Kaiser Permanente has resolved some of the problems with its mental health services that led to $4 million in fines in 2013, but it still has work to do, according to a newly issued state report.
The Oakland, Calif.-based healthcare giant is doing a better job of tracking whether mental health care is delivered in a timely manner, but it still faces issues with timely access to care and educating plan members about the scope of services covered, according to the report (PDF) issued Tuