added Johnson. “And then as providers, we’re told, ‘Only treat people who meet medical necessity.’ So it’s really difficult because we have this huge influx of people trying to seek services, but there aren’t enough of us to actually meet the demand, so we’re just completely overwhelmed. … We’re drowning, as clinicians.”\u003c/p>\n\u003cfigure id=\"attachment_11923078\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923078\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"a protest\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57886_021_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers rally before a march from Oakland Kaiser Medical Center to Kaiser’s corporate headquarters on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>How does understaffing affect patients seeking treatment?\u003c/h2>\n\u003cp>“There are currently 2,600 Kaiser patients for every mental health worker in (the) Northern California Kaiser system,” Ilana Marcucci-Morris, a licensed clinical social worker in Kaiser’s psychiatry department in Oakland, told Forum. That means the average Kaiser therapist sees between seven and 12 patients per day, while someone in private practice might see between three and six. After a series of initial intake calls, the majority of Kaiser patients calling with a “nonurgent” need wait between two and three months to see a therapist.\u003c/p>\n\u003cp>The National Union of Healthcare Workers points to \u003ca href=\"https://nuhw.org/more-than-2000-kaiser-permanente-mental-health-clinicians-to-start-open-ended-strike-august-15/\">internal Kaiser documents illustrating\u003c/a> that “patients who received an initial mental health assessment on June 13 weren’t scheduled for follow-up appointments for a month in San Francisco, more than two months in Sacramento and three months or more in other parts of Northern California.” That length of time, experts say, does a disservice to those who have already taken the often-difficult first step of seeking support.\u003c/p>\n\u003cp>“The goal is to help people get better and terminate,” said Marcucci-Morris. “But the system within Kaiser does not allow for that. It’s the opposite. People are waiting longer, and deteriorating to where they either give up and pay [for therapy] out of pocket, which sets up a system for folks who have those resources to pay a private practice therapist and get better.” She said people who can’t afford private therapy and insurance premiums aren’t able to get better. “They get worse and they stay in Kaiser and they just stay sick,” she said.\u003c/p>\n\u003cfigure id=\"attachment_11923083\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923083\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"protestors reflected in a bus window\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57866_005_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers and supporters hold signs on the picket line outside Oakland Kaiser Medical Center. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>What is causing the understaffing?\u003c/h2>\n\u003cp>Kaiser administrators point to what they describe as a nationwide staffing shortage. “Across the country, there are not enough mental health care professionals to meet the increased demand for care,” said Kaiser’s Catsavas in an Aug. 15 statement. “This has created challenges for Kaiser Permanente and mental health care providers everywhere.”\u003c/p>\n\u003cp>Company administrators say they have worked to combat the shortage by hiring new mental health clinicians, including nearly 200 new clinicians since January 2021; improving mental health care access through virtual care; and launching a $500,000 initiative to recruit new employees.\u003c/p>\u003c/div>",
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"content": "‘There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>But those on strike said the severity of the shortage is specific to Kaiser, and that burnout and poor working conditions are contributing to low retention of existing employees, and making it difficult for the company to recruit new ones.\u003c/p>\n\u003cp>“There isn’t a shortage of clinicians. There’s only a shortage of clinicians that want to work for Kaiser,” said Marcucci-Morris. “We get 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. It’s really, really not ethical. And I personally have a handful of colleagues and friends who are therapists with time in their schedules who I’ve tried to recruit for Kaiser. But the reputation is just so poor.”\u003c/p>\n\u003cp>It’s more appealing, said those striking, for qualified therapists to work for a private practice. “Workers just don’t want to work for Kaiser anymore, and that’s the real crisis we’re facing,” said Marcucci-Morris.\u003c/p>\n\u003cp>The union said the rate at which mental health clinicians are leaving Kaiser nearly doubled in the past year, with 668 clinicians leaving between June 2021 and May 2022, compared to 335 clinicians the previous year. In a union survey of 200 of those departing clinicians, 85% said they were leaving because their workload was unsustainable 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.”