New to this website? Welcome! If you’re looking for the story about my last three months at Kaiser, fighting the system from the inside out, you can find all the posts in order at the tab “The First 90 Days (Reader’s Edition).” Happy reading!
I’ve launched a second ninety day campaign to reform the delivery of mental health services at Kaiser. After a rejuvenating summer, I jumped off the fence to organize a new wave of challenges to the current system of care. While the first “90 Days” might be seen as a primer for fighting an institution from the inside out, the next segment (from October 2014 through New Year’s Day), will, if I’m lucky, demonstrate how one person can make a difference from the outside.
Now that I’m no longer an employee of The Permanente Medical Group (TPMG), and am no longer a card carrying member of the National Union of Healthcare Workers (NUHW), my perspective on the global deficits in Kaiser’s mental health program has changed. Now I’m a concerned member of the community — we all suffer when the number one provider of mental health services in California delivers less than adequate care. I speak also as a private therapist who sees the fallout of poor treatment in my Kaiser member clients, those who paid their premiums through their employer, privately, or through the Medicare or Medicaid system. I speak as a payer of state and federal taxes, subsidizing these substandard, federally- and state-funded mental health programs.
On September 9, 2014, moments before they were slated to argue their case in front of an administrative law judge in Oakland, Kaiser dropped its appeal of the Department of Managed Health Care’s $4 million fine. (The fine, if you recall, was levied for delaying access to initial mental health appointments and for discouraging members from seeking services, e.g. by telling them that Kaiser doesn’t offer individual psychotherapy.) Just as remarkably, Kaiser has begun to develop protocols to subcontract the overflow of psychiatry department intakes to a behavioral managed health care group, ValueOptions.
These are incredible developments! In the first case, Kaiser lawyers must have withdrawn because they knew they couldn’t prove Kaiser mental health administrators had responded to the DMHC’s allegations sufficiently or quickly enough. And, by subcontracting mental health services to ValueOptions, Kaiser is admitting that they are unable to do the job without hiring more help. That, in fact, they are understaffed. Which is what therapists have been shouting for three years now.
This is no time to take the pressure off! As a corporation, Kaiser will spend as little money as possible appeasing state regulators. They will continue to need their feet held to the fire if they are going to implement meaningful change.
So, whether you’re inside Kaiser, fighting to get your clients the basic help they need, or out, trying to improve the mental health of our entire community, let’s keep this mighty ball a-rollin’!
(90 days (or so) to go.)