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Kaiser’s mental health clinicians launch strike

Workers on Maui plan to hold rally Thursday at Maui Lani clinic

Mental health clinicians at Kaiser Permanente are planning to strike at the Maui Lani Medical Office on Thursday, saying patients are having to wait months to get their first therapy appointment due to understaffing. The Maui News / MATTHEW THAYER photo

Mental health clinicians with Kaiser Permanente are launching a three-day strike starting today, saying their patients are having to wait months for therapy sessions due to growing caseloads at understaffed clinics.

More than 50 psychologists, licensed clinical social workers, medical social workers, psychiatric nurses and chemical dependency counselors at seven medical facilities and a call center on Maui, Oahu and Hawaii island plan to participate in the strike that lasts through Friday, according to the National Union of Healthcare Workers that represents more than 16,000 health care workers in Hawaii and California.

“Kaiser talks a big game about how they are a great place to work and about how they are mental health providers and about how they care about communities,” Rachel Kaya, an adult psychotherapist at the Kaiser Maui Lani Medical Office, said Tuesday. “Those are words. Their actions are that the people of Maui are struggling because Kaiser will not hire enough staff, and they treat the current staff poorly.”

On Maui, workers will be picketing from 7 a.m. to 4 p.m. Thursday at the Maui Lani office.

Kaiser Permanente called the union’s plans to strike for three days “unproductive,” describing it as “a bargaining tactic the union has used every time they negotiate a contract with Kaiser Permanente.”

“It is especially disappointing that the union is asking our dedicated and compassionate employees to walk away from their patients,” Kaiser Permanente said in a statement on Tuesday. “The need for mental health care among our members and patients has never been greater, and the stress and disruption caused by the ongoing pandemic has made it even more important.”

Both sides met for contract negotiations on Tuesday, but “no agreement is in sight,” the union said. Kaiser, the union claims, 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,” the union said in a news release Tuesday.

At the Maui Lani office, Kaya carries a caseload of about 150 patients, more than she can squeeze into a 40-hour work week. She sees seven patients a day for an hour each, for a total of 35 patients a week.

“You just run the math, there is no way I can do what I was trained to do, which is empirically validated types of psychotherapy, which takes one hour per week per patient,” she said.

Kaya is a generalist, which means she’s trained to handle a wide range of conditions, though she specializes in adult anxiety, adult depression and trauma-based treatment. She said there are about 10 employees in the Maui Lani clinic’s Integrated Behavioral Health department, though caseloads vary depending on each person’s role.

Because Kaiser has to provide services to patients who buy the insurance policies, caseloads “constantly increase” even if there’s not enough staffing, meaning that patients can sometimes wait months to get their first therapy session, Kaya said.

“We’re all just doing the best we can,” Kaya said. “Patients wait way longer between appointments than is probably good for them. … We try to catch them in brief little phone calls instead of full therapy hours, and really, frankly, a lot of the people we see, the people of Maui, wait and wait and wait and just are out there not able to get services they deserve.”

In November, the union filed a 57-page complaint with the Hawaii Department of Commerce and Consumer Affairs raising concerns that included Kaiser members waiting months to get their first therapy session due to understaffed clinics and encountering long wait and callback times with the understaffed mental health call center. The union also said that according to Kaiser’s own records, only 28 percent of Kaiser’s out-of-network mental health therapists are accepting new Kaiser members for care. Kaiser contracts the out-of-network therapists to help augment Kaiser clinicians’ care.

Kaiser told the department in a letter in December that staffing challenges and issues with behavioral health access are not unique to Kaiser and that the longstanding provider shortage in Hawaii was “exacerbated by the unprecedented spike of demand due to the pandemic.”

The health care provider said it has set “aggressive targets” internally to immediately hire six full-time psychiatrists as well as 11 new full-time therapists annually over the next four years, as well as 10 more administrative staff to support behavioral health functions.

“We strongly believe that a strike is unwarranted,” Kaiser Permanente said Tuesday. “In the face of a national shortage of mental health clinicians, and the growing need for mental health services, Kaiser Permanente continues to actively recruit in Hawaii to ensure care is available for our members.”

Kaiser reported that in the last 12 months, it has hired 21 behavioral health clinical staff and significantly expanded virtual care access.

The union, however, said that the number of full-time Kaiser clinicians providing mental health care in Hawaii has decreased since November from 51 to 47.

During the three-day strike, Kaiser said that facilities will be open for normal operations and that most appointments are not affected. Patients who have appointments at one of the facilities during picketing should arrive a little early due to possible traffic congestion, Kaiser said.

To cancel or change an appointment, visit kp.org/appointments or call the appointment call center on Maui at (808) 243-6000.

* Colleen Uechi can be reached at cuechi@mauinews.com.

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