NUHW Kaiser Mental Health

After five years and multiple strikes, three thousand NUHW-represented Kaiser Permanente mental health clinicians —  psychologists, licensed clinical social workers, marriage and family therapists, and psychiatric nurses —  won a major victory that not only benefits their patients but also assists their fellow Kaiser workers in more than thirty other unions.

In November 2015, clinicians reached an eleventh-hour settlement with Kaiser that averted an open-ended strike at fifty Northern California Kaiser facilities. The clinicians are the largest group of private-sector mental health professionals in California.

The central issues:

  • Kaiser’s severe understaffing, which led to long, illegal appointment wait times for patients. Kaiser was cited twice in two years by the California Department of Managed Health Care (DMHC) for these “serious” and “systemic” violations and forced to pay a $4 million fine. Nonetheless, patients’ lengthy wait times persisted.
  • Wage freezes and cuts to pension benefits.

Under the agreement, mediated by former California State Senate Pro Tem Darrell Steinberg, Kaiser clinicians established a first-of-its-kind staffing ratio that allows them to treat patients more frequently and creates a trigger mechanism that requires Kaiser to hire more clinicians if the HMO fails to meet the scheduling ratio for a period exceeding three months.

The agreement underscores clinicians’ right to continue their patient advocacy efforts, both internally and externally, without threat of discipline or discharge. 

In 2011, clinicians filed a complaint with California’s Department of Managed Health Care (DMHC) regarding Kaiser’s understaffing of its mental health services, which forces patients to endure excessive appointment wait times that violate California’s timely access regulations. After conducting a fifteen-month investigation, the government agency fined Kaiser $4 million and ordered the HMO to “cease and desist” from committing its “serious” and “systemic” violations of patients’ rights.

Kaiser’s understaffing left clinicians unable to see patients frequently enough to provide effective, ongoing treatment. For patients suffering from depression, post-traumatic stress disorder, or other conditions, these delays can be insurmountable obstacles, often with harmful effects. 

Following clinicians’ successful complaint to the DMHC, Kaiser’s patients and their families filed five class-action lawsuits against the HMO for delayed care and violating the California Mental Health Parity Act. 

Meanwhile, the clinicians conducted a week-long statewide strike in January 2015 that brought national and even international media attention to the issue and helped spark a broader discussion of mental health care. The strike also brought many allies to the clinicians’ cause, including former Congressman Patrick Kennedy, who planned to walk the picket line with striking clinicians.

We still have a long way to go to achieve mental health parity within the Kaiser system and in the country as a whole, but the agreement between Kaiser and its clinicians is a good first step.

As far as wages and pension, the clinicians’ struggle resulted in important victories for Kaiser employees. Five years ago, Kaiser proposed to eliminate employees’ defined-benefit pension and put NUHW members — and all of Kaiser’s more than 100,000 unionized workers — into a 401(k) plan. 

NUHW was the first union to face Kaiser’s demand for this massive concession. The clinicians conducted an initial set of strikes that forced Kaiser to partially dial back its proposal from completely eliminating the pension to eliminating it only for new employees. 

Next, NUHW members fought this proposal as well. In late 2015, Kaiser announced it was unilaterally implementing a two-tiered system that would force newly hired clinicians into a cheaper 401(k) plan. However, just hours before NUHW members were set to launch their open-ended strike, Kaiser backpedaled and announced it was withdrawing its two-tiered system for NUHW’s Northern California clinicians. 

Kaiser also agreed to a three-year contract with annual pay increases of 6 percent, 4.5 percent, and 4.5 percent along with 5 percent bonuses in the second and third years of the contract.

The struggle has not been easy. NUHW-represented Kaiser employees worked for five years without a contract and went several years without pay increases. They waged multiple statewide strikes, acted as whistleblowers, traveled across the country to tell their story, and experienced harassment, retaliation, and attacks from Kaiser management. They also workforce to battle the leaders of Kaiser’s “partnership” unions who were fully prepared to accept Kaiser’s elimination of the defined-benefit pension and who teamed up with management to try to break our strikes. 

In the end, we were successful because NUHW members simply wouldn’t give up. It’s an important lesson for our era of ever-more-powerful corporations: even relatively small groups of workers can prevail against multi-billion dollar corporations like Kaiser Permanente if we are determined, well organized, have a plan, and are ready to fight.