Kaiser Permanente doctors say California patients are still being denied prompt treatment: People’s World

Members of the National Union of Healthcare Workers picket the Kaiser Permanente Fontana Medical Center, December 10, 2018, in Fontana, California. Thousands of Kaiser Permanente mental health professionals across California went on a weeklong strike that day to protest what they say is a staff shortage impacting on care. Now, even with a new state law requiring faster patient follow-up, doctors say patients are still subject to long waiting times between appointments. | James Quigg / The Daily Press via AP

OAKLAND, California — Californians’ long struggle to access timely mental health care is entering a new era. A new law, Senate Bill 221, by state Senator Scott Wiener, D-San Francisco, went into effect on July 1 to address an important ongoing problem: the extremely long waits patients have to endure between the initial appointment. for recruitment and follow-up care.

The measure addresses a longstanding gap in California law: while health maintenance organizations and insurers must provide initial mental health assessments within two weeks of a patient’s request, they have not been required to provide follow-up. within the same time frame, which leads to long waiting times for many patients.

SB 221 passed the legislature with an overwhelming bipartisan majority in the legislative session of 2021. It was signed into law last October, but did not go into effect immediately, to give suppliers time to prepare to meet the new requirements. Under its provisions, health insurers must provide a follow-up appointment for behavioral health within two weeks of the initial intake appointment, unless the therapist deems it medically unnecessary.

Speaking to reporters on June 30, Wiener said the measure “means health plans must provide timely access to mental health appointments, that you can’t give someone a first date and then make them wait two or three months.” for the second and subsequent appointments, because this completely undermines effective mental health treatment ”.

Wiener said he was together with Kaiser Permanente’s frontline mental health workers and Kaiser members because they are very concerned that health plans, and Kaiser in particular, are not yet prepared to meet the requirements of SB 221.

“These are people with severe mental health problems and addiction problems and they need quick access to treatment, like someone breaking their arm or having another serious health problem.”

At the Zoom conference, triage therapist Kaiser Sarah Soroken and clinical social worker Josh Garcia joined Wiener.

Soroken, who said he works with people in crisis and in need of a first date, told reporters that waiting times have actually gotten worse since SB 221 went into law. She said she received many calls from patients who waited weeks or months to get an appointment for individual therapy and whose symptoms often worsened during the long wait.

When, as is often the case, he cannot offer them timely appointments within the Kaiser system, Soroken asks managers to provide immediate assistance through Kaiser’s network of external suppliers. But, she said, “sadly, Kaiser doesn’t allow patients with more severe symptoms to be referred outside the system for treatment and they end up waiting six to eight weeks or more.”

Meanwhile, many patients with mild to moderate symptoms who are referred outside of Kaiser are unable to find an available therapist in the healthcare giant’s overworked network of external providers and end up calling back with worsening symptoms.

Soroken shared drafted patient medical records showing wait times ranging from one month to more than three months between hiring appointments and the first therapy appointment.

“Kaiser can tell he has many plans to comply with SB 221,” he said, “but this is the reality for patients: the law will go into effect tomorrow and they can’t be seen for months yet.”

Garcia expressed concern that Kaiser did not share any specific plans with doctors at his clinic and said the only idea he heard was reducing mental health appointments to 30 minutes; Soroken later confirmed that even shorter appointments were being implemented in Kaiser’s psychiatry office in Vallejo.

“We want to work with Kaiser leaders to implement SB 221 because it would have a profound benefit for all of our patients,” said Garcia, “but the only way to do this is to add more sessions of 45 minutes or more” with intervals of seven to 10 days between appointments and even more frequently in some cases.

The human toll of Kaiser’s long waiting times was graphically described by longtime Kaiser patient Jasmin Hakes, whose daughter, now 21, was first diagnosed with multiple serious mental health problems in 2013. In 2019 and again in 2020, her daughter was hospitalized with severe depression and suicidal thoughts, even ending up on life support at some point after overdosing.

Hakes said that despite daily calls, voicemails and emails and repeated assurances that Kaiser would contact them once a therapist was available, “to this day, he still doesn’t have a therapist.”

Kaiser’s mental health doctors are represented by the National Union of Healthcare Professionals, whose president, Sal Rosselli, described the doctors’ 12-year struggle with the health giant’s administration and medical leaders over “lack of access timely to return care caused by Kaiser’s severe staff shortage at his mental health clinics.

Rosselli credited that fight for contributing to the nearly unanimous bipartisan passage of SB 221.

“This law has the potential to help so many Californians, which is why it is so disappointing that Kaiser, as the provider of more than a third of all insured Californians, has taken no steps to comply,” he said.

In fact, the California Department of Managed Health Care launched a special “non-routine survey” in May to see if Kaiser is providing adequate mental health coverage to its 9.4 million California subscribers.

Challenging Kaiser’s claims that he is having difficulty preparing for SB 221 compliance due to a nationwide shortage of doctors, Rosselli pointed out that mental health doctors are leaving Kaiser in record numbers – 668 over the past 12 months – which according to him it was about double the number coming out in each of the previous two years. He also noted that Kaiser posted a net profit of $ 8.1 billion in 2021.

“If our members were given the tools they need, including the right staff, Kaiser could have the best mental health care system in the country,” he said. “But once again, Kaiser’s executives have refused to invest in its mental health services and its members are suffering the consequences.”

Rosselli said Kaiser therapists and their union are ready to help Kaiser comply, “but right now, the best way to enforce Kaiser and all health insurers is to make sure everyone knows their right to timely treatment.” She urged patients, their families and those interested in the matter to learn more about the new law and ways to file a complaint when providers are non-compliant by going to nuhw.org/sb221 and a related website. , kaiserdontdeny. org.

He also drew attention to another provision by state Senator Wiener, SB 858, which passed the Senate last month and is currently under consideration in the Assembly. That bill would dramatically increase fines for violating mandatory consumer protections, which in many cases have not been updated since the 1970s.

Unfortunately, Rosselli said, “organizations like Kaiser Permanente see fines as the cost of doing business, so this is another piece of legislation that we hope and imagine will pass this year, and we hope Governor Newsom will sign, to raise the rate again. pressure on providers to obey the law and provide adequate access to care ”.


COLLABORATOR

Marilyn Bechtel


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