Northern California Kaiser therapists win major gains as strike concludes

NewsOctober 26, 2022

After walking picket lines for more than two months, more than 2,000 NUHW-represented therapists employed by Kaiser Permanente in Northern California and the Central Valley won a contract that includes major gains for their patients and themselves.

The therapists, who include psychologists, licensed clinical social workers, chemical dependency counselors and marriage and family therapists voted 1,561 to 36 to ratify the four-year contract that is retroactive to September 2021 and expires in September 2025. The agreement includes significant economic gains — essentially the same financial terms therapists had agreed to before going on strike August 15 — but now also includes provisions to improve mental healthcare services for Kaiser patients.

More than a dozen news outlets covered the ratification vote.

Key contract provisions include:

  • Nearly two additional hours per week for therapists to perform critical patient care duties such as responding to patient emails and voicemails, tailoring treatment plans, communicating with social service agencies and charting appointments. A recent union survey found that the lack of time to perform these duties has been the primary reason for Kaiser’s high turnover rate, which has doubled over the past year. Staff departures combined with overall understaffing has resulted in longer appointment wait times for patients.
  • An increase in extra pay for bilingual therapists from $1 per hour to $1.50 per hour. This will help Kaiser recruit and retain therapists who can meet the needs of non-English speakers. The new rate is the highest differential for bilingual workers that Kaiser has agreed to in California.
  • A commitment by Kaiser to hire more therapists and expand its new treatment track programs which allow certain patients better access to appointments over a shorter period of treatment.
  • A commitment by Kaiser to work with therapists on a plan to expand crisis services to nearly all of its clinics.
  • An agreement to increase from 60 to 90 minutes the amount of time therapists have to conduct initial assessments of children seeking mental health care.

“It took much longer than it should have to reach this agreement, but in the end, we succeeded in securing important improvements in patient care that Kaiser negotiators told us across the bargaining table that they’d never agree to,” said Jennifer Browning, a licensed clinical social worker for Kaiser in Roseville who served on the NUHW bargaining committee. “At a time when there are so few appointment cancellations because we’re seeing patients remotely, giving us enough time to perform all of our patient care duties is going to help keep a lot of us at Kaiser, and it’s going to help Kaiser hire more therapists.”

The contract also includes five separate labor–management Model of Care Committees that will meet over the next six months to make recommendations on critical aspects of Kaiser’s service model, including patient intakes, child and family therapy, and crisis care. These Model of Care Committees will be different than previous ones that left therapists disappointed, in that:

  • Kaiser will be required to implement and fully fund the committees’ recommendations.
  • If the committees stalemate, Mayor Steinberg has agreed to help mediate solutions as he did with the contract.

The Model of Care Committees will help guide Kaiser as it seeks to comply with SB 221, a new NUHW-sponsored state law that requires all health insurers to provide therapy sessions within 10 business days unless the treating therapist determines that a longer wait would not be detrimental to the patient.

Currently, Kaiser is not in compliance with the state law. Patients routinely wait months to start therapy sessions and four-to-eight weeks between appointments. Putting a stop to dangerously long wait times was among the reasons therapists chose to strike.

“This contract puts us on much stronger footing to work with Kaiser to help it become a great place to give and receive mental health care,” said Ilana Marcucci-Morris, a licensed clinical social worker for Kaiser in Oakland. “But any successful collaboration will require Kaiser’s total commitment to devote the resources necessary to meet California’s timely access to care requirements. We expect Kaiser to follow the law, and we expect the state to enforce it.”

“I’m proud of Kaiser therapists for standing up for their patients and their profession,” said Sal Rosselli, president of the National Union of Healthcare Workers, which represents Kaiser therapists in California and Hawaii. “Therapists, like other professionals, join unions so that they will have a voice on important professional issues along with leverage on wages, benefits and quality of life issues. Our members want to apply their professional judgment to better serve patients and they want to be treated with respect by their employer, rather than as cogs in a wheel. They want to be given the time necessary to do their jobs properly. Kaiser wanted to give orders, but not listen. This contract will help reset that relationship.”

Therapists agreed to Kaiser’s wage proposal before going on strike. The final agreement mirrors the initial terms with both sides agreeing to add an additional year to the contract. Wage increases, including retroactive pay, will be as follows:

  • Year 1: 4 percent
  • Year 2: 3 percent + a 1 percent lump sum bonus
  • Year 3: 3 percent
  • Year 4: 3 percent + a 1 percent lump sum bonus

“Our strike was difficult and draining, but it was worth it,” said Natalie Rogers, a therapist for Kaiser in Santa Rosa. “We stood up to the biggest nonprofit HMO in the nation, and we made gains that will help us better serve our patients and will advance the cause of mental health parity throughout the country.”

However, the struggle to achieve parity for mental health care at Kaiser is far from over. In Hawaii, there is still no settlement to a strike by Kaiser therapists that is now in its ninth week. The HMO has not only refused to provide similar terms for its Hawaii-based therapists as for its California-based therapists, it’s demanding that that they accept wage freezes and cuts to retirement benefits that would make it harder to recruit and retain therapists even though Kaiser’s accreditation agency has placed it under “corrective action for violating accepted clinical standards for mental health care.