Bargaining continues with key proposals on the table

This message was sent on behalf of Lionel Sims, senior vice president, Human Resources, Kaiser Foundation Health Plan and Hospitals; and Priya Smith, chief employee human resources officer, The Permanente Medical Group; to Kaiser Permanente’s Northern California mental health and addiction medicine professionals on Thursday, April 2.

To our mental health and addiction medicine professionals,

Kaiser Permanente and the National Union of Healthcare Workers bargaining teams met on Wednesday, March 25, and Tuesday, March 31, to continue negotiations for a new contract for our Northern California mental health and addiction medicine employees.

The union presented a counterproposal for their proposed New Technology provision and Wages (Article 17), which are under consideration. We are disappointed that, after 31 bargaining sessions, the union has not responded to our comprehensive proposal with a counter or meaningfully engaged on our key operational proposals, which must be addressed to reach a tentative agreement.

Cutting through the noise and getting to the point

During the March 18 strike, much was made of AI and seeking to void contract language that limits our use of technology so that we can lay off therapists.

We’ve said it before, and we will say it again: AI does not make medical or care decisions. We believe it can be helpful when it supports clinicians — by reducing administrative work or improving efficiency — but it does not replace clinical judgment or human assessment. Our staff employment and retention track record speaks for itself.

Laws, regulations, and technology change over time, and we must have the ability to adapt as the science of mental health and members’ expectations evolve. It is simply not prudent or productive to include restrictive contract language that limits our ability to successfully adapt and provide the care our patients need and expect well into the future.

What we’re proposing — and why

We leverage both our internal providers and external network to meet the needs of our members. However, to maintain that hybrid model, we need flexibility so we can evolve our practices to address the ever-changing needs and expectations of our members.

We have placed 3 key proposals on the table to enable us to do that.

• Model of Care: There is currently an increased demand for mental health services. Despite our ongoing efforts to bring new clinicians into the field, supply has not kept up with demand. Members have different care needs, and we must ensure that they have timely access to that tailored care. Our proposal would create needed flexibility to better leverage both our internal valued clinicians and our external network to meet our members’ specific needs and expectations for mental health care now and into the future. This will enable us to continuously optimize our model of care.
• New to Return Patient Ratios: The fixed ratio of new to existing patients was created to address previous challenges in timely follow-up care. However, these challenges have been resolved and are now appropriately governed through regulatory agencies. The reality is that patients have different needs. Some need more 1:1 therapy visits, and some need less. We have proposed eliminating static ratios to ensure we can tailor care to each member based on their specific needs. This, in turn, maximizes access for all patients. We currently do not have required ratios in place with a number of our clinical programs and have seen positive patient outcomes. It’s time to eliminate outdated restrictions and adapt our staffing model to meet current patient needs and improve access to mental health services.
• Practice Management or Indirect Patient Care: We are proposing to maintain 20% indirect patient care time. We are also proposing a change in how indirect patient care time is defined to more accurately reflect how time is spent. We understand that time spent in direct patient care gives rise to a need for time preparing for and following up on individual and group therapy. But time spent in training or department meetings does not create a need for additional time away from direct patient care. Our proposal simply closes that loophole. In most cases, this change results in a small reduction in indirect patient care time. It is necessary to maximize access for patients.

Let’s come to the table with a focus on solutions

Our goals in contract negotiations are to reach an agreement that recognizes the skill and contributions of our clinicians and enables us to optimize mental health care for our members. We have made the 3 key proposals above to enable us to optimize our mental health care for our members — and the role of our clinicians — now and into the future. We urge NUHW to accept these proposals or come to the table with viable counterproposals and possible solutions that enable us to achieve that.

We value what you do, and our proposed wage increases of 17.5% over 4 years are a recognition of that.

We return to the bargaining table on Friday, April 24, and Thursday, April 30.

Thank you for your proven commitment to our members and patients.

For more information, visit kp.org/nuhwbargaining.