Kaiser Hawaii mental health therapists to strike starting May 18
Demand for mental health services in Hawaii is surging, but Kaiser Permanente fails to add adequate staff or improve access, placing patients at risk
Clinicians schedule statewide strike starting May 18 to force changes at HMO that serves 260,000 Hawaii residents
HONOLULU — Kaiser Permanente has a double-standard in Hawaii. The healthcare provider has recently settled labor agreements with staff and made improvements for patients at its medical offices and hospitals across the state, but this isn’t the case for those who work in mental health care — or patients needing mental health services. On May 18, Kaiser’s psychologists, licensed clinical social workers, medical social workers, psychiatric nurses and chemical dependency counselors in Hawaii will go on strike in an effort to force the HMO to both raise standards and better address the growing demand for mental health services. The three-day strike is scheduled to begin Wed., May 18 and last through Fri., May 20 at medical facilities across the state.
Kaiser officials have confirmed to state regulators that the HMO is dramatically understaffing its mental health services, forcing patients to endure dangerously long waits for care. Yet, despite the huge uptick in demand for services, largely due to anxiety and depression caused by isolation and economic pressures linked to the COVID-19 pandemic, Kaiser has refused to make changes at the bargaining table that would help improve access to care.
“We cannot keep apologizing daily to patients in need and members seeking services, for Kaiser’s lack of available care,” said Tami Swonigan, a psychologist at Kaiser Permanente’s Waipio Medical Office. “Kaiser refuses to take any meaningful steps and the crisis just keeps getting worse.”
Kaiser is infamous for failing to provide adequate mental health care. The HMO has been fined $4 million and forced to accept outside monitoring by state authorities in California for delays and denials of mental health care that Kaiser patients in Hawaii have also endured for many years.
National survey data shows that the rate of anxiety and depression tripled from 2020 to 2021. During the same period, the CDC found that Hawaii went from having among the lowest levels for symptoms of anxiety and depression to ranking in the bottom half of U.S. states.
Still, Kaiser is failing to make adjustments in the services it offers and continues to underfund its mental health care services with Hawaiian residents often being forced to wait months to see a Kaiser therapist.
In November, the National Union of Healthcare Workers (NUHW), which represents Kaiser mental health clinicians in Hawaii and California, filed a 57-page complaint with the Hawaii Department of Commerce and Consumer Affairs. The complaint, utilizing Kaiser’s own records, found that:
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Due to understaffed clinics, Kaiser members are frequently waiting months for their first therapy session to treat conditions such as depression, PTSD, anxiety, panic attacks and eating disorders — wait times that vastly exceed clinical practice guidelines.
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Only 28 percent of Kaiser’s out-of-network mental health therapists are accepting new Kaiser members for care. Kaiser contracts with these therapists to augment the care provided by its directly employed clinicians.
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Kaiser’s understaffed statewide mental health call center routinely forces patients to wait on hold for up to an hour before they can speak to a clinician, and stunningly up to four weeks for a return call.
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Kaiser appears to be violating state laws requiring that it conduct performance reviews of its behavioral health services and that it provide members with out-of-network care when it doesn’t have a healthcare provider available.
Rather than challenge the complaint’s findings, Kaiser issued a 7-page written response last December deflecting responsibility for its violations claiming that it’s hamstrung by a shortage of behavioral health care workers in Hawaii.
Meanwhile, Hawaii’s mental health crisis, a parallel pandemic, is getting worse at Kaiser clinics. Many therapists report that their schedules are now completely booked through July, and patients who phone the Call Center are being put on a waitlist. While Kaiser told state regulators in its December letter that it planned to hire 44 more mental health clinicians, the number of full-time staff has actually decreased from 51 to 47.
“Kaiser executives are making it crystal clear that mental health care does not matter to them,” said Rachel Kaya, a psychologist at Kaiser Permanente Maui Lani clinic. “As a therapist, my caseload is five times what it should be, and my patients can’t get the care they’re paying to receive. The problem isn’t that there are too few mental health clinicians in Hawaii; the problem is that Kaiser doesn’t want to pay to provide the level of mental health care that its members need.”
Kaiser reported an $8.1 billion net profit last year with $56.7 billion in cash and investments. Despite its strong financial footing, Kaiser has rejected proposals by clinicians to increase staffing and improve access to care. The HMO’s most recent offer in contract negotiations would result in a wage freeze for most clinicians with cuts to health and retirement benefits.
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The National Union of Healthcare Workers represents more than 16,000 healthcare workers in California and Hawaii, including 58 Kaiser mental health providers who provide treatment to 266,000 Kaiser enrollees at seven medical facilities and a call center on Oahu, Maui, and the Big Island.