Still without a contract, Kaiser clinicians go on strike | News, Sports, Jobs

A dozen behavioral health workers and union representatives from Maui and Oahu line the sidewalk and wave signs outside the Kaiser Permanente Maui Lani medical office Wednesday morning as part of an ‘open’ wide strike government for more staff, better salaries, and increased access to mental health services for patients. Kaiser and the National Union of Health Care Workers have been struggling to reach an acceptable contract, an effort that has been ongoing since 2018. The Maui News/DAKOTA GROSSMAN photos

MAUI LANI — Delayed mental health care services, understaffing issues and a lack of contractual agreement are the reasons why Maui psychologist Rachel Kaya went on strike alongside a dozen other Kaiser Permanente workers on Wednesday.

“We are sorely understaffed” Kaya said as he stood outside Kaiser’s Maui Lani clinic as part of a “open” picket line as Kaiser and the National Union of Health Care Workers struggle to secure a contract, an effort that has been ongoing since 2018. “That’s a fair representation of the number of employees we have for the 62,000 Kaiser policyholders on Maui, so taking care of their mental health care isn’t enough. We can’t see people often enough.

Kaiser Permanente Hawaii has 266,000 subscribers in Hawaii, but only has 57 to 60 mental health workers, according to the union, which represents about 50 mental health clinicians across the state. In other words, there is one therapist for every 5,200 members.

While not every member needs a therapist, there are still only nine mental health clinicians available to Kaiser’s patients on Maui, handling about seven appointments a day. This results in extremely long waiting times of up to two months, which is “beyond clinical standards” and leaves behind untreated cases of mental illness, according to the union.

Kaya, who has worked for Kaiser for 12 years, doesn’t have an opening until November.

Psychiatric nurse Rikki Patrizio (from left), clinical psychologist Cassendra Caceres-Licos and licensed clinical social worker Kathleen Rubio stand in solidarity Wednesday morning on Maui Lani Parkway outside the Kaiser Permanente Maui Lani Medical Office.

“One of the things I like to keep in mind is that Hawaii has a very high suicide rate and so when you think of people at risk of suicide, call our call center and say ‘hey , I need help “but not being able to get a first date for maybe two, three months is not acceptable”, Kaya said.

For the past three years, Lahaina resident Kayanna Bayly has been “severely frustrated” trying to access mental health services and arrange appointments for her teenage son, including giving him the necessary psychological assessment and medication management.

Bayly said it’s “ridiculous” that there are fewer than 60 mental health clinicians statewide given the high demand for services.

“I am angry with Kaiser for not supporting the doctors” she added. “But from the patients’ point of view, the strike does nothing and it hurts them too, because they lose money.”

In a bid to get her son back to school, she called 30 child psychiatrists and therapists and conducted her own research in hopes of finding the best care. She now pays out of pocket for the services.

“It is really important that we unite in our advocacy,” she says. “My voice is about bringing change for keiki and adults with mental health issues.”

Kaiser addressing staff shortages is first on employees’ wish list, Kaya said, which can be done by improving the work environment, increasing wages to offset the high cost of living in Hawaii and establishing a sufficient contract to recruit new employees and retain current ones. .

In 2021, the voluntary mental health employee turnover rate in Hawaii was 11.5%, which is higher than Kaiser would like, but the employer said it was still lower than the national average.

“The pandemic has tested our frontline care teams, including nurses, healthcare workers, doctors and, of course, our mental health clinicians,” KPH said in a statement. “We have the greatest respect and gratitude for our mental health professionals, and we are committed to supporting them in their important work.

On Wednesday morning, clinical psychologist Tami Swonigan, who has worked for Kaiser in Oahu for 15 years, led the megaphone chants.

Swonigan said patients report that delayed mental health care leaves them feeling lost, hopeless, avoidant at work or reverting to substance use.

“I am here with my peers to defend the interests of patients,” she says. “They lose, they get sicker, they don’t get the help they deserve, the help they need or really, the help they pay for in their premiums.”

On the other hand, his colleagues feel burned out, ignored and unsupported, so they retire early, change employers or leave the profession altogether.

Kaiser said the union’s claims about contract negotiations and staffing are false and misleading, and that they have been on a “journey of several years” increase the number of behavioral health clinicians “to meet the needs of our members and patients.

The employer has added 11 new behavioral health clinical positions, which are expected to be filled this year, as well as additional support staff. KPH plans to add the same type and number of positions each year until 2025.

Kaiser said 28 clinicians in Hawaii have been hired since the start of 2021, including eight people who will begin work in the next two months. They are currently recruiting for 14 vacancies for psychologists, licensed clinical social workers and licensed mental health professionals.

“It is unfortunate that NUHW leaders are asking our caring and compassionate mental health employees to distance themselves from their patients,” Kaiser said in a statement Wednesday. “This is the second time in less than a year that the union has called on our 60 NUHW-represented mental health providers to strike in an attempt to disrupt care and create pressure at the bargaining table.”

Kaiser agreed that patients were waiting weeks or even months for appointments. When appointments are not readily available, however, there is a “escalation process” in place to support patients with urgent needs and coordinate appropriate care, according to KPH.

They contacted patients whose appointments were affected by the strike to reschedule them or offer them another option, KPH added Wednesday.

Despite the strike, many mental health staff are still working — about half of behavioral health patients receive their care from providers not involved in the strike.

“We greatly respect the right of all our mental health professionals to decide for themselves whether or not to strike, and we appreciate those who have chosen to come to work for their patients,” said KPH. “In addition, our Kaiser Permanente psychiatrists, clinical managers and other licensed clinicians stepped in to meet with those in need of care.”

Kelly Harnick, who holds a doctorate in clinical psychology and president of the West Maui Counseling Center, said staffing shortages and delays in care aren’t just a problem at Kaiser as clinics battle across the state to improve access to mental and behavioral health treatment.

“Mental health is just as serious as any physical illness and can be deadly,” Harnick said Wednesday afternoon by phone. “It’s very important that the community really understands that they have a right to better access to care and that we all get involved in trying to improve it.

At the West Maui center, there are five clinicians, but one is on sick leave, and there is a psychiatric nurse practitioner who handles medication management.

Still, Harnick is actively hiring up to three other clinical psychologists or social workers, including a child physiatrist, to meet community demands — there are 500 to 600 active patients, some of whom are waiting for new providers.

The center also sees many patients with Kaiser insurance pay rolling fees out of pocket to receive care, she said.

“We need clinicians of all levels of training, we need more of all on Maui,” she says.

Picket lines will move to Kaiser’s facilities in Hilo on the island of Hawaii on Thursday before returning to Oahu on Friday.

Kaiser mental health workers in California have also been on strike over the same issues since August 15.

* Dakota Grossman can be reached at [email protected]

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