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California finds Kaiser has fixed some but not all of its mental health access issues

Kaiser Permanente Microclinic, Garfield Center 2
tedeytan/Flickr (Creative Commons-licensed)
Kaiser Permanente Microclinic, Garfield Center 2

The  state Department of Managed Health issued a follow-up report Tuesday to a 2013 survey of Kaiser Permanente’s Mental Health saying the insurer is still failing to provide timely mental health services and information to members.

In 2013 the state found the health insurer deficient in four areas – tracking and records, staff training, patient access to appointments and information about services for patients. 

At that time the state cited Kaiser because patients were waiting too long for mental health appointments and fined the insurer $4 million, which Kaiser appealed and then paid last year.

Read the Survey

The current survey shows that Kaiser has fixed two of the problems around tracking services and training staff but continues to struggle with providing prompt access to behavioral and mental health appointments and sharing information with members.

"Although Kaiser has taken substantial steps to identify and monitor issues related to timely access to behavioral health services, significant and serious concerns remain," said Shelley Rouillard, director of the Department of Managed Health Care. "Kaiser’s actions have not been sufficient to ensure enrollees have consistent timely access to behavioral health services."

According to the state report, appointments in Kaiser’s southern region showed that 9 percent of the time patients did not receive appointments within the timeframe that is required. In the northern region that figure was 22 percent.

These issues have been referred to the department's office of enforcement for investigation.

Kaiser acknowledges it needs to do more but also said the report does not accurately reflect current staffing and member appointment times.

"Since the follow-up review was conducted, we have made even more progress. We have hired new mental health therapists in Northern and Southern California, and we currently are recruiting to hire more. We have engaged with high quality community-based mental health care providers, including ValueOptions, a network of community providers with which we began successfully partnering in 2014, to ensure our patients receive timely access to mental health care," the company said in a statement.

Kaiser said it is doing the following to address these issues:

  • making caregivers available where needed
  • recruiting more staff
  • partnering with community providers
  • improve clarity and accuracy of information in files

The National Union of Healthcare Workers has been protesting Kaiser for months over patient access to mental health appointments and the lack of service providers on staff.
Kaiser said it wants to work with the union and the insurer said it is in active discussions with the labor group.

These concerns were at the center of a week-long strike last month of thousands of Kaiser Permanente mental health works across the state. NUHW called the strike because workers said Kaiser does not have enough mental health workers on staff to meet the needs of the members.

Sal Rosselli, president of the Union, said it is reviewing the survey findings.

"We are working with Kaiser on a collaborative method to fix the remaining problems," Rosselli said.

The state’s next routine survey of Kaiser’s operation will take place later this year.

According the state report Kaiser has corrected:

  • Kaiser has made “significant system changes and conducted training to address data problems, and performed audits to verify the effectiveness of its corrective actions... The data appears to reflect accurate dates of appointment requests and occurrences.”
  • Kaiser “created a new measure for tracking and reporting appointment wait times, developed reports that identify this data by medical center and department, and uses the reports for ongoing monitoring and reporting of its compliance with timely access.”

The state said Kaiser needs to continue to address the following problems:

  • Kaiser’s “corrective actions have not sufficiently fixed” the problems related to monitoring and providing access to behavioral health services.
  • Kaiser “implemented policies requiring internal review of printed and on-line health education materials prior to making those materials available to enrollees, the Department’s review revealed individual cases in which providers disseminated inaccurate and misleading health education information to enrollees regarding the scope of their coverage for behavioral health services.”