Hawaii Joins No.California KaiserPermanente Mental Health Workers Strike; CA investigates KP

Mental healthcare workers in KaiserPerm/Hawaii last week joined the since-Aug.16 striking northern California KP clinicians, psychologists, licensed clinical social workers, medical social workers, case manager nurses and chemical dependency counselors. They are demanding an end to KP management’s dozen-plus years of under-staffing their departments that forces patients to wait weeks and months for appropriate care.

Example of the disparity:

[Fifty-seven clinicians are required to] provide services for 266,000 Kaiser members at seven medical facilities and a call center on Oahu, Maui, and the Big Island…

The clinicians charge that

the understaffing within Kaiser’s mental health clinics has led to overwhelming caseloads and is putting patients’ health at risk. They’ve been pushing Kaiser to increase salaries and benefits to attract more staff.

“People’s lives are at stake,” said Andrea Kumura, a licensed clinical social worker at Kaiser’s Waipio Medical Office, in a press release announcing the strike. “Kaiser is making us violate our professional ethics by delivering care that doesn’t meet the needs of our patients, and the proposal that Kaiser has on the table would result in people waiting even longer for care.”

...This is the second time this year that Kaiser’s mental health staff, who are represented by the National Union of Healthcare Workers, have gone on strike. They went on strike for three days in May. This time, the union says the strike is open-ended and was launched as a last resort. ... In addition to the strikes, the union has filed complaints with regulators.

     Last Monday, healthcaredive.com reported that the California Department of Managed care on August 22 had

launched a targeted enforcement investigation into whether [KP] health plans are providing patients with timely access to appointments, as required by law…

The probe follows a complaint earlier this month by the National Union of Healthcare Workers to the DMHC that accused Kaiser Foundation Health Plan of illegally canceling behavioral health services for thousands of enrollees in Northern California in response to the impending strike by non-physician clinicians. The strike by DMHC-represented clinicians began on Aug. 15….

     The unions contend that KP has long actively neglected to comply with California law on timely access.

...The more than 2,000 mental health therapists on strike will remain off the job until Kaiser increases staffing at its clinics and ends “dangerously long” wait times for therapy sessions, according to the NUHW. The union contends Kaiser is breaking California law and violating clinical standards by making patients wait months to start therapy and four to eight weeks between appointments.

California law requires health plans to arrange for care to be provided out of network if timely access to mental health services is unavailable from in-network providers….

     Although KP is popularly believed to be a nonprofit “health maintenance organization“ (i.e., insurer as well as provider of medical “care”), that’s only one-third true.

Kaiser Permanente ..Kaiser Permanente is made up of three distinct but interdependent groups of entities: the Kaiser Foundation Health Plan, Inc. (KFHP) and its regional operating subsidiaries; Kaiser Foundation Hospitals; and the regional Permanente Medical Groups [which are] physician-owned organizations, which provide and arrange for medical care for Kaiser Foundation Health Plan members in each respective region. <big>The medical groups are for-profit partnerships or professional corporations and receive nearly all of their funding from Kaiser Foundation Health Plans. ... Around [1997] The Permanente Company was also chartered as a vehicle to provide investment opportunities for the for-profit Permanente Medical Groups</big>^[13] [one such opportunity being] Kaiser Permanente Ventures, a venture capital firm that invests in emerging medical technologies...^[14]

     This is far from the first time that KP has run afoul of state of California regulators: KP has a long history of being fined in the millions for medical workplace and related violations, and California has passed legislation requiring rigorous financial reportage to the state more in the way commercial businesses are required than are nonprofit organizations. A fairly thorough overview of the impacts of KP’s habitual financial habits upon vulnerable patients and non-physician staff are detailed in this post. and the other 60+ dk posts at that tag. Below is the full bibliography of professional journalism and union links for the several KP posts by me, most recent first:

1. National Union of Healthcare Workers
2. SFGate — Sep. 2, 2022 California regulators launch investigation into Kaiser's mental health care during strike
3. kron4.com — Sept 1, 2022 Bay Area Kaiser nurses picket for safety
4. sacobserver.com — Aug 31, 2022 Black Doctors March to the Kaiser Permanente Bernard J. Tyson School of Medicine Shine Spotlight on Institutionalized Racism; Some at the rally are in litigation against Kaiser,
5. BeckersHospitalReview.com — August 30th, 2022 Lawsuit accuses Kaiser Permanente medical school of of racial discrimination for the second time since opening in summer 2020
6. healthcaredive.com — 29 Aug 2022 California probes Kaiser over enrollee access to mental health
7. BeckersHospitalReview — August 29th, 2022 Kaiser mental health workers' strike expands to Hawaii
8. staradvertiser.com 29 August 2022 Kaiser mental health therapists in Hawaii launch second strike.
9. HawaiiNewsNow.com — Aug 28, 2022 Grappling with staffing shortages, Kaiser’s mental health professionals go on strike
10. khn.org — 19 Aug 2022 Kaiser Permanente Staff Strike Spreads To Hawaii
11. PressEnterprise.com —  August 16, 2022 Kaiser Permanente plans $1.7 billion hospital, office expansion in Riverside County: New facilities are rising in Riverside, Moreno Valley, Murrieta and Wildoma
12. TheGuardian — 15 Aug 2022 ‘Patients are getting ripped off’: California’s mental health workers go on strike
13. fiercehealthcare.com — Feb 14, 2022 <big>Kaiser Permanente reports $8.1B net profit in 2021</big> despite shrinking operating income
14. fiercehealthcare — Feb 7, 2022 California inks sweetheart deal with Kaiser Permanente, jeopardizing Medicaid reforms
15. latimes.com — Feb 6, 2022 Kaiser gets a special healthcare deal with California. Are Medicaid reforms in jeopardy?
16. NATIONAL NURSES UNITED.org — Nov 4, 2021 National Nurses United condemns industry plans to maximize profit by sending patients home all alone, replacing 24/7 hands-on nursing care with technology “Registered nurses have a legal and moral obligation to always advocate for the best interests of our patients. That is why we are completely opposed to Kaiser Permanente’s current and long-term plans to maximize revenue by dramatically limiting opportunities for nurses to care for patients in a hospital setting, and instead sending patients home to be remotely monitored by technology. In a program that Kaiser calls “Advanced care at home...”
17. abc7news.com — September 30, 2021 Hundreds of striking Kaiser engineers rally in the streets of Oakland
18. timesofsandiego.com —October 21, 2021 Kaiser Permanente Pharmacy and Lab Workers Authorize Strike in Southern California  
19. oaklandnorth.net — October 21, 2021 UPDATE: Kaiser Permanente meets with striking engineers and mediators
20. hawaiinewsnow.com — Oct. 21, 2021 Kaiser healthcare workers vote in favor of strike after failed contract negotiations
21. stateofreform.com/ — Oct 21, 2021 Kaiser Permanente health care workers prepare strike vote in Hawaii and California
22. jacobinmag.com — Oct 20, 2021 Kaiser Wants to Cut Health Care Workers’ Wages. It Might Provoke a Massive Strike.
23. LaborNotes 19oct2021 Kaiser's Outrageous Two-Tier Wage Proposal May Provoke a Massive Strike
24. kovi.com 18oct2021 Kaiser Permanente Strike Votes Expand to Hawaii and Northern California
25. sacbee.com 18oct2021Surgery delays at Kaiser Roseville frustrate patient who pays ‘good money for insurance’
26. northbaybusinessjournal.com 17oct2021 Sonoma County affordable housing efforts to receive over $2.5 million in grants from Kaiser Permanente
27. denvergazette.com 15oct2021 Colorado health care worker union sues Kaiser Permanente, alleging company ignored chronic understaffing
28. fox40.com 14oct2021 ‘They offered 11 cents more ‘
29. sacbee.com 14oct2021Kaiser Roseville health care workers to protest staffing: ‘We are at our limit’
30. AP 12oct2021 Kaiser Permanente faces strike votes in California, Oregon.
31. OregonLive 12oct2021 Big majority of Oregon, SW Washington Kaiser Permanente employees approve strike
32. thehill.com 12oct2021 Kaiser Permanente workers authorize strikes in California, Oregon
33. sacramento.newsreview.com 12oct2021 Kaiser Permanente strike standoff in Sacramento area
34. LosAngelesTimes 11oct2021 Kaiser Permanente workers vote to authorize strike, citing staffing and safety concerns
35. washingtonpost 11oct2021 24,000 Kaiser Permanente health workers authorize strike over pay, working conditions
36. nurse.org/ 8oct2021 Kaiser Permanente Nurses Prepare to Strike Nationwide
37. capitalandmain.com 8oct2021 Kaiser Permanente Employees May Strike Over Two-Tier Pay System
38. streetroots.org 5oct2021 Thousands of [Oregon] Kaiser workers on the verge of strike
39. WorldSocialistWebsite.org 4Oct2021 Northern California Sutter health care workers join Kaiser Permanente engineers on strike
40. healthcaredive.com 1oct2021 Kaiser Permanente union in California nearing strike
41. healthcaredive.com 10aug2021 Kaiser Permanente's Q2 profit down one-third despite revenue climb
42. fiercehealthcare.com 10may2021 Kaiser Permanente generates $2B profit for Q1
43. fontanaheraldnews.com — Oct 5, 2020 — staff member at Kaiser Permanente facility in Fontana tests positive for COVID-19, county says
44. National Union of Healthcare Workers/NUHW.org— September 2020 Hospital Corporation Government Bailout Tally update.
45. florence-health.com/ — Sep 29, 2020 — Health is the heart of the economy: KP pledges to consider ‘hero bonus” asked by KP Unions in California, Colorado, Hawaii, Maryland, Oregon, Virginia, Washington, D.C. and Washington state
46. beckershospitalreview.com — Sep 28, 2020 — Coalition of KP worker unions seek 'hero bonus' for 85,000 members
47. mauinews.com — Sep 25, 2020 — Contrary to union contracts Kaiser shutdown of gastrointestinal and ambulatory surgeries at clinic costs workers jobs & patients some access: services being transferred to operating rooms at Maui Memorial Medical Center, operated by a Kaiser affiliate, despite ↷
48. https://wa-business.kaiserpermanente.org/kaiser-permanente-CARES-act-funding/ including $11.8 million for Maui Health System, a nonprofit subsidiary of Kaiser Foundation Hospitals.
49. dailyrecordnews.com — Sep 23, 2020 — Kittitas Valley Healthcare, Kittitas County, Washington’s only hospital, terminates contract vith KP effect July 2021 after years of difficulties for its members.
50. opensecrets.org - the Center for Responsive Politics — 2020 — Lobbying Firm Profile: Kaiser Foundation Health Plan: Federal Bills Lobbied by Kaiser Foundation Health Plan, 2020
51. Healthcaredive.com — Aug 10, 2020 — Kaiser Permanente reports $4.5B in net income, joining other operators in large Q2 increases
52. queenannenews.com — July 22, 2020 — KP pledges $500,000+ to meal service for it senior members & other seniors in Washington state.
53. Healthcaredive.com — June 23, 2020 — 2nd in a series examining the bailout funds health systems received amid the COVID-19 pandemic.
54. World Socialist Web Site.org — Jun 15, 2020 — Nurses outraged over US hospital chain bailouts, layoffs and bloated CEO pay
55. NewYorkTimes — Jun 8, 2020 — Dozens of top recipients of government aid have laid off, furloughed or cut the pay of tens of thousands of employees while paying CEOs millions.
56. bizjournals.com/sanfranciscobusinesstimes —  Jun 5, 2020 — Greg Adams, CEO, KP
57. JOHNS HOPKINS.edu COVID-19 DASHBOARD
58. kff.org (not affiliated with KaiPerm) — May 13, 2020 — hospitals serving wealthier patients have received far more funding than those that treat low-income patients
59. HealthcareDive.com — May 11, 2020 — Kaiser reports $1.1B net loss in Q1 due to stock market slide
60. USAToday — May 10/11, 2020 — Rich hospitals, poor safety plans leading up to coronavirus: Should rules change for them now?
61. ColeMarketResearch — May 11, 2020 —  Impact of COVID-19 Outbreak on Recent Edition of Pension Insurance Market 2020 | Key Companies Overview- UnitedHealthcare, Allianz, Kaiser Permanente, MetLife,CNP Assurances, PICC, ICICI Prulife , Ping An, China Life
62. May 8, 2020 — Kaiser Foundation Health Plan and Hospitals Q1 2020 Financia  UPDATE with mission comment and thanks to its workers.
63. HealthcareDive.com — Mar 25, 2020 — Kaiser Permanente shelves $900M headquarters build
64. modernhealthcare.com  — Mar 16, 2020 — KP Pledges $1million to treat homeless for COVID-19
65. kff.org/policy-watch — Mar 31, 2020 — A Look at the $100 Billion for Hospitals in the $2trillion CARES Act
66. climaterwc.com — Apr 23, 2020 — Rotary Club of Redwood City pledges weekly donations to feed hospital heroes & community essential workers.
67. kff.org — Apr 9, 2020 — The Coronavirus Aid, Relief, and Economic Security Act: Summary of Key Health Provisions
68. verywellhealth.com — Feb 23, 2020 — Healthcare Capitation
69. beckershospitalreview.com/ — Feb 20, 2020 — KP pledges $32m to fight housing insecurity in Sacramento, California’s state capital.
70. fontanaheraldnews.com — Jan 18, 2020 — KP pledges $25million to help state homeless project.
71. www.prnewswire.com — jan 17, 2020 — KP pledges $25m to governor’s California Housing fund
72. beckershospitalreview.com/ — Jan 16, 2020 — [1] KP $200million Thriving Communities Fund buys $5.2mil housing complex near its Oakland HQ [2] KP & Enterprise Community Partners launch $100 million loan fund for affordable housing [3] KP & community partners announce effort for housing & services for 500 over-age-50 chronically ill Oakland denizens.
73. fiercehealthcare.com — Jan 9, 2020 — Per the 2019 labor agreement reached by KP and the Service Employees International Union-United Healthcare Workers West (SEIU-UHW), new joint nonprofit Futuro Health created to train and graduate 10,000 new licensed and credentialed allied health workers in California by 2024.
74. SanFranciscoCBS  — Dec 17, 2019 —  Kaiser Permanente Mental Health Workers Strike For 2nd Day
75. BizJournals.com — Dec 13, 2019 — 4,000 California Kaiser mental health workers will strike Monday
76. BizJournals.com — Dec 11/13, 2019 — 5 things to know about Kaiser's new CEO Greg Adams
77. HealthcareDive.com — Dec 11, 2019 — Kaiser interim chief Greg Adams named full-time CEO
78. Cision PR Newswire — Ded 5, 2019 Kaiser Permanente Ventures closes Fund V with $141 million in total capital
79. beckershospitalreview.com — Oct 9, 2019 — Kaiser Permanente pledges $2.75M to study childhood trauma effects
80. Oct 2019 About the CDC-Kaiser ACE Study and www.cdc.gov/violenceprevention/aces/fundedresearch.html
81. HealthcareDive.com — Sept 25, 2019 — Kaiser strike called off as company, unions reach tentative agreement
82. opb.org — Sept 27, 2019 — Biggest Strike US Has Seen In Years Poised To Hit Kaiser Permanente
83. HealthcareFinanceNews.com — Sept 16, 2019 — Kaiser Permanente and Enterprise are investing in affordable housing — referencing HealthcarefinanceNews.com — July 5, 2018 — ROI from social determinants investment inc’g housing homeless patients.  
84. HealthcareDive.com — Sept 13, 2019 — Colorado union votes to strike at Kaiser, bringing 'yes' votes nationwide to 42K
85. goodjobsfirst.org VIOLATION TRACKER: 57 KP workplace violation records and $38,657,920 in penalties on KP between 2000 and Sept 2018.
86. HealthcareDive.com — Sept 6, 2019 — Starting in 2020, profit-soaring Kaiser loses California non-profit privilege of minimal expense & revenue breakdown. Another bill, requiring nonprofit health systems to report more on executive and physician compensation is wending its way thru’ state legislature.
