Editorial: Mental health services at risk with Kaiser strike

As a strike by Kaiser Permanente’s mental health workers continues for a 15th week, frustration has grown over difficulties and delays in getting mental health and behavioral health services from the provider.

It’s proper, then, that the board overseeing the Hawaii Employer-Union Health Benefits Trust Fund (EUTF), which manages health benefits to public employees, has voted to allow Kaiser members to switch their insurance plans while the strike continues, or through June 30, whichever comes first.

EUTF is the biggest health insurance buyer in the state, providing benefits to approximately 195,000 eligible state and county workers, retirees and their dependents throughout the islands. The EUTF board’s vote on Tuesday reflects valid concern that those workers covered by Kaiser can’t access mental health services.

It’s not known how many workers would change providers. Doing so won’t be easy: Kaiser members will have to file an appeal, and while they can simply state that they have struggled to access mental and behavioral health services, rather than submit verification, EUTF Administrator Derek Mizuno projects that the requests will still take one to three weeks to process.

Additionally, because Kaiser is a self-contained system, both an insurer and health-care provider, Kaiser members who switch to HMSA will have to choose a new primary-care provider, specialists, pharmacists and other services.

It’s a burden on employees to undergo that transition while also urgently seeking mental health care — but also a ringing statement of lost faith in Kaiser that EUTF would make this option available.

Kaiser didn’t help itself by declining to speak to the EUTF board in person. Instead, in a statement, Kaiser said appearing before the board would be the wrong place to engage in “labor negotiations.” But there was more at stake than that; in fact, EUTF staff said that Kaiser is contractually required to attend board meetings.

EUTF board members were right to criticize Kaiser for not showing up to answer questions. What Kaiser’s clients — all of them, including Hawaii government employees — need during this difficult strike is reassurance that the provider is doing all possible to meet the needs of those requiring mental health services. The no-show didn’t inspire confidence that Kaiser could defend the adequacy of its services.

Kaiser did send a letter to EUTF stating that it has hired more staff and expanded its network of contracted providers who can accept new patients. It also claims to have shortened wait times for appointments. Meanwhile, the National Union of Healthcare Workers, representing Kaiser’s striking mental health clinicians, states that understaffing at Kaiser’s health clinics has led to overwhelming caseloads.

Aside from the specifics of salary packages and hiring efforts, what the public has a right to expect is that Kaiser will do what is necessary to provide adequate care. Neglecting the growing discontent among its mental health-care providers and allowing this dispute to interfere with patient care isn’t acceptable.

There is a shortage of mental health workers in Hawaii, as well as nationally, just as there is a shortage of other health workers. That should create a sense of urgency on Kaiser’s part to find common ground with its 60 psychologists, social workers, psychiatric nurses and chemical dependency counselors who have been on strike for about 100 days — believed to be the longest strike of mental-health workers in U.S. history, according to the union representing them.

Kaiser has a plan to hire 54 new full-time therapists and support staff by 2025, nearly doubling its behavioral health staff. That number can only be reached by bringing striking clinicians back to work — with both sides overcoming this impasse to get that job done.