Patients and clinicians tell Assembly hearing Kaiser underinvests in behavioral health; NUHW strike spotlights workforce and continuity gaps

A panel of enrollees, clinicians and union leaders told the Assembly Health Committee on May 6 that Kaiser Permanente’s behavioral‑health delivery system is under‑resourced and that operational practices — including very short therapy appointments, limits on scheduling and heavy reliance on external vendors — have harmed patients and driven clinicians to strike.

Milton Brown, a licensed psychologist who testified as a Kaiser enrollee, described his daughter’s suicide attempt and a series of delays and gaps in follow‑up care he said violated state timely‑access requirements. Brown said a required post‑discharge follow‑up occurred 11 days after an inpatient stay when law requires follow‑up within 10 days and that other recommended services were delayed. "The biggest trauma of my adult life was when my daughter almost died by suicide," Brown said during testimony; he added that it took months to secure dialectical behavior therapy (DBT), an evidence‑based treatment he said could have reduced risk sooner.

Clinicians and union leaders described workplace and care models they said reduce clinical quality. Cassandra Gutierrez Thompson, a licensed clinical social worker and NUHW member who works in Kaiser’s ADAPT program in Southern California, said therapy sessions in her program are limited to 30 minutes and that clinicians often see 14 to 16 patients back‑to‑back. "This model creates a factory‑like setting where both clinicians and patients feel like they're on a conveyor belt together, rushed and pressured to watch the clock," she said. Thompson and other witnesses said the compressed model impairs therapeutic continuity and contributes to clinician burnout and turnover.

Sofia Mendoza, president of the National Union of Healthcare Workers, said Kaiser has undervalued behavioral health relative to medical‑surgical services and pointed to compensation and benefit disparities across regions. "Kaiser simply does not give behavioral health the same priority that it gives medical surgical care," Mendoza said. She told the committee that behavioral health employees in Southern California have faced lower wage growth and pensions that differ from other Kaiser employees and that the disparity has contributed to staffing shortages.

Witnesses raised several operational problems: an alleged Kaiser rule that limits patients to scheduling one behavioral‑health appointment at a time (which clinicians said blocks continuity), overreliance on group therapy or prerecorded webinars in place of individualized care, a heavy use of external vendors that may require patients to enter separate systems and pay cancellation fees, and inconsistent application of evidence‑based therapies. Lauren Fink, senior director of public policy at the Kennedy Forum, urged standardized public reporting on parity metrics, including out‑of‑network utilization, prior‑authorization denial rates and timely‑access measures, to improve regulatory oversight.

Union leaders and witnesses also described a prolonged strike in Southern California by NUHW behavioral‑health members. Mendoza said the strike lasted more than six months and that NUHW had reached a tentative agreement that had restored some annual cost‑of‑living increases and added patient‑care time, though she said the contract fell short of full parity with Northern California staffing and compensation levels. Witnesses said the strike revealed how fragile continuity of care is when clinicians are unavailable and how referrals to external networks sometimes left patients disconnected from integrated care.

Multiple advocacy groups and professional associations offered public comment: Health Access California urged that Kaiser treat mental‑health patients as it treats those with serious medical conditions; the California Association of Marriage and Family Therapists and the California Psychological Association asked DMHC for continued oversight and transparency; Western Center on Law and Poverty urged a publicly approved reimbursement process for out‑of‑pocket behavioral‑health costs; and California Panethnic Health Network asked DMHC to require culturally and linguistically appropriate services.

The committee chair expressed disappointment that no Kaiser representative attended the hearing in person; Kaiser provided a two‑page letter to the committee, which members read into the record. Witnesses asked legislators and regulators to press for clearer, measurable corrective actions and for stronger enforcement to ensure members get clinically appropriate care in a timely fashion.