87. SacramentoBee — Sept 6, 2019 — Newsom signs [bill requiring Kaiser to disclose more financial data] — consumer group Health Access California, SEIU and the California Public Employees’ Retirement System, and business groups such as Small Business Majority were among other supporters of the bill. “..As part of the legislation, Kaiser will have to break out expenses and revenue for each of its facilities; break out revenue by type of payor (Medicare, Medi-Cal or private insurance) at each facility; and break out rate increases by type of service (hospital, physician services, pharmacy, radiology and laboratory).
         “We think it’s an important transparency measure,” said Anthony Wright, the executive director of Health Access California. “Right now, we do require rate review of our insurers, and Kaiser has had a fairly broad exemption from much of the rate review processes that other insurers have to follow, and what this bill does is fairly simple. It ensures Kaiser is providing the same types of information justifying their rates as other health insurers have to do...”
88. California Senate Bill 343 — Sept 5, 2019 — Health care data disclosure: California state insurance code amendments.
89. NW Labor Presss.org — Sept 5, 2019 — Massive Kaiser Permanente strike could come in October
90. American Prospect — Sept 3, 2019 — Kaiser Hospital Workers Mobilize for Largest Strike in Two Decades
91. HealthcareDive.com — Aug. 29, 2019 — Kaiser Permanente workers are set to strike. Does it mark a new trend?
92. CBSNews — Aug. 27, 2019 — Bill Targeting Kaiser Permanente Financial Disclosures Heads To Gov. Newsom’s Desk
93. cpr.org — Aug 26, 2019 — If Kaiser Permanente Votes To Strike, Thousands Of Workers Would Walk Out From The Colorado Health Care Giant
94. San Diego Reader — 26 August 2019 — Kaiser to face largest strike anywhere in 20 years — Unions claim company made $5.2 billion in profits the first 6 months of 2019.
95. danilfineman.com — Aug 22, 2019 — Kaiser mortgage to rehab Metropolis Heights reasonably priced houses
96. LA Times — Aug 12, 2019 — Kaiser Permanente workers in California vote to approve strike
97. HealthcareDive.com — Aug 12, 2019 [2nd quarter of 2019] KP net income $2 billion, up from 2018 2nd Qtr $653 million.
98. Medscape — August 2, 2019 — Docs Get Tiny Raises While Nonprofit Healthcare CEOs get >$10M
99. Wikipedia — KaiserPermanente as of July 2019.
100. ABCNews — July 20, 2019 Oakland City Council approves $28mill sale to KP of public parking garage
101. Forbes — Jul 12, 2019 — 85,000 KP Health Workers Threaten Strike 
102. ABCNews — July 10, 2019 — Kaiser mental health workers strike in San Francisco, demand more staffing for patients
103. ABC7 — July 10, 2019 — Oakland approves sale of city-owned [public] garage for Kaiser HQ
104. Medscape — July 5, 2019 — Are Exorbitant Corporate Salaries in Healthcare Unethical?
105. SanFranciscoChronicle — June 23, 2019 — KaiserPerm deal for Warriors arena plaza & Chase Center area to be renamed “Thrive City” could hit $295 million.
106. HealthcareDive.com — June 18, 2019  — Kaiser Permanente announces new headquarters in California
107. Modern Healthcare — June 17, 2019 — $900million New KP HQ in Oakland
108. Kaiser Permanente.org — Local ‘markets’ and other “Fast Facts” as of June 2019.
109. ABCNews — March 11, 2019 — Family speaks out after grandfather told he’s dying by KP doctor video robot.
110. HealthcareDive.com — [First quarter of 2019] KP net income nearly $3.2 billion compared with about $1.2 billion the prior-year period [following open enrollment seasons].
111. search — Jan-Aug 2019 RxHomeFund/ThrivingCommunities/...
112. HeathcareDive.com — [First half of 2018] KP posted nearly $40billion in revenue
113. National Union of Health Workers — January 7, 2019 Chronology: Kaiser Permanente’s Mental Health Crisis
114. ProPublica Nonprofit Explorer 2019 — Form 990, Schedule J for KP Fiscal Year Ending Dec 2017.
115. goodjobsfirst.org WORKPLACE VIOLATION TRACKER - 56 workplace violatIon records and $37,757,920 in penalties on KP, 2000 - 2018.
116. ABCNews -- December 20, 2018 — Thousands of KP’s unionized mental health workers make arrangements to meet patient needs for the week before walking out on strike.