\u003c/p>\n\u003cp>“We need to grow the mental health workforce, there’s no doubt about that,” California state Senator Scott Wiener told KQED Forum. “It is also the case that the shortage is not as severe right now as the health plans say … health plans can take steps to expand their workforce, including paying better, providing better reimbursements to private providers, and those are investments that they should be making that they have not made.”\u003c/p>\n\u003cp>“I don’t think it’s the case that they can just throw up their hands and say, we have some challenges with the workforce, and so therefore, we’re going to make people wait three months,” he added. “We have real shortages of physical health care providers, but we don’t tolerate around physical health what we have long tolerated around mental health, which is effectively denying people access to lifesaving care.”\u003c/p>\n\u003cfigure id=\"attachment_11923080\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11923080\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg\" alt=\"a baby in a stroller as part of a protest \" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/08/RS57907_044_KQED_KaiserStrikeOakland_08192022-qut-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser mental health care workers carry signs on the picket line outside Oakland Kaiser Medical Center on Friday, Aug. 19, 2022, the fifth day of an open-ended strike. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>Has California passed any recent laws to address this shortage?\u003c/h2>\n\u003cp>\u003ca href=\"https://openstates.org/ca/bills/20212022/SB221/\">Senate Bill 221\u003c/a>, which passed in 2021 and went into effect July 1, 2022, said that “health plans, including Kaiser, must provide timely access to mental health and addiction treatment,” Senator Wiener told Forum. “And that means a prompt first visit.”\u003c/p>\n\u003cp>The law codifies existing regulations from the Department of Managed Health Care and the Department of Insurance that require a health care service plan or an insurer to ensure that “for an enrollee requesting a non-urgent appointment with a non-physician mental health care provider … appointments are offered within 10 business days of the request for an appointment.” Follow-up visits have to happen within two weeks, added Wiener.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billVotesClient.xhtml?bill_id=202120220SB858\" target=\"_blank\" rel=\"noopener noreferrer\">Senate Bill 858\u003c/a>, which recently passed on the California State Assembly floor and will now move 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 the 1970s, said Wiener. Currently, the maximum fine possible stands at $2,500 per violation; the bill, if passed, would increase that amount to $25,000.\u003c/p>\n\u003cp>“We think that will create a much larger incentive to actually follow the law and provide people with timely and appropriate access to health care,” he said.\u003c/p>\n\u003ch2>What exactly are the strikers asking for? What’s the current status of negotiations?\u003c/h2>\n\u003cp>In negotiations that led up to the strike, the National Union of Healthcare Workers accepted Kaiser’s wage-increase offer. But the union held fast on its demand that nine hours per week — up from the current six hours — be allotted for administrative work. Kaiser rejected that demand, arguing it would not leave adequate time to see patients. The company’s counteroffer, of an additional 1.2 hours for that work, was flatly rejected.\u003c/p>\n\u003cp>“We wouldn’t be striking right now if money was the primary [issue],” said Marcucci-Morris, pointing to burnout, retention issues and poor morale — as well as what the union describes as the lack of a clear plan for how the company is going to meet the requirements laid out by SB 221.\u003c/p>\n\u003cp>“It’s not going to fix the problems to buy the therapists out and pay us more,” she said. “What good is more pay when you’re drowning and can’t come up for air?”\u003c/p>\n\u003ch2>How is the strike affecting patients in need of care?\u003c/h2>\n\u003cp>Kaiser is legally obligated to continue providing care for its members during a labor strike.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Beginning this week, our patients will receive care from those mental health clinicians who choose patient needs over the strike, as well as from our psychiatrists, clinical managers, and other licensed professionals,” said Catsavas in a statement on the first day of the strike, while noting that “some nonurgent appointments may need to be rescheduled” and that patients whose appointments might be affected “will be directly contacted prior to the date of the appointment to ensure they receive the care they need.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Thousands of mental health care workers maintained picket lines Wednesday in front of Kaiser Permanente facilities in the Bay Area and Central Valley, the third day of an open-ended strike to demand the health care giant increase mental health staffing and wages.\u003c/p>\n\u003cp>“This strike is a long time coming,” said state Sen. Scott Wiener, D-San Francisco, among a growing number of state legislative leaders backing the workers. “There have been major issues at Kaiser in terms of providing people with timely access or any access to mental health and addiction treatment and the workers have been advocating for years to have more staffing and compliance with the law and that hasn’t happened.”