A sign fronting Kaiser Permanente’s Wailuku Clinic is shown on Thursday afternoon. Days after Kaiser physical and occupational therapists and pharmacists voted to authorize a strike against the health care provider, Kaiser mental health clinicians in Hawaii also voted to authorize a strike. The Maui News / MATTHEW THAYER photo

Kaiser Permanente mental health clinicians have voted to authorize a strike against the major health care provider, citing a lack of raises, lower pay for new workers and other issues that have come up in contract negotiations.

The vote does not guarantee that a strike will take place, according to a news release from the National Union of Healthcare Workers, which represents the 51 clinicians who provide mental health and addiction medicine services to 260,000 Kaiser members in Hawaii.

On Maui there are nine full-time Kaiser mental health clinicians and one part-time clinician, a union official said.

The clinicians have not yet submitted a formal strike notice to Kaiser and no strike date has been set. Contract bargaining resumes next week, the union said in a news release Wednesday.

Last week more than 1,500 Kaiser Hawaii and California pharmacists, physical therapists, occupational therapists and speech-language pathologists also voted to authorize a strike. They are represented by the United Nurses Association of California/Union of Health Care Professionals.

Similarly, the vote doesn’t mean a strike will happen immediately, but gives the bargaining teams the option of calling a strike when they choose.

The unions did not have an update Thursday as to whether Hawaii therapists and pharmacists planned to strike but a news release Thursday afternoon from the unions said fellow workers in California are planning to go ahead with a strike on Nov. 15 over contract issues regarding wages and working conditions.

The votes to strike and contract issues with Kaiser Permanente do not affect Maui Health, which is a Kaiser affiliate that operates Maui Memorial Medical Center, Kula Hospital and Lanai Community Hospital, a Maui Health spokesperson said.

The National Union of Healthcare Workers, which represents the mental health clinicians, formed in 2018 in hopes of improving access to care. Instead of hiring more therapists, Kaiser is proposing significant cuts to wages and benefits that would make it harder to recruit and retain staff, the union said.

Kaiser is proposing no raises for its current mental health clinicians along with higher health insurance co-payments, according to the union. It is also proposing the elimination of pensions and significantly lower pay for mental health clinicians hired after 2022. The union added that the wage scale Kaiser is proposing for new hires would cap their salaries far below what current clinicians are currently earning.

“I’m currently carrying a caseload of over 150 active therapy patients,” Rachel Kaya, a psychologist at Kaiser Permanente’s Maui Lani clinic, said in a news release. “It would take more than five full-time therapists to provide my patients timely, clinically appropriate care. The access problem causes repeated, shameful, horrifying violations of my professional code of ethics.”

On Wednesday, the National Union of Healthcare Workers also filed a complaint with the state Department of Commerce and Consumer Affairs calling for an investigation into Kaiser’s “apparent violations of state and federal laws, including mental health parity laws.”

The complaint cites internal Kaiser records documenting how Kaiser’s understaffing of its mental health clinics and external provider networks “severely delay thousands of enrollees’ access to mental health services and place their health and safety at risk,” according to the news release.

Arlene Peasnall, senior vice president of human resources at Kaiser Permanente, said the two sides are still bargaining on an initial contract “and are committed to reaching an agreement.”

“We have the greatest respect and gratitude for our mental health professionals and we are dedicated to supporting them in their important work,” she said.

A significant shortage of mental health clinicians was already a “challenge” prior to the pandemic, and over the past year-and-a-half, the demand for care has increased everywhere, she said.

Over the past five years, Kaiser has added new mental health clinicians to its workforce all across the country and has also expanded its ability to provide virtual care to patients who want it, even as the union initially objected to the effort, Peasnall said.

“While the union is issuing press statements about staffing, the real issue at the table is how much therapists are paid,” she said. “At the heart of the challenge is this: Health care is increasingly unaffordable, and escalating wages are half of our costs.”

She said Kaiser Permanente is “indisputably one of the most labor-friendly organizations” in the U.S.

“But we cannot continue to allow costs to grow beyond what our members can afford,” Peasnall said.

Mental health care professionals are paid very competitively in Hawaii, she said. Psychologists earn more than $120,000 in wages on average, which is more than $17,000 higher than the market average, and licensed clinical social workers earn more than $91,000 in wages on average, which is more than $10,000 higher than the market average.

Peasnall said the threat of a strike is a “key part” of the union’s bargaining strategy “and it is especially disappointing that they are asking our dedicated and compassionate employees to walk away from their patients when they need us most.”

Peasnall said that if there is a strike, the facilities will be staffed by trained and experienced managers and contingency staff who will be brought on as needed. Physicians will continue to be available to patients.

* Melissa Tanji can be reached at mtanji@mauinews.com.