This article was produced by Capital & Main. It is published here with permission.
The announced end of a nearly 200-day strike by Kaiser Permanente mental health care workers in Southern California will surely come as a relief to many of those employees. Some 2,400 of them — therapists, psychologists, social workers and others — walked off their jobs last October.
What the strike’s conclusion won’t do, for Kaiser patients, is radically change a mental health care system that is so dysfunctional, it’s been the subject of multiple fines and citations by the state — yet shows almost no sign of improving.
To that end, a California State Assembly bill is advancing to reimburse desperate Kaiser patients who have had to obtain their mental health care outside the health giant’s system. The Assembly’s Committee on Health, meanwhile, scheduled a Tuesday hearing to examine Kaiser’s continued failure to provide adequate behavioral health services.
And the state’s Department of Managed Health Care, which regulates Kaiser and other health providers in California, recently reported that among the 20 deficiencies it identified in Kaiser’s mental health services in 2022, all but one remain uncorrected.
It’s part of a larger trend, going back more than a decade, in which Kaiser has been dinged repeatedly by state regulators for running a system that doesn’t come close to providing the mental health care that many of its 9.4 million California members want and need.
“The fight goes on, and now it’s shifting to the state Legislature,” said Sal Rosselli, founder and president emeritus of the National Union of Healthcare Workers, which represents the workers in Southern California. (The NUHW is a financial supporter of Capital & Main.)
Kaiser officials declined to comment on the contract agreement. “We will have no additional information until the conclusion of the ratification process,” said spokesperson Terry Kanakri.
The strike’s end, announced late Sunday night, came after more than six months of off-and-on contract negotiations that mostly went nowhere. Gov. Gavin Newsom urged the parties to enter into mediation in February, and while the union quickly agreed, Kaiser refused to do so for nearly another full month, claiming the union’s contract requests made it clear that the NUHW was not “a willing partner committed to engage in constructive negotiations.”
Darrell Steinberg, formerly a state senator and mayor of Sacramento, was one of the mediators who finally helped broker a deal. The other was Mark Ghaly, who previously ran the state’s Health and Human Services department under Newsom.
“We would never have settled this contract without the help of those two mediators,” Rosselli said. “We had to end this strike for obvious reasons after 196 days, and clearly, Kaiser would have let the strike go on, as opposed to rectifying the issues that were causing it.”
Details of the agreement, which is subject to ratification by the affected NUHW membership, aren’t yet known. Union negotiators had sought:
28% in wage increases spread over three years (in part to compensate for what they claim are years of workers receiving no cost of living increases). The reinstatement of a suspended pension plan that Kaiser offers to almost all of its other employees. Seven hours per week set aside for therapists to work on their patients’ cases outside of actual therapy sessions, which is the current allotment for Kaiser’s Northern California workers.Rosselli said the new agreement will mark “only incremental progress” on improving patient access to care and getting wages that are more in line with what other Kaiser medical professionals in Southern California receive. During negotiations, Kaiser officials portrayed the union’s asks as exorbitant and claimed that Kaiser pays mental health professionals well above Southern California averages, though it was not clear which sets of workers it was comparing.
For years, Kaiser executives have maintained that there has been a substantial uptick in patients who want mental health care, but not enough professionals available to be hired to meet the need. Union representatives — and many Kaiser therapists who’ve spoken with Capital & Main over that time — counter that the company’s pay and working conditions prevent it from successfully filling jobs. Those same concerns led to a 10-week strike of Northern California Kaiser mental health workers in 2022, which Steinberg ultimately mediated to a settlement.
The NUHW cites Kaiser’s own data that shows about a quarter of the 1,500 therapists hired in Southern California between January 2021 and September 2024 have already left their positions. Nearly 65% of those departed within the first 12 months.
Kaiser’s chronic failure to provide adequate mental health services cost it a $4 million fine in 2013 for insufficient patient access, and four years later, it reached another settlement with the state on the same issues. Finally, in 2023, the Department of Managed Health Care announced a $200 million settlement with Kaiser that included a $50 million fine, the largest of its kind in state history.
As the DMHC’s recent findings make clear, Kaiser has moved at a glacial pace in correcting its systemic failures regarding mental and behavioral health care. Among the issues that haven’t been fixed: a lack of follow-up appointments for ongoing patients; failure to offer urgent mental health care appointments; an inadequate system of external providers as part of Kaiser’s network; and failure to promptly reschedule appointments that have been cancelled or missed.
A bill introduced by Assemblymember Jasmeet Bains, D-Delano, would require Kaiser to reimburse mental health patients who must seek care outside the clogged system. It’s backdated to May 2022 and wouldn’t conclude until Kaiser has “successfully completed implementation” of the corrective action work plan identified in its 2023 settlement with the state. That bill passed out of the Committee on Health and has been referred to Appropriations.
In the meantime, Health committee Chair Mia Bonta, D-Oakland, called Tuesday’s meeting. Its agenda, according to the posting of the hearing: “Kaiser Permanente’s Behavioral Health Care System.” Testimony is expected from a Kaiser patient and a therapist, DMHC representatives and union President Sophia Mendoza, among others. The agenda includes a space for an invited Kaiser representative; no name was listed, indicating that Kaiser had not accepted the invitation.
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