\u003c/p>\n\u003cp>Jason Lechner, a therapist focused on addiction services for youth, was among a throng of protesters outside a Kaiser Oakland facility on Tuesday, where workers chanted, “What do we want? Patient care. When do we want it? Now!”\u003c/p>\n\u003cp>Lechner said Kaiser doesn’t offer him enough time to carry out essential tasks like answering phone calls and emails, or referring patients to other experts, forcing him and his colleagues to regularly work extra hours in order to complete crucial administrative tasks.\u003c/p>\n\u003cp>“If I need to communicate with your primary care physician about what substances you’re abusing, where’s my time to do that?” he said.[aside label=\"Related Stories\" postID=\"news_11922524,forum_2010101884368,stateofhealth_21358\"]The National Union of Healthcare Workers, which represents Kaiser psychologists, therapists, social workers and chemical dependency counselors in Northern California, is in the thick of negotiating a new contract with Kaiser, and demanding the company hire more mental health workers to ease the burden placed on current staff. The union said negotiations with management this weekend ended without resolution, with Kaiser rejecting the union’s “proposals to increase staffing and end dangerously long waits for mental health therapy appointments.”\u003c/p>\n\u003cp>Nicole Riddle, a labor and delivery nurse, said she has experienced the consequences of staffing shortages, not only as a health care worker, but also as a Kaiser member who has tried to access mental health services for herself.\u003c/p>\n\u003cp>“I’ve had my own experiences, both trying to advocate for myself throughout really traumatic birth experiences, postpartum depression, and then for my own child,” she said. “And I feel like Kaiser kind of banks on people being burnt out enough to not keep escalating and advocating for themselves. And then those who are privileged enough to do so pay out of pocket.”\u003c/p>\n\u003cp>“We deserve a better situation,” she added.\u003c/p>\n\u003cp>\u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/committed-to-reaching-a-fair-and-equitable-agreement\">In a statement\u003c/a> issued Sunday, after negotiations stalled, Deb Catsavas, Kaiser’s regional senior vice president of human resources, said the Oakland-based company has “the deepest appreciation and gratitude for our mental health professionals and the extraordinary care they provide to our members.” But, she noted, “there are not enough mental health care professionals to meet the increased demand for care,” both locally and nationwide.\u003c/p>\n\u003cp>The company has hired “nearly 200 new clinicians since January 2021” and launched a $500,000 initiative to recruit new mental health practitioners, Catsavas added.\u003c/p>\n\u003cp>“Despite the union’s harmful tactics, we remain committed to bargaining in good faith to reach a fair and equitable agreement that is good for our therapists and our patients,” she said.\u003c/p>\n\u003cp>In negotiations, the union accepted Kaiser’s wage-increase offer, but held fast on its demand that nine hours per week — up from the current six hours — be allotted for administrative work. Kaiser, however, rejected that demand, arguing it would not leave adequate time to see patients. Its counteroffer, of an additional 1.2 hours for that work, was flatly rejected.\u003c/p>\n\u003cp>California law requires health care providers like Kaiser to offer patients timely care even during labor strikes, and state regulators say they are closely monitoring consumer complaints about the company’s compliance. Kaiser has said it will prioritize urgent mental health situations, but may have to reschedule some ongoing appointments.\u003c/p>\n\u003cp>Oakland City Councilmember Dan Kalb, who joined Oakland staffers on the picket line on Tuesday, said mental health care has been undervalued for far too long.\u003c/p>\n\u003cp>“Mental health care is health care. And (it) needs to stop being seen as the stepchild of health care,” Kalb said, pointing to the longstanding demand for services that has only further escalated since the start of the COVID-19 pandemic. “Kaiser should be ashamed of themselves for not staffing up the mental health care clinicians that they need and not paying them a fair wage. It’s inexcusable.”\u003c/p>\n\u003cp>Kalb called for “unanimous support” for mental health workers, not just at Kaiser, but in all health care settings “to make sure that there are enough health care workers everywhere to meet the needs that people have.”\u003c/p>\n\u003cp>\u003cem>KQED’s Matthew Green contributed reporting.\u003c/em> [ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Thousands of mental health care workers maintained picket lines Wednesday in front of Kaiser Permanente facilities in the Bay Area and Central Valley, the third day of an open-ended strike to demand the health care giant increase mental health staffing and wages.\u003c/p>\n\u003cp>“This strike is a long time coming,” said state Sen. Scott Wiener, D-San Francisco, among a growing number of state legislative leaders backing the workers. “There have been major issues at Kaiser in terms of providing people with timely access or any access to mental health and addiction treatment and the workers have been advocating for years to have more staffing and compliance with the law and that hasn’t happened.”