Kaiser Permanente and the National Union of Healthcare Workers (NUHW), which represents approximately 60 of our mental health professionals in Hawaii, are negotiating an initial collective bargaining agreement. Unfortunately, NUHW leadership has taken the unproductive action of calling for an open-ended strike.
Only behavioral health appointments are affected, and Kaiser Permanente facilities are open for normal operations.
Kaiser Permanente continues to reach out to every behavioral health patient whose appointment has been affected by the strike to reschedule or offer another option.
Despite the strike, many of our dedicated Kaiser Permanente mental health staff remain on the job caring for members. We greatly respect the right of all our mental health professionals to decide for themselves whether or not to strike, and we appreciate those who chose to come to work for their patients. In addition, our Kaiser Permanente psychiatrists, clinical managers, and other licensed clinicians have stepped in to meet with people needing care.
Kaiser Permanente Hawaii has been on a multi-year journey to increase the number of mental health clinicians to meet the needs of our members and patients. Despite a local and national mental health workforce shortage, we’ve hired 25 clinicians in Hawaii since the start of 2021. We’ve also added 11 new mental health clinical positions to be filled in 2022, along with additional support staff, and plan to add the same type and number of positions each year nearly doubling our Behavioral Health staff by the end of 2025.
NUHW leadership continues to exploit the national and local mental health worker shortage, using their old-fashioned corporate campaign tactics of filing complaints with regulators, elected officials and media, to create pressure at the bargaining table. Although we disagree with this bargaining approach, we continue to negotiate with NUHW in good faith and are committed to reaching a fair and equitable agreement.
Setting the record straight
Addressing NUHW's false claims about Kaiser Permanente contract bargaining.
Staffing and Hiring
Kaiser Permanente is not doing enough to solve the Behavioral Health understaffing issue.
The national shortage of mental health clinicians was a crisis before the pandemic and has further strained an already stressed mental health care system and its limited number of caregivers.
Kaiser Permanente Hawaii has been on a multi-year journey to increase the number of mental health clinicians to meet the needs of our members and patients. Despite a local and national mental health workforce shortage, we’ve hired 25 clinicians in Hawaii since the start of 2021. We’ve also added 11 new mental health clinical positions and additional support staff to be filled this year and subsequent years, nearly doubling our Integrated Behavioral Health staff by the end of 2025.
Advocating for Mental Health Access
NUHW is striking to advocate for better access to mental health services.
NUHW activists are contacting community therapists, encouraging them not to see Kaiser Permanente patients during the strike. These actions are outrageous and demonstrate a shocking disregard for the health care needs of our patients. NUHW members cannot credibly claim that they are advocating for better access to mental health services while at the same time trying to decrease the ability of Kaiser Permanente members to get care. Interfering with needed patient care should not be a bargaining strategy.
Current Mental Health Appointments
Kaiser Permanente Hawaii is cancelling all mental health appointments.
Kaiser Permanente continues to reach out to every mental health patient whose appointment has been affected by the strike to reschedule or offer another option. Approximately half of our behavioral health patients receive their care from mental health community providers who are not involved with the strike. For those patients who choose to cancel their own appointments or choose not to reschedule, we will be conducting clinical quality reviews to ensure they receive the care they need.
Despite the strike, around 40% of the NUHW bargaining unit members who are scheduled to work on a given day remain on the job caring for members. We greatly respect the right of all our mental health professionals to decide for themselves whether or not to strike, and we appreciate those who chose to come to work for their patients. In addition, our Kaiser Permanente psychiatrists, clinical managers, and other licensed clinicians have stepped in to meet with people needing care.
Kaiser Permanente has a high turnover rate as clinicians leave due to worsening working conditions.
In 2021, the voluntary turnover rate for our represented mental health employees was 11.5% in the Hawaii Market. While this is higher than we would like, it is far below the national health care worker attrition rate of 18.9%*. Retaining our talented employees is critical to meeting the growing demand for mental health care, and we are focused on working with our clinicians to address this challenge.
*Source Saratoga Benchmarking Data https://www.pwc.com/us/en/products/saratoga.html
Drawn Out Contract Negotiations
Kaiser Permanente has been dragging out the process of negotiating a new contract with NUHW.
Behavioral Health workers at Kaiser Permanente Hawaii first organized under NUHW in September 2018. NUHW declined all earlier attempts to schedule bargaining sessions. Negotiations finally started in January of 2020.
We are committed to continue bargaining in good faith to reach a mutually beneficial agreement.
Kaiser Permanente forces patients to wait weeks, even months for appointments.
Recognizing every person’s needs are unique, our clinicians work with each patient to independently develop a care plan that is clinically appropriate and tailored specifically for them.
When appointments are not readily available, we have an escalation process in place to support and triage patients with urgent needs to the appropriate care.
Kaiser Permanente’s integrated system provides a safety net for patients, offering added support to help members in crisis navigate to the care they need. Patients outside of an integrated system must frequently call multiple individual providers when seeking care.
Kaiser Permanente is at risk of losing accreditation from the National Committee on Quality Assurance (NCQA)
Kaiser Permanente Hawaii performed well on its recent routine NCQA accreditation survey (completed May 2022), and successfully achieved full 3-year NCQA accreditation status through May 11, 2025 for all applicable services.
Number Of Patients Per Provider
The approximately 60 NUHW-represented employees must care for all 260,000+ Kaiser Permanente Hawaii members.
The simplistic math of dividing Kaiser Permanente Hawaii’s total membership by NUHW-represented staff results in inflated caseload counts that are inaccurate and misleading for several reasons.
- Fewer than 8% of Kaiser Permanente Hawaii’s 260,000+ members seek mental health services in a given year based on our internal data from 2020 and 2021.
- The approximately 60 mental health clinicians represented by NUHW are just one part of our Kaiser Permanente Hawaii mental health care team, along with psychiatrists and additional behavioral health care staff.
- Approximately half of our behavioral health patients receive their care from practitioners such as our contracted mental health providers in the community, who are not involved with the strike.
- We continue to hire more clinical staff and are currently recruiting for 14 open positions for psychologists, LCSWs, and LMHP.
Workload And Burnout
Therapists maintain unsustainable workloads under tremendous circumstances, which has led to employee burnout and clinicians leaving for other jobs.
The pandemic has challenged our front-line care teams, including nurses, health care workers, physicians, and of course our mental health clinicians. We have the greatest respect and gratitude for our mental health professionals, and we are dedicated to supporting them in their important work.
Our therapists are scheduled for an average of 6 to 7 appointments per day. Our model provides our full-time therapists room to focus almost solely on their patients. In addition, we have an administrative structure in place to ensure an appropriate amount of preparation time, as well as time to support ongoing education.
Financial Issues On The Table
Kaiser Permanente Hawaiiʻs current offer on the table proposes a wage freeze for 60% of employees and benefit cuts.
Kaiser Permanente provides market competitive wages and benefits to attract and retain top-quality employees.
Wages and benefits for represented employees are negotiated at the bargaining table. We are committed to continuing bargaining in good faith to reach a mutually beneficial contract and we ask NUHW to join us to resolve our differences.
Kaiser Permanente only cares about profits
Despite these challenging times, we are committed to remaining an employer of choice for mental health professionals by continuing to offer our employees market-leading wages and benefits. However we, like every other health care provider, cannot continue to allow costs to grow beyond what our members can afford.