117. ModernHealthcare.com — Dec 20, 2018 — KP settles in 2014 patient class action lawsuit.
118. TheBusinessJournals.com — Nov 14, 2018 — Hospitals and health systems with highest-paid leaders…
119. ABCNews — September 3, 2018 — Over 1,000 Kaiser employees and their unions and supporters marched in Oakland to protest planned job cuts and outsourcing.
120. HealthcareDive.com — Aug. 24, 2018 — KP reported $39.9billion in operating revenue for the first six months of 2018
121. HealthcareDive.com — April 30, 2018 — 55,000 member SEIU-UHW protests KP layoffs & outsourcing of pharmacy warehouse & call center operations.
122. ABCNews — September 18, 2017 — Kaiser nurses rally for better resources for patients at 21 California locations as contract end approaches and negotiations drag on.
123. HealthcareDive.com — August 31, 2017 — NorthBay Healthcare’s 2nd Lawsuit vs Kaiser Permanente for underpayment on Emergency Department care.
124. ABCNews -- July 12, 2015 — Thousands of Kaiser mental health professionals strike for better resouces after 5 years of contract negotiations fail to remedy dearth from increased patient ‘memberships’.
125. medscape.com — July 5, 2017 — Despite three warnings and a multimillion-dollar fine a few years ago, Kaiser Permanente still fails to provide members with appropriate access to mental health care,
126. Los Angeles Daily News — March 26, 2015 — CalState Student wins $28.2mil KP lawsuit for negligence causing loss of leg, half pelvis & parts of spine.
127. opensecrets.org — Center for Responsive Politics — 2015 — Lobbying Firm Profile: Kaiser Foundation Health Plan: Federal Bills Lobbied in 2015
128. medscape.com — Feb 25, 2015 — For 2nd time in 2 years, the state of California faults HMO giant KP on failing access to patients for mental health care
129. ABCNews — Jan 26, 2015 — KaiserPerm averts strike by tentative agreement w/ California Nurses Association/National Nurses United for 18,000 employees’ 3-year contract: “...The nurses claimed Kaiser was cutting back on its patient care standards by decreasing hospital services, making restrictions on admitting patients for hospital care and discharging patients early though they needed further hospitalization, according to the CNA.
          “[Also] that Kaiser provided them with insufficient resources, equipment and training that put nurses and patients at risk.”
130. PressDemocrat — January 10, 2015 — Kaiser braces for strike Monday by mental health clinicians
131. topclassactions.com — Sept 11, 2014 — Class Action Suit alleges KP tells guardians of psychiatric patient ‘members’ they can only receive care if they cancel KP insurance/“membership & get covered by Medicare & Medi-Cal
132. Medscape - April 3, 2013 — California Dept of Managed Health Care (DMHC) cites Kaiser Permanente in mental health service cover-up
133. sportspromedia.com — June 13, 2012 — Golden State Warriors NBA team sponsor Kaiser Permanente becomes naming-rights partner in 3,200-capacity Santa Cruz arena in deal rumored largest ever for NBA's Developmental League.
134. HuffingtonPost — November 14, 2011 — Kaiser Permanente Makes Billions In Profits While Overburdening Staff: Report “Kaiser Permanente has made an estimated $5.7 billion in profit since 2009.”
135. AMA Journal of Ethics — January 2009 — elderly patient suffering from dementia, in nothing but a hospital gown, ‘dropped off’ by Kaiser Permanente Bellflower Medical Center at Union Rescue Mission, an organization that serves the needy and homeless
136. npr.org — November 2006 — Kaiser Faces Charges for [literally] Dumping Homeless Patient [on skid row].
137. kaiserthrive.org  — April 2006 — Kaiser Permanente sued for lack of disabled accommodations.
138. kaiserthrive.org — March 2006 — Patient Dumping on skid row said caught on tape.
139. lmpartnership.org — 1997 Labor Management Partnership Agreement between Kaiser Permanente and the Coalition of Kaiser Permanente Unions