Every morning this week, Elizabeth White has woken up at the crack of dawn with memories of a Kaiser Permanente representative laughing in her face during a recent bargaining session weighing heavily on her mind.
White, a licensed clinical social worker, said she reached her boiling point after more than four years of unsuccessfully lobbying the health care provider to hire more mental health clinicians amid a growing patient caseload. For her, the time felt right to take her colleagues’ fight to the picket line.
“Kaiser representatives have their heads in the sand and think that the problem won’t go away, but they don’t know that we’re part of a movement for health care as a human right,” White, a National Union of Healthcare Workers (NUHW) member, told ThinkProgress.
White counted among nearly 2,600 NUHW psychologists, therapists, and social workers who forwent pay and picketed at 35 locations across California this week as part of an effort to shed light on what union members consider Kaiser’s negligence toward mental health care workers and patients in need of quality mental health care.
“We live in a state that has an attorney general who went after the banks for consumer rights issues. This is a consumer rights issue. The public buys Kaiser’s plans thinking that they will get all parts of the package when, in fact, they don’t,” said White, who picketed at Los Angeles County’s South Bay Medical Center on Tuesday.
Months after Kaiser paid a $4 million fine for violating the California Mental Health Parity Act, NUHW members allege it hasn’t become compliant in filling the gap in mental health care. They said the health care provider instead shifted resources to give care to more than 387,000 clients newly enrolled through the Affordable Care Act at the expense of other patients returning for follow-up care. NUHW says that Kaiser’s disregard for patients tripled the average wait time, which caused at least four class-action lawsuits filed by patients and families who say its violations played a role in patient suicides.
NUHW members’ frustration with the status quo has kept them working around the clock. Since Monday, picketers have held signs, marched, and chanted in front of hospitals scattered across the Golden State as patients and passersby look on, some asking questions about the event and deciding to join the mental health care workers in their cries of protest. When they’re not picketing, NUHW members have chatted with media outlets, maintained contact with their comrades at other facilities, and planned for the days ahead.
“It’s important that [Kaiser] sees that people are affected. When I read about the class-action suit about Kaiser, I could relate to the families involved. Our loss shouldn’t have happened,” Marsha Grilli told ThinkProgress.
Grilli, a city councilmember in Milpitas, California who said she plans to join protesters at the Santa Clara Medical Center on Thursday, recounted the two-year battle her family fought with Kaiser in 2010 after doctors diagnosed her sister with depression during her last semester at San Jose State University. When Grilli’s sister committed suicide at her home in 2012, it had been weeks since she had last seen a Kaiser psychiatrist.
“Families should not have to fight as hard as we did to save my sister,” she said. “It’s an insult to us to say that there is a lack of mental health professionals. I don’t believe that. Kaiser just hasn’t invested in mental health care. The quality of service was poor. I don’t feel that they weren’t concerned about my sister getting well.”
However, Kaiser representatives contend that they have worked to meet growing patient demand, saying that the weeklong strike undermines the care that NUHW members said they want to give their patients. In a press statement provided to ThinkProgress, Kaiser Vice President of Government Relations John Nelson said that NUHW has not tried to work with the health care provider to reach a fair labor agreement.
“NUHW has spent the last several years publicly attacking our mental health services, while at the same time resisting important steps we are taking to enhance mental health care for our patients,” Nelson said. “Although NUHW has been using intimidation and obstructionism to try to achieve its goals, we will not let that stop us from continuing to make progress on addressing the national challenge facing all mental health care providers. We remain fully committed to meeting that challenge.”
However, with the gap in mental health care affecting more than 60 percent of adults in California — many of whom live in the rural regions of the San Joaquin Valley and the Inland Empire — both union members and patients’ families say that little has changed, especially as Kaiser has amassed profits of more than $14 million since 2009.
“The problems these centers face aren’t new. If anything, they have certainly gotten worse in the last five years,” Clement Papazian, an NUHW psychiatric social worker with 25 years of experience in emergency and acute care, told ThinkProgress. Earlier this week, Papazian picketed at the Richmond Medical Center alongside more than 100 other mental health care workers.
“Kaiser is required to meet patient need in a timely manner but they have used a business model [hinging on] them not staffing these clinics,” Papazian said. “It’s a fallacy that they have done anything. We actually have documentation from their workforce records that indicate that they’re not keeping pace with patient enrollment.”
Papazian touched on what he described as the ripple effect of the backlog in patient care: “The clinics are interdependent services. If people can’t see their provider in a timely fashion, we see pressure [in the form of] emergency room trips and demand for inpatient and outpatient services. The whole system becomes implicated in this problem to the point that it becomes unsustainable. I’ve seen a lot of it,” said Papazian, who has also served as NUHW chapter president for Northern California since 2010.
NUHW therapist Jim Clifford said he could attest to the stress that a growing patient caseload has brought mental health care workers. During his interview with ThinkProgress, Clifford recounted instances when he had to tell patients that he would not be able to give them the follow-up care they needed as soon as they would have expected. He said that nightmare continues, even he strikes with more than 200 of his colleagues at San Diego Medical Center.
“It has been a very uncomfortable position that Kaiser puts us in with our patients. This affects us daily. That’s why many of us haven’t gone to sleep this week,” said Clifford, a therapist of 13 years. “That’s the nature of what we’re dealing with on the front lines.”