Report finds mental health understaffing threatens patient health and safety

Despite recording $5.6 billion in profits since 2009, Kaiser Permanente, California’s largest HMO, jeopardizes patient health and safety by refusing to adequately staff its mental health facilities. That’s the conclusion of a report, entitled Care Delayed, Care Denied, recently published by National United Healthcare Workers, a union representing Kaiser healthcare providers in California.

Based on the results of a survey of 300 mental health professionals working at 57 Kaiser-owned facilities in Northern and Southern California, the report finds that:

  • 90 percent of the respondents reported delays in scheduling patient return appointments caused by understaffing at the facilities where they work,
  • Patients must frequently wait four to six weeks for a return appointment even though California regulations require a return visit within 10 days,
  • Kaiser requires clinicians to “speed up” their evaluations, which sometimes leads to miscoding errors and subsequent fraudulent Medicare and other insurance claims, and
  • Kaiser falsifies records to conceal return appointment delays.

NUHW is currently engaged in contract talks with Kaiser. One of the major concerns of workers represented by the union is that understaffing at Kaiser facilities seriously undermines the health and safety of the patients served by the providers.

“What we’re dealing with as providers is that we work for a company that is requiring us to provide the bare minimum type of service,” said Emily Ryan, a psychiatric social worker. “And what happens because of that is that patients suffer.”

Bill Hawkins is a patient at Kaiser, says he has seen service at Kaiser deteriorate as the wait time for return visits have become longer and less reliable. Hawkins suffered a stroke, then was diagnosed with Parkinson’s, which led to some mental health problems.

“I began to notice a shift in the practice three or four years ago when it became very difficult to get an appointment,” Hawkins said. “The therapist would try to schedule a return appointment, but would be told that the next available appointment was six to eight weeks down the road. They would put me on a waiting list in case an appointment time opened up before then, but they didn’t give you much advanced notice when that happened. The impression I get with Kaiser Mental Health is that there are far too many patients and not enough staffing.”

Timm Sinclair’s 76-year old mother is being treated by providers at Kaiser. She too suffers from Parkinson’s as well as depression and anxiety disorder, which causes falls and serious injuries. “A Kaiser psychiatrist prescribed medicine for her anxiety disorder,” Sinclair said. “But he resigned, and Mother was put on a three- to four-month wait list for a follow up visit to determine how well the medicine was working. There weren’t enough psychiatrists to see my mother in a timely way.”

The California Chapter of the National Social Workers Association reviewed Care Delayed, Care Denied and issued a statement on its findings. “We are seriously concerned with the key findings of this report. It appears that there are very serious and clear violations of California law relating to timely access to care and inadequate health care practices at Kaiser that appear to fall short of recommended clinical standards,” reads the statement.

The California Psychologists Association also reviewed the report. It issued a statement of concern saying that “We are seriously concerned with the key findings of this report. It appears that there are very serious and clear violations of California law relating to timely access to care and inadequate health care practices at Kaiser that appear to fall short of recommended clinical standards.”

NUHW and Kaiser Permanente, which describes itself as a health care organization for the 21st Century, have been negotiating a new contract since 2010. The union is seeking guarantees that will ensure that Kaiser will address the understaffing issues that lead to poor patient care. The union also opposes benefit cuts that the employer is seeking. In September, NUHW members staged a three-day strike to press their demands for adequate staffing at Kaiser facilities.

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One thought on “Report finds mental health understaffing threatens patient health and safety

  1. If conditions at Kaiser Permanente are bad where the workers have a strong union, one can only imagine what they are like in Texas state hospitals. I worked at the San Antonio State Hospital in the mid 80’s and I can attest to the following: both workers and patients were in danger as staff to patient ratios as mandated by a federal court went often ignored. Pay for the direct care staff was pathetically low and with public workers denied the right to bargain collectively and/or strike, the chance of any real improvements are quite dim.

    I fully support public health programs, but there is a lot that must change, if quality care and worker justice is to be achieved! Without justice on the job, there will never be quality care!

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