\u003c/p>\n\u003cp>Jason Lechner, a therapist focused on addiction services for youth, was among a throng of protesters outside a Kaiser Oakland facility on Tuesday, where workers chanted, “What do we want? Patient care. When do we want it? Now!”\u003c/p>\n\u003cp>Lechner said Kaiser doesn’t offer him enough time to carry out essential tasks like answering phone calls and emails, or referring patients to other experts, forcing him and his colleagues to regularly work extra hours in order to complete crucial administrative tasks.\u003c/p>\n\u003cp>“If I need to communicate with your primary care physician about what substances you’re abusing, where’s my time to do that?” he said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The National Union of Healthcare Workers, which represents Kaiser psychologists, therapists, social workers and chemical dependency counselors in Northern California, is in the thick of negotiating a new contract with Kaiser, and demanding the company hire more mental health workers to ease the burden placed on current staff. The union said negotiations with management this weekend ended without resolution, with Kaiser rejecting the union’s “proposals to increase staffing and end dangerously long waits for mental health therapy appointments.”\u003c/p>\n\u003cp>Nicole Riddle, a labor and delivery nurse, said she has experienced the consequences of staffing shortages, not only as a health care worker, but also as a Kaiser member who has tried to access mental health services for herself.\u003c/p>\n\u003cp>“I’ve had my own experiences, both trying to advocate for myself throughout really traumatic birth experiences, postpartum depression, and then for my own child,” she said. “And I feel like Kaiser kind of banks on people being burnt out enough to not keep escalating and advocating for themselves. And then those who are privileged enough to do so pay out of pocket.”\u003c/p>\n\u003cp>“We deserve a better situation,” she added.\u003c/p>\n\u003cp>\u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/committed-to-reaching-a-fair-and-equitable-agreement\">In a statement\u003c/a> issued Sunday, after negotiations stalled, Deb Catsavas, Kaiser’s regional senior vice president of human resources, said the Oakland-based company has “the deepest appreciation and gratitude for our mental health professionals and the extraordinary care they provide to our members.” But, she noted, “there are not enough mental health care professionals to meet the increased demand for care,” both locally and nationwide.\u003c/p>\n\u003cp>The company has hired “nearly 200 new clinicians since January 2021” and launched a $500,000 initiative to recruit new mental health practitioners, Catsavas added.\u003c/p>\n\u003cp>“Despite the union’s harmful tactics, we remain committed to bargaining in good faith to reach a fair and equitable agreement that is good for our therapists and our patients,” she said.\u003c/p>\n\u003cp>In negotiations, the union accepted Kaiser’s wage-increase offer, but held fast on its demand that nine hours per week — up from the current six hours — be allotted for administrative work. Kaiser, however, rejected that demand, arguing it would not leave adequate time to see patients. Its counteroffer, of an additional 1.2 hours for that work, was flatly rejected.\u003c/p>\n\u003cp>California law requires health care providers like Kaiser to offer patients timely care even during labor strikes, and state regulators say they are closely monitoring consumer complaints about the company’s compliance. Kaiser has said it will prioritize urgent mental health situations, but may have to reschedule some ongoing appointments.\u003c/p>\n\u003cp>Oakland City Councilmember Dan Kalb, who joined Oakland staffers on the picket line on Tuesday, said mental health care has been undervalued for far too long.\u003c/p>\n\u003cp>“Mental health care is health care. And (it) needs to stop being seen as the stepchild of health care,” Kalb said, pointing to the longstanding demand for services that has only further escalated since the start of the COVID-19 pandemic. “Kaiser should be ashamed of themselves for not staffing up the mental health care clinicians that they need and not paying them a fair wage. It’s inexcusable.”\u003c/p>\n\u003cp>Kalb called for “unanimous support” for mental health workers, not just at Kaiser, but in all health care settings “to make sure that there are enough health care workers everywhere to meet the needs that people have.”\u003c/p>\n\u003cp>\u003cem>KQED’s Matthew Green contributed reporting.\u003c/em> \u003c/p>\u003c/div>",
