As Kaiser Permanente mental health care workers enter the third week of an open-ended strike, the union that represents them says the health care giant still has not provided a key state regulator with the details of how it will continue treating patients with so many workers holding picket signs.

Fred Seavey, a researcher with the National Union of Healthcare Workers, cited a document sent to the state Department of Managed Health Care before the strike began. Obtained under a union public records act request, the document, dated Oct. 18, 2024, states that Kaiser will provide the department with an amended statement with more real-time information on its plans to continue care during the strike by Oct. 21, the day that the current work stoppage began.

We communicated with the DMHC last week, and they said they have not received the additional information that Kaiser promised about its contingency plans, Seavey said.

In a written statement sent Thursday morning, Kaiser did not directly confirm or deny that it has not updated its contingency planning as indicated in the state document that the union provided.

However, Kaiser said that its planning efforts started weeks before the strike began, allowing expansion of our already very broad network of high-quality community-based therapists.

Nearly 60 percent of our patients currently receive care from providers who are not participating in the strike, the Kaiser statement added. As more and more Kaiser Permanente therapists return to work, our overall number of providers continues to grow.

However, the union wants a better enumeration of exactly how many people are available to take up the work no longer handled by striking workers.

Seavey said that the union has received reports from workers and patients indicating that many appointments have been put on wait lists and that Kaiser has been unable to keep up with the needs of those who have serious mental health diagnoses for conditions that require regular checkups. While the providers plans might seem like a technical detail, the analyst said they are a critical way for the union and the public to judge whether enough resources are being brought to bear.

The one-and-a-half page contingency plan that they have provided is incomplete and inadequate, and its important because we know that Kaiser canceled more than 111,000 mental health appointments during the mental health care strike that occurred in Northern California in 2022, Seavey said. That information was disclosed in Kaisers settlement agreement with the Department of Managed Health Care in 2023.

Indeed, the settlement agreement, available online, states that during the NUHW strike in Northern California, the plan reported that 11,803 behavioral health appointments were canceled, affecting a total of 63,808 individuals.

Of those, the document continues, there were 29,645 enrollees for whom the canceled appointment was rescheduled internally outside of 10 business days.

Kaiser called the unions claims about a lack of contingency planning grossly inaccurate, saying that it has experienced only a handful of issues that were quickly resolved, during the strike so far. The organization says it has contacted members with pending appointments and offered the option of waiting for their therapist to return to work, but those with higher acuity needs are being contacted within 10 days to monitor their well-being and again offer a scheduled appointment with an external therapist.

Every member who chooses to wait is provided with a director appointment line number to call should they change their mind, and the crisis line number if they experience a more acute need at any time, Kaiser said. Furthermore, those who are identified as high-risk are regularly monitored by our clinical team to ensure their needs are being met.

Crisis clinicians are available 24/7 to all patients with urgent needs.

Kaiser and the union remain far apart on several key negotiating points, including the amount of time that mental health care workers should receive each week to tend to matters outside direct patient care.