Patients who seek mental health services at Kaiser Permanente have to wait for weeks for appointments, are routed into group therapy even when they need individual attention and are not given proper initial evaluations, according to a new report by the National Union of Healthcare Workers, that represents some 2,500 mental health clinicians.
The study is based on a survey of over 300 Kaiser mental health professionals practicing at 57 Kaiser facilities in Northern and Southern California, along with dozens of open-ended interviews with clinicians and patients.
Among its findings:
- Kaiser mental health clinics are insufficiently staffed, with patients often forced to wait four weeks or longer for return appointments. That’s despite the fact that California state regulations require that patients be seen within ten business days,
- Staff conduct accelerated initial patient evaluations that fall short of recommended clinical standards, which are then miscoded incorrectly in order to avoid penalties,
- Patients that are funneled into group therapy even when their diagnoses call for individual therapy,
- Falsified patient scheduling records that conceal appointment delays from state regulators, through practices such as "shadow" paper records and deliberately canceling and rescheduling patients' appointments while falsely attributing the cancellation to the patient.
Clinicians interviewed for the study describe a pattern of “deceptive practices by Kaiser administrators that routinely compromise the health and safety of thousands of patients suffering from emotional pain and distress in order to save the company money,” according to the report, titled “Care Delayed, Care Denied.”
Kaiser has more than 6.6 million members and is California's largest HMO. Since 2009, it has reported profits of $5.7 million and last year paid its Chief Executive Officer George Halvorson $6.7 million.
“It’s clear to us that decisions are being made from an accounting standpoint, that Kaiser’s approach to treatment is about making money for Kaiser and basically denying patients the treatment they deserve,” said Jim Clifford, a therapist for Kaiser in San Diego.
In an issued statement, Kaiser said the findings of the study were inconsistent with its patient and provider survey data and that the HMO regularly performs better than the standards set by the state of California.
“We are disappointed that the NUHW is going to such effort to attempt to discredit the great work performed every day by our clinicians and mental health therapists,” the company said. “They (therapists) provide timely, high-quality mental health care services to our patients, day in and day out, and whenever emergencies arise.”
The company went on to say that it offers Urgent Services where patients in crisis can get same-day or next-day appointments along with consultations for patients who have been admitted to a hospital or those who arrive in the emergency room. In addition, Kaiser says it offers a mix of individual and group therapy and defends the latter as a proven and effective method for mental health treatment.
Now, NUHW is demanding an investigation by the California Department of Managed Health Care, that regulates Kaiser's HMO plans and the Department of Insurance, which regulates the company's fee-for-service offerings.
They also want the Attorney General's office to look into potential unfair business practices at Kaiser mental health.