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"content": "\u003cp>Some 2,000 Kaiser Permanente psychologists, therapists, social workers and chemical dependency counselors in Northern California began what they called an “open-ended” strike Monday over staffing shortages that their union said have overwhelmed workers and resulted in patients waiting months to get help. Workers formed picket lines at Kaiser facilities in San Francisco, San José, Fresno and Sacramento.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents the workers, is negotiating a new contract with the Oakland-based health care giant, and demanding the company hire more mental health workers to ease the burden placed on current staff. The union said negotiations with management ended without resolution this weekend.\u003c/p>\n\u003cp>Kaiser rejected “union proposals to increase staffing and end dangerously long waits for mental health therapy appointments,” organizers said in a statement Sunday.\u003c/p>\n\u003cp>“We’ve been telling Kaiser executives since Day One that this isn’t about money,” said Jennifer Browning, a Kaiser social worker in Roseville, and part of the union’s bargaining team, noting that organizers did accept Kaiser’s wage-increase offer. “It’s about our professional integrity and our ability to provide care that will help patients get better.”\u003c/p>\n\u003cp>At a picket line outside a Kaiser center in San Francisco on Monday, employees held signs that read “patients over profits.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Jeffery Chen-Harding, a clinical social worker with Kaiser who was picketing there, said his patients are having to wait longer and longer for care.\u003c/p>\n\u003cp>[aside postID=\"news_11921580\" hero='https://ww2.kqed.org/app/uploads/sites/10/2022/08/RS40555_KAISER-MENTAL-HEALTH-CASES-photo-qut-1020x680.jpg']“We have people waiting six to eight weeks to get an appointment,” he said.\u003c/p>\n\u003cp>Petaluma clinical psychologist Alexis Petrakis, also picketing in San Francisco, echoed Chen-Harding’s comments about the wait times, describing her caseloads as unrelenting.\u003c/p>\n\u003cp>“I meet somebody new, they tell me their story, and maybe they even are honest about trauma that they’ve experienced,” she said. “I try to find a 30-minute phone call just to check in, but it’s not the care that I know that they deserve.”\u003c/p>\n\u003cp>Deb Catsavas, Kaiser’s senior vice president of human resources in Northern California, said in a statement Sunday that \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/committed-to-reaching-a-fair-and-equitable-agreement\">the company has hired hundreds of new mental health workers\u003c/a>, including 200 since January 2021. She also pointed out that the shortage in mental health care professionals is happening nationwide.\u003c/p>\n\u003cp>There are two main issues, Catsavas noted. “One is wage increases and the other is the union’s demand to increase the time therapists spend on tasks other than seeing patients,” she said. “The primary role — and essential need — for our therapists is to provide mental health care and treat our patients.”\u003c/p>\n\u003cp>The union is demanding that nine hours per week be allotted for administrative work, which would leave only 31 hours to see patients, the company said. It said it proposed increasing the time for administrative tasks from 6 to 7.2 hours, leaving 32.8 hours to see patients.\u003c/p>\n\u003cp>“Our patients cannot afford a proposal that significantly reduces the time available to care for them and their mental health needs,” Catsavas said. “In recognition of our therapists’ concerns and priorities, we have proposed an increase in the scheduled time allocated to administrative tasks, but the union is demanding still more administrative time.”\u003c/p>\n\u003cp>But Chen-Harding argued that the time in question is actually important work related to patient care.\u003c/p>\n\u003cp>“What they’re calling administrative time, it’s actually time when I am calling people who are in a crisis. It may be time when I am learning about the patient that I’m about to meet with,” he said.\u003c/p>\n\u003cp>A shortage in mental health clinicians has been a sticking point between the company and the union for years. In December 2019, Kaiser mental health care workers held a five-day strike over staffing shortages.\u003c/p>\n\u003cp>Catsavas said Kaiser recently reached an agreement with the same union in Southern California, representing about 1,900 mental health professionals.\u003c/p>\n\u003cp>Kaiser said some clinicians will remain on the job during the strike. It also has expanded its network of “high-quality community providers and will continue to prioritize urgent and emergency care” through the duration of the strike, it said, adding that some nonurgent appointments may need to be rescheduled and patients whose appointments may be affected will be contacted directly prior to the date of the appointment.\u003c/p>\n\u003cp>The union said state law requires Kaiser to pay for out-of-network services if it’s unable to provide urgent mental health appointments within 48 hours, and nonurgent appointments within 10 business days, unless the therapist determines that a longer wait would not be detrimental to the patient’s health.\u003c/p>\n\u003cp>No date has been set for further negotiations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story includes reporting from The Associated Press, Bay City News and KQED’s Lesley McClurg.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Some 2,000 Kaiser Permanente psychologists, therapists, social workers and chemical dependency counselors in Northern California began what they called an “open-ended” strike Monday over staffing shortages that their union said have overwhelmed workers and resulted in patients waiting months to get help. Workers formed picket lines at Kaiser facilities in San Francisco, San José, Fresno and Sacramento.