Survey Reveals Problems With Mental Health Care At Kaiser Permanente

Who sits on the boards of those "independent rating agencies" and State of California offices that "recognize the quality" of Kaiser Permanente's mental health services? And who sits on the boards of "independent" agencies who rate other aspects of Kaiser's medicalcare? Kaiser doctors and administrators!

Survey Reveals Problems With Mental Health Care At Kaiser Permanente
November 14, 2011
By Kenny Goldberg
KPBS

SAN DIEGO — A union-backed survey of providers at Kaiser Permanente shows widespread dissatisfaction with the HMOs' mental health services. The union representing mental health professionals has been negotiating a new contract.

The National Union of Healthcare Workers surveyed more than 300 mental-health providers at Kaiser facilities in California. Many said they're not given enough time to evaluate patients, and they're not able to schedule return appointments in a timely way.

Jim Clifford has been a therapist at Kaiser's outpatient clinic in Otay Mesa for 10 years. He said mental-health care has gotten short shrift.

"We're trained to know what adequate care is and to provide it," he said. "And it's very troubling ethically to be in a position due to poor staffing not to be able to provide that. And it's been a chronic situation at Kaiser."

Clifford said Kaiser has refused to beef up staffing so that mental-health patients can get better care.

In a written statement, Kaiser officials said the quality of their mental health services has been recognized by independent rating agencies, and the state of California. The HMO said the NUHW survey was inaccurate and biased.



Long Wait Times The Norm At Kaiser Mental Health, Study Finds
Says company posting record profits while patients being denied the care they need.
Suisun City Patch
By Karina Ioffee
Nov. 15, 2011

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.

Click here to listen to interviews with Kaiser mental healthcare providers and patients

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.