By Sheri Williams
After a ten-week strike at Kaiser facilities throughout northern California, union health care workers have won a new contract.
“I’m proud of Kaiser therapists for standing up for their patients and their profession,” said Sal Rosselli, president of the National Union of Healthcare Workers, which represents Kaiser therapists in California and Hawaii. “Therapists, like other professionals, join unions so that they will have a voice on important professional issues along with leverage on wages, benefits and quality of life issues. Our members want to apply their professional judgment to better serve patients and they want to be treated with respect by their employer, rather than as cogs in a wheel. They want to be given the time necessary to do their jobs properly. Kaiser wanted to give orders, but not listen. This contract will help reset that relationship.”
Union members walked picket lines for more than two months in what became the longest health strike by mental healthcare workers in U.S. history. An agreement between NUHW and Kaiser Permanente was reached in October after Sacramento Mayor Darrell Steinberg stepped in to serve as a mediator. The agreement includes breakthrough provisions to retain staff, reduce wait times for patients and a plan for labor and management to collaborate on transforming Kaiser’s model for providing mental health care.
“It took much longer than it should have to reach this agreement, but, in the end, we succeeded in securing important improvements in patient care that Kaiser negotiators told us across the bargaining table that they’d never agree to,” said Jennifer Browning, a licensed clinical social worker for Kaiser in Roseville who served on the NUHW bargaining committee. “At a time when there are so few appointment cancellations because we’re seeing patients remotely, giving us enough time to perform all of our patient care duties is going to help keep a lot of us at Kaiser, and it’s going to help Kaiser hire more therapists.”
Therapists employed by Kaiser Permanente in Northern California and the Central Valley—members of the National Union of Healthcare Workers—voted 1,561 to 36 to ratify a contract that includes major gains for patients as well as clinicians.
The four-year contract is retroactive to Sept. 2021 and expires in Sept. 2025. It includes significant economic gains for the more than 2,000 Kaiser therapists, essentially the same financial terms that they had agreed to before going on strike Aug. 15, but now also includes provisions to improve mental healthcare services for Kaiser patients.
The contract also provides early two additional hours per week for therapists to perform critical patient care duties such as responding to patient emails and voicemails, tailoring treatment plans, communicating with social service agencies and charting appointments.
A recent union survey found that the lack of time to perform these duties has been the primary reason for Kaiser’s high turnover rate, which has doubled over the past year. Staff departures combined with overall understaffing has resulted in longer appointment wait times for patients.
The union workers also won an increase in extra pay for bilingual therapists from $1 per hour to $1.50 per hour. This will help Kaiser recruit and retain therapists who can meet the needs of non-English speakers. The new rate is the highest differential for bilingual workers that Kaiser has agreed to in California.
Kaiser also agreed to hire more therapists and expand its new treatment track programs which allow certain patients better access to appointments over a shorter period of treatment.
The healthcare giant also said it would work with therapists on a plan to expand crisis services to nearly all of its clinics and increase from 60 to 90 minutes the amount of time therapists have to conduct initial assessments of children seeking mental health care.
The contract also includes five separate labor-management Model of Care Committees that will meet over the next six months to make recommendations on critical aspects of Kaiser’s service model, including patient intakes, child and family therapy, and crisis care. These Model of Care Committees will be different than previous ones that left therapists disappointed, in that Kaiser will be required to implement and fully fund the committees’ recommendations. If the committees stalemate, Mayor Steinberg has agreed to help mediate solutions as he did with the contract.
The Model of Care Committees will help guide Kaiser as it seeks to comply with SB 221, a new state law that requires all health insurers to provide therapy sessions within 10 business days unless the treating therapist determines that a longer wait would not be detrimental to the patient.
Currently, Kaiser is not in compliance with the state law, according to the union. Patients routinely wait months to start therapy sessions and four-to-eight weeks between appointments, it said in a statement. Putting a stop to dangerously long wait times was among the reasons therapists chose to strike.
“This contract puts us on much stronger footing to work with Kaiser to help it become a great place to give and receive mental health care,” said Ilana Marcucci-Morris, a licensed clinical social worker for Kaiser in Oakland. “But any successful collaboration will require Kaiser’s total commitment to devote the resources necessary to meet California’s timely access to care requirements. We expect Kaiser to follow the law, and we expect the state to enforce it.”
Therapists agreed to Kaiser’s wage proposal before going on strike. The final agreement mirrors the initial terms with both sides agreeing to add an additional year to the contract.
“Our strike was difficult and draining, but it was worth it,” said Natalie Rogers, a therapist for Kaiser in Santa Rosa. “We stood up to the biggest nonprofit HMO in the nation, and we made gains that will help us better serve our patients and will advance the cause of mental health parity throughout the country.”