\u003c/p>\n\u003cp>The National Union of Healthcare Workers, which represents the workers, is negotiating a new contract with the Oakland-based health care giant, and demanding the company hire more mental health workers to ease the burden placed on current staff. The union said negotiations with management ended without resolution this weekend.\u003c/p>\n\u003cp>Kaiser rejected “union proposals to increase staffing and end dangerously long waits for mental health therapy appointments,” organizers said in a statement Sunday.\u003c/p>\n\u003cp>“We’ve been telling Kaiser executives since Day One that this isn’t about money,” said Jennifer Browning, a Kaiser social worker in Roseville, and part of the union’s bargaining team, noting that organizers did accept Kaiser’s wage-increase offer. “It’s about our professional integrity and our ability to provide care that will help patients get better.”\u003c/p>\n\u003cp>At a picket line outside a Kaiser center in San Francisco on Monday, employees held signs that read “patients over profits.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We have people waiting six to eight weeks to get an appointment,” he said.\u003c/p>\n\u003cp>Petaluma clinical psychologist Alexis Petrakis, also picketing in San Francisco, echoed Chen-Harding’s comments about the wait times, describing her caseloads as unrelenting.\u003c/p>\n\u003cp>“I meet somebody new, they tell me their story, and maybe they even are honest about trauma that they’ve experienced,” she said. “I try to find a 30-minute phone call just to check in, but it’s not the care that I know that they deserve.”\u003c/p>\n\u003cp>Deb Catsavas, Kaiser’s senior vice president of human resources in Northern California, said in a statement Sunday that \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/committed-to-reaching-a-fair-and-equitable-agreement\">the company has hired hundreds of new mental health workers\u003c/a>, including 200 since January 2021. She also pointed out that the shortage in mental health care professionals is happening nationwide.\u003c/p>\n\u003cp>There are two main issues, Catsavas noted. “One is wage increases and the other is the union’s demand to increase the time therapists spend on tasks other than seeing patients,” she said. “The primary role — and essential need — for our therapists is to provide mental health care and treat our patients.”\u003c/p>\n\u003cp>The union is demanding that nine hours per week be allotted for administrative work, which would leave only 31 hours to see patients, the company said. It said it proposed increasing the time for administrative tasks from 6 to 7.2 hours, leaving 32.8 hours to see patients.\u003c/p>\n\u003cp>“Our patients cannot afford a proposal that significantly reduces the time available to care for them and their mental health needs,” Catsavas said. “In recognition of our therapists’ concerns and priorities, we have proposed an increase in the scheduled time allocated to administrative tasks, but the union is demanding still more administrative time.”\u003c/p>\n\u003cp>But Chen-Harding argued that the time in question is actually important work related to patient care.\u003c/p>\n\u003cp>“What they’re calling administrative time, it’s actually time when I am calling people who are in a crisis. It may be time when I am learning about the patient that I’m about to meet with,” he said.\u003c/p>\n\u003cp>A shortage in mental health clinicians has been a sticking point between the company and the union for years. In December 2019, Kaiser mental health care workers held a five-day strike over staffing shortages.\u003c/p>\n\u003cp>Catsavas said Kaiser recently reached an agreement with the same union in Southern California, representing about 1,900 mental health professionals.\u003c/p>\n\u003cp>Kaiser said some clinicians will remain on the job during the strike. It also has expanded its network of “high-quality community providers and will continue to prioritize urgent and emergency care” through the duration of the strike, it said, adding that some nonurgent appointments may need to be rescheduled and patients whose appointments may be affected will be contacted directly prior to the date of the appointment.\u003c/p>\n\u003cp>The union said state law requires Kaiser to pay for out-of-network services if it’s unable to provide urgent mental health appointments within 48 hours, and nonurgent appointments within 10 business days, unless the therapist determines that a longer wait would not be detrimental to the patient’s health.\u003c/p>\n\u003cp>No date has been set for further negotiations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story includes reporting from The Associated Press, Bay City News and KQED’s Lesley McClurg.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"soldout": {
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"info": "Tech Nation is a weekly public radio program, hosted by Dr. Moira Gunn. Founded in 1993, it has grown from a simple interview show to a multi-faceted production, featuring conversations with noted technology and science leaders, and a weekly science and technology-related commentary.",
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