Clinicians continue fight to preserve Patient Management Time

NewsSeptember 7, 2023

While Kaiser management in Northern California has mostly worked with us constructively following our 10-week strike last year, we are continuing to have to fight back against efforts by Kaiser management in Southern California to enact takeaways that violate our contract.

The biggest issue we’re facing in Southern California is management’s attempt to cut Patient Management Time, which in Northern California is called Indirect Patient Care Time.

In Northern California, the contract we won following the strike requires Kaiser to provide full-time clinicians with approximately 7 hours per week to perform critical patient care duties such as responding to patient emails and voicemails, tailoring treatment plans, communicating with social service agencies, consulting with colleagues on clinical questions, and charting appointments.

During contract bargaining in Southern California, our committee successfully rejected proposals to standardize Patient Management Time at 4 hours per week but allow management to book into two hours of that time for clinicians who have more than 10 percent of patients no-show their appointments.

Now, management at most service areas in Southern California is trying to unilaterally implement what they couldn’t win in bargaining.

But, NUHW members and our allies are fighting back to prevent Kaiser from implementing cuts to Patient Management Time.

Kaiser therapists have signed petitions opposing any reduction in time for critical patient care duties and NUHW has filed grievances aimed at stopping Kaiser from taking unilateral action after it failed to secure the cuts during collective bargaining last year.

Meanwhile, elected officials are starting to chime in, making it clear to Kaiser that they won’t stand for their constituents receiving a lower standard of care than Kaiser patients in Northern California.

Assemblymembers Sharon Quirk-Silva, Cottie Petrie-Norris and Avelino Valencia and State Senator Dave Min wrote a letter to Kaiser executives, stating that:

We strongly encourage SCPMG to take the lead in improving mental healthcare and consider following the example set by your counterparts in Northern California. Expanding PMT and responding to therapist concerns by increasing staffing would undoubtedly result in improved mental healthcare for KCPMG members. We urge you to carefully consider this approach for the betterment of mental health services in Southern California.

The letter comes on the heels of a separate correspondence to Kaiser management from Congresswoman Katie Porter, who was joined by State Senators Scott Wiener and Josh Newma. They wrote:

“This proposed reduction would leave Southern California therapists with significantly less time to perform critical patient care tasks compared to their counterparts in Northern California. Psychologists, social workers, marriage and family therapists, and other counselors are already burdened with limited (Patient Management Time). This proposed reduction would also impede their professional integrity and ability to sufficiently address patients’ mental health. In addition, we’ve heard serious concerns that the proposed PMT reduction will result in therapists departing (Kaiser), leaving patients waiting even longer for much needed care…

(The Southern California Permanente Medical Group) is among the largest private providers of mental healthcare in Southern California, and these issues raise credible concerns as to the quality and legality of the services being provided. The most sustainable approach to providing excellent healthcare and complying with SB 221 is to increase staffing rather than reducing (Patient Management Time), which would have detrimental effects on quality of care and therapist retention. We believe (Kaiser) can and should help lead the way on improving mental healthcare. We strongly encourage you to consider following the lead of your counterparts in Northern California by expanding PMT and responding to therapist concerns by increasing staffing, which will result in improved mental healthcare for (Kaiser) members. Thank you for your full and fair consideration of this matter.”