Therapists demand action in response to tragic Santa Rosa suicide that highlights the failures of Kaiser Permanente’s mental health care services

KaiserAugust 3, 2015

Therapists demand action in response to tragic Santa Rosa suicide that highlights the failures of Kaiser Permanente’s mental health care services

Mental health clinicians call on Kaiser to immediately increase staffing and correct illegal practices that affect thousands of patients throughout California

Union also calls on California’s Department of Managed Health Care to urgently follow through on its investigations by levying financial penalties against Kaiser and demanding immediate staffing increases
EMERYVILLE — As reported by the Santa Rosa Press Democrat August 1, on July 3 Barbara Ragan, a retired Kaiser Permanente employee suffering from severe depression, sought help at Kaiser’s Santa Rosa Medical Center. Due to the systemic understaffing of its mental health clinics, for which Kaiser has been cited and fined $4 million by state regulators, Ragan was informed that she would have to wait eight weeks for a psychiatric appointment — six weeks beyond the state-mandated limit for non-urgent appointments and far in excess of the 48-hour standard for urgent care.

Two days later, on a Sunday morning, dressed in a robe and slippers, Barbara drove to the top of Kaiser’s Santa Rosa parking garage and, Kaiser card in hand, jumped to her death. Her family says she was making a statement about the lack of care made available to her by Kaiser.

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NUHW-represented Kaiser clinicians call on Kaiser Permanente to immediately staff its mental health clinics with enough psychologists, therapists, social workers, psychiatric nurses and psychiatrists to provide the timely, appropriate care that patients need and deserve and which the law requires.

“These tragic, preventable deaths are the inevitable human cost of a system run by accountants, not caregivers,” said NUHW President Sal Rosselli. “How many people have to die before Kaiser fixes the problem?”

“It’s a dangerously understaffed system that prioritizes profits over patients,” said Clement Papazian, a psychiatric social worker at Kaiser in Oakland. “How much money does Kaiser need to make before it starts meeting its legal and ethical obligations to its patients?”

Clinicians also call on California’s Department of Managed Health Care (DMHC) to follow through on its damning investigations of Kaiser by levying strong financial penalties against the HMO.

“DMHC officials have been sitting on their hands for six months while Kaiser patients are suffering,” said Elizabeth White, a psychiatric social worker at Kaiser in West Los Angeles. “The DMHC is a consumer protection agency. It needs to step up and do its job.”

The problem is simple: Kaiser does not provide enough clinicians to provide adequate mental health care, despite state and federal laws that require HMOs to provide timely, appropriate mental health care on par with physical healthcare. This systemic understaffing results in overbooked clinics that force patients to wait weeks, even months for appointments. Over the past four years, NUHW has supplied more than one thousand pages of documentation showing illegal appointment delays, falsification of records to conceal delays, illegal directives given by managers to clinicians, and internal reports that show Kaiser deliberately understaffs its clinics and emphasizes group therapy over individual therapy as a cost-saving measure. These records document violations at Kaiser clinics throughout California including Santa Rosa, San Francisco, Sacramento, Vallejo, Oakland, Walnut Creek, Fremont, San Jose, Fresno, Bakersfield, Los Angeles, Ontario, San Bernardino, and San Diego.

In 2013 the DMHC cited Kaiser for “serious” and “systemic” violations of state law and levied a $4 million fine — the second largest in the agency’s history — against the HMO.

Yet the DMHC has done nothing to enforce the law since the February 2015 release of the findings of its follow-up investigation, which found that Kaiser is still violating the law and understaffing its clinics two years later. In the report, DMHC investigators found that 22% of Kaiser’s Northern California patients experienced excessive appointment delays that violate California law.

Kaiser claims to have increased clinic staffing by 25%, but clinicians working in those facilities report minimal increases, most of which have been offset by staff attrition due to the difficult working conditions. Kaiser has tried outsourcing therapy to a subcontractor, ValueOptions, which not only has a spotty record of its own but has proven unable to handle the caseload Kaiser has saddled it with.

Meanwhile, “nonprofit” Kaiser is bringing in record profits — $1 billion in the first quarter of 2015, more than $15 billion over the past five years — and has stockpiled $22 billion in reserves, an amount that exceeds state-mandated levels by 1500 percent.

The consequences of Kaiser’s violations and the DMHC’s inaction are often tragic. Barbara Ragan’s death is not an isolated case. In 2011, Peter Kingston, the husband of Sonoma County Supervisor Shirlee Zane, took his own life two weeks into a six-week wait for therapy at Kaiser Santa Rosa, a case reported on by the Santa Rosa Press Democrat. Another tragedy, for which Kaiser has somehow managed to avoid media attention, occurred in December 2014 when a Kaiser nurse in Sacramento took her own life in a Kaiser restroom after apparently failing to obtain treatment from the HMO’s mental health department. In 2012, Fred Paratoud of Point Richmond hanged himself after Kaiser denied him one-on-one therapy for bipolar disorder. Kaiser’s failure to provide timely, adequate care for Paratoud is the subject of a lawsuit making its way through the courts. In a Courage Campaign press conference in June, Sarah Dougherty shared the story of her husband, who managed to obtain one-on-one therapy from Kaiser San Francisco only after attempting suicide following years of delayed appointments and group therapy that he found ineffective.

These are just a few of the thousands of Kaiser patients who have been denied the care they desperately needed.
The National Union of Healthcare Workers (NUHW) represents more than 10,000 healthcare workers, including 2,650 Kaiser Permanente mental health clinicians at facilities throughout California.