SUBJECT
Title
A RESOLUTION TO OPPOSE KAISER PERMANENTE’S ATTEMPT TO REDUCE MENTAL HEALTH THERAPISTS’ PATIENT MANAGEMENT TIME (DISTRICTS: ALL)
Body
OVERVIEW
Over the last year, Kaiser Permanente has cut patient management time (PMT) in half from four hours to as little as two hours per week for mental health therapists across Southern California. This reduction threatens to impact patient mental health care for residents in San Diego County and could accelerate the trend of burnout in our healthcare workforce, resulting in more therapists departing and leaving patients waiting even longer to get the care they need.
Kaiser Permanente is one of the largest providers for mental health services in the region. Over 11,000 County of San Diego employees use Kaiser Permanente as their healthcare provider, with thousands of other San Diego County residents rely on Kaiser for these critical health services. While the pandemic may be over, mental health is worse than ever across the United States. This is the wrong time to be making cuts to the quality of care that San Diegans need and deserve. The health of our communities suffers when there is less time to tailor treatments, less time to communicate with patients, less time to consult with providers, and less time to schedule appointments.
Actions across the state are calling for support on this issue. After a 10-week strike, Kaiser Permanente officials in Northern California reach an agreement with striking therapists, agreeing to substantially raise the allotted PMT to approximately 7 hours per week. This move was critical to ensuring stronger workforce retention and ensuring patients get timely access to mental health services.
In contrast to the progress made in Northern California, therapists at Southern California Kaiser Permanente are facing a starkly different situation. We cannot accept a lower standard of care and less access to mental health services for residents of San Diego County than Kaiser patients in Northern California.
The item today requests that the San Diego County Board of Supervisors to approve a resolution to oppose Kaiser Permanente's reduction in Patient Management Time and calls upon Kaiser leadership to reverse the reduction so that therapists have sufficient time to properly care for patients, and that San Diego residents have equal access to mental health services as our Northern California counterparts.
RECOMMENDATION(S)
VICE CHAIR TERRA LAWSON-REMER AND SUPERVISOR MONICA MONTGOMERY STEPPE
1. Adopt the resolution entitled: A RESOLUTION OF THE BOARD OF SUPERVISORS OF THE COUNTY OF SAN DIEGO TO OPPOSE KAISER PERMANENTE’S ATTEMPT TO REDUCE MENTAL HEALTH THERAPISTS’ PATIENT MANAGEMENT TIME
EQUITY IMPACT STATEMENT
When mental health treatment care is limited, restricted, or jeopardized- people of color, immigrants, young individuals, and people with low incomes are often the first to be impacted. It is imperative that the County of San Diego be a pro-active partner in pushing for entities to provide a continuum of support of health services and increase public awareness about what services are available within our local communities.
SUSTAINABILITY IMPACT STATEMENT
Today’s actions support healthcare workers, county employees and community residents to access critical health services that promote healthy communities. It also helps to further the County of San Diego’s Sustainability Goals through ensuring equity and access to important medical resources locally and will help promote the health and well-being of San Diegans
FISCAL IMPACT
There is no fiscal impact associated with this action. There will be no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
N/A
BACKGROUND
In 2022, mental health therapists at Kaiser Permanente in Northern California held a 10-week strike that secured approximately seven hours per week for patient-management times. Patient Management Time refers to the time therapists have to perform critical patient care duties such as responding to patient emails and voicemails, communicating with social service agencies, designing treatment plans, preparing for appointments, documenting appointments and clinical findings in patients’ medical charts, and doing required paperwork. Insufficient time to perform these tasks is a leading cause of burnout that results in resignations that further worsen Kaiser’s severe understaffing of its behavioral health services.
Over 2,000 Kaiser Permanente mental health therapists in Northern California struck in 2022, prioritizing increased time for critical patient care tasks like email and voicemail responses, treatment planning, and paperwork. This was due to burnout caused by insufficient "Patient Management Time," leading to therapist attrition and long patient wait times. After a 10-week strike, Northern California Kaiser agreed to boost Patient Management Time to 7 hours weekly.
However, in Southern California, Kaiser management has slashed Patient Management Time to as little as two hours per week, further jeopardizing therapist retention and prolonging therapy appointment wait times, a violation of SB 221, a law mandating follow-up therapy sessions within 10 business days. Southern California therapists face pressure not to advocate for timely appointments, with excessive paperwork and managerial challenges to their clinical judgment. This reduction in Patient Management Time highlights Kaiser's unequal treatment of therapists and patients between regions. Southern California therapists seek support to advocate for their patients.
More than 11,000 County of San Diego employees and their dependents receive health coverage from Kaiser Permanente. It is imperative that appointment wait times are reduced and people have the opportunity to access their health professionals in a timely manner. The San Diego County Board of Supervisors, the community, and its workforce urge Kaiser Permanente to reverse its reduction to Patient Management Time.
The pandemic may be over but people still carry the emotional distress and trauma it has caused on our entire society. Patient Management Time remains a critical service and should be a priority for Kaiser Permanente.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today's proposed action supports the Equity and Empower Strategic Initiatives in the County of San Diego's 2024-2029 Strategic Plan by reducing disparities in health services and investing in our regional workforce.
Respectfully submitted,
Terra Lawson-remer MONICA MONTGOMERY STEPPE
Supervisor, Third District Supervisor, Fourth District
ATTACHMENT(S)
ATTACHMENT A: A RESOLUTION OF THE BOARD OF SUPERVISORS OF THE COUNTY OF SAN DIEGO TO OPPOSE KAISER PERMANENTE’S ATTEMPT TO REDUCE MENTAL HEALTH THERAPISTS’ PATIENT MANAGEMENT TIME.