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Kaiser mental health workers strike in Hawaii

NewsMay 24, 2022

NUHW-represented Psychologists, social workers, psychiatric nurses and chemical dependency counselors held a three-day strike May 18-20 at clinics and medical facilities across Hawaii to protest Kaiser Permanente’s severe understaffing of its behavioral health services that forces patients to wait months for therapy sessions.

The workers held spirited strike lines on Oahu, Maui and the Big Island and marched to the offices of the Hawaii Department of Commerce and Consumer Affairs, where they urged agency officials to fully investigate Kaiser’s failure to provide legally-required behavioral health care.

“We’ve sent a clear message to Kaiser that we won’t let it get away with treating behavioral health as second class and making people wait months to see a therapist,” said Robert Locklear, a licensed mental health counselor — certified substance abuse counselor at Kaiser’s Ala Moana Behavioral Health Clinic. “Hearing patients and community leaders talk these past few days about the struggles they and their loved ones face getting mental health care has made us even more determined to demand that Kaiser provide equal treatment for behavioral health care.”

Elected officials and community leaders spoke at daily rallies on the picket line, and several patients took the time to thank the striking workers. Members of the Hawaii chapter of the National Associations of Social Workers joined strikers and pledged further support.

The strike made headlines in Hawaii, with coverage from KHON,KITV,Hawaii News Now, the Honolulu Star-Advertiser, Maui News, West Hawaii Today, Becker’s Hospital Review, Hawaii Public Radio, Big Island Now, and Cialisppo.

In addition to covering the strike, the Star-Advertiser published an editorial endorsing the action and calling on Kaiser to provide better care. Coverage began a week before the strike got underway and continued throughout the weekend after the strike had ended.

Kaiser currently employs approximately 50 full-time equivalent clinicians who provide direct mental health care for Kaiser’s 266,000 members in Hawaii, a ratio of approximately one mental health clinician for every 5,320 Kaiser members in the state.

Kaiser officials have acknowledged to state regulators that the HMO is dramatically understaffing its mental health services, forcing many patients to endure dangerously long waits for care. Yet, despite increasing patient demand in Hawaii and across the country, since the start of the pandemic, Kaiser has refused to make changes at the bargaining table that would help improve access to care even as patients wait months to see a Kaiser therapist.

Kaiser, which reported an $8.1 billion net profit in 2021 and $56.7 billion in cash and investments, has rejected proposals to increase staffing and improve patient access. The HMO’s proposal would result in a wage freeze for more than 60 percent of its mental health workforce along with cuts to retirement and health benefits that would make it even harder for Kaiser to recruit and retain mental health therapists.

In November, NUHW filed a 57-page complaint with the Hawaii Department of Commerce and Consumer Affairs. The complaint, utilizing Kaiser’s own records, found that:

  • 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.
  • 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.
  • 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.
  • Kaiser appears to be violating multiple state and federal laws including ones that require Kaiser to have sufficient numbers of clinicians available to ensure timely mental health appointments for its members as well as a second provision of state law that requires Kaiser to provide members with out-of-network care when it doesn’t have a healthcare provider available.

On May 19, striking therapists in Hawaii marched to the Department of Commerce and Consumer Affairs Insurance Division, where they held a rally and presented officials with a letter demanding an investigation into the complaint they filed in November.

“Our message to the Insurance Division is simple: ‘Do your job,’” Andrea Kumura, a licensed clinical social worker at Kaiser’s Waipio Clinic, said during Thursday’s rally. “This is a crisis that demands urgent action. The time for lip service is over. We need to know your plan for conducting a thorough investigation into Kaiser, and your timeline for completing it.”