After a 3-month hiatus, new contract talks resumed on January 16

On Thursday, January 16, Kaiser Permanente and NUHW returned to the bargaining table. Our desire is to reach an agreement that provides fair wages and benefits to our valued NUHW-represented employees while protecting our members’ continued, timely access to high-quality and affordable mental health care. Our strong offer, on the table since October 25, 2024, does this and also provides protected time for activities such as planning, preparation, coordination, and administrative work.

Review of progress — NUHW delivers counterproposal to our standing offer

Both Kaiser Permanente and NUHW began by reviewing their records of open items and tentative agreements. Kaiser Permanente reiterated our request for a response from the union to the open items from the October 25, 2024, session. After 3 months, NUHW presented a comprehensive counterproposal to Kaiser Permanente’s offer. The union adjusted its positions on a number of economic and noneconomic issues, and we are carefully reviewing them, and will respond. Unfortunately, by the end of the day, it was clear that Kaiser Permanente and the union continue to have different positions on what is required to meet the needs of our members sustainably and affordably and remain a best place to work. We will continue to bargain and have scheduled 3 additional bargaining dates in the coming weeks.

Wage proposals and market comparisons

Our offer considers industry standards and economic dynamics specific to the Southern California market. This market-based approach — the same approach we use everywhere — ensures all employees are supported in a way that is competitive for the geographic market they work in. Our philosophy at Kaiser Permanente is to pay employees up to 10% above market. On average, the majority of our NUHW-represented employees in Southern California are currently paid approximately 18% above market. Our offer would increase that amount even more.

In NUHW’s new wage proposal made at the January 16 session, the union is still demanding a wage increase that over the 3-year contract would place Kaiser Permanente therapists’ pay at approximately 35% above what other therapists make in the Southern California market. This new wage proposal, like the union's earlier one, is not sustainable or acceptable. It would substantially increase the cost of mental health care for our members at a time when they are already dealing with the impacts of high inflation across other goods and services, and it would be counter to our commitment to keep health care affordable for our members.

Misleading claims and real issues

The union is making misleading claims to the public about Kaiser Permanente’s patient care. Any member who needs an appointment is able to get one. During this unnecessary open-ended strike, Kaiser Permanente has remained focused on ensuring our members receive the mental health and addiction medicine care they want and need. Patients in crisis get care 24/7, those with urgent needs can get appointments within 48 hours, and patients seeking nonurgent care are offered appointments on average within 6 days, which is better than the state’s requirement. We appreciate that this level of responsiveness is possible because of our thoughtful planning and because 50% of our Southern California NUHW-represented employees have now returned to work and are helping to increase our effectiveness in delivering timely care to anyone who needs it.

Responding to questions about calculations of non-direct patient care time

We also want to address the union’s questions about how we estimated the impact of its October proposal for non-direct patient care activities such as planning, preparation, coordination, and administrative work. We acknowledge that the union presented an updated proposal on January 16, which moved from its fall proposal of 10 hours with 7 protected, to 7 hours protected. We show the calculations of the effect of this updated proposal below. Even with the union’s modest change, the demand for 7 hours a week is problematic given the impact on time available to see patients. The union’s January 16 proposal may still reduce available care time for patients by approximately 19 hours in a full-time week.

NUHW is currently proposing 7 hours a week of protected time during which patients would not be seen. This time would be used for charting, coordination, and administrative tasks. This guaranteed 7 hours would be in addition to up to 12 to 14 hours of non-patient facing time a week. The breakdown of the time is as follows:

• A therapist working a 5-day, 40-hour workweek may have, on average, 6 patient appointments per day that are scheduled for 1 hour each. The standard of care is that 50 minutes are used for patient-facing consultation time and 10 minutes are for charting. This time is self-managed by the therapist and represents the national practice. This 10 minutes of charting time within each 60-minute visit creates 5 hours of non-direct patient care time per week.
• In addition, there can be 1 to 2 hours of care review, clinical supervision, or other meetings per week. While this number varies, the average is 2 hours.
• As well, there can be 4 to 6 more hours of net loss, defined as times when patients don’t show for appointments or cancel at the last minute without giving us the ability to schedule another patient. Net loss averages 15% across the service areas but was as high as 22% for some areas in 2024.

With the proposed 7 hours of protected time, these average time increments add up to 19 hours of non-patient time a week: