Kaiser Permanente on Lawrence Expressway in Santa Clara, California, on October 6, 2021. (Harika Maddala/Bay City News)
(BCN) Kaiser Permanente must overhaul its behavioral health services and pay a $50 million fine under a settlement announced Thursday by the California Department of Managed Health Care.
Under the settlement, Kaiser will also invest a total of $150 million over five years to improve behavioral health services.
Gov. Gavin Newsom praised the settlement on Thursday, saying it will give Kaiser enrollees full and timely access to services to which they are entitled under state law.
Newsom said today’s actions represent a tectonic shift in our accountability in providing behavioral health services. Private sector responsibility is fundamental to ensuring our entire behavioral health system works for all Californians,” said Governor Newsom.
DMHC Director Mary Watanabe said the $50 million fine is the highest the state-run health care agency has ever imposed.
This agreement stems from two actions of state agencies: coercive investigation and unexpected survey.
Those actions found several violations and deficiencies in Kaiser’s provision of behavioral health services to enrollees, including access to timely care and supervision. Monitor plan providers and medical groups.
State agency found Kaiser Permanente canceled behavioral health appointments and in many cases failed to provide enrollees with appointments that met timely access and required clinical standards despite a strike by mental health clinicians in August 2022.
In addition to the time enrollees had to wait for appointments, the state found violations including a lack of contracted senior behavioral health facilities within the programs’ network and oversight Inadequate supervision of the plan’s medical teams in assessing appropriate care.
Under the settlement, Kaiser Permanente will hire an outside consultant to focus on corrective actions and provide expert guidance.
The settlement was welcomed by the National Healthcare Workers Union, which represents more than 4,000 psychologists, social workers and marriage and family therapists employed by Kaiser Permanente in California.
“This settlement is a monumental victory for Kaiser Permanente patients and their mental health therapists, who have waged multiple strikes,” union president Sal Rosselli said. over the past decade to force Kaiser to fix its broken behavioral health care system.
The managed care agencies’ report confirms everything Kaiser therapists have said about their patients’ inability to receive adequate mental health care, Rosselli said. sufficient and timely.
In a statement about the settlement Thursday, Kaiser CEO Greg Adams said demand for mental health services has increased unprecedentedly over the past three years, largely due to the pandemic. global epidemic and its consequences.
Adams said Kaiser saw a 33% increase in demand during the pandemic and a 20% increase in people seeking care in 2023 compared to the same time last year.
Adams said there has been an ongoing shortage of qualified mental health professionals, clinician burnout and turnover, and even a 10-week strike last year by 2,000 doctors. mental health clinic in California, all contribute to the difficulty of meeting this growing need for care.
Adams said Kaiser has increased staffing and facilities, and since 2020, has invested an additional $1.1 billion to provide mental health treatment to members.
Kaiser hired nearly 600 more therapists, expanded its network to include thousands of community therapists, and invested an additional $195 million in new clinical facilities including 329 health care provider offices mental.
Even so, throughout the DMHC survey period, we failed to meet our members’ expectations as well as our own, Adams said.
Our agreement with DMHC to take full responsibility for our performance during the survey period, including any shortcomings, acknowledges our work to improve mental health care. mental health and ensure that our ongoing investments not only help Kaiser Permanente members but also build a better mental health foundation in the communities we serve,” said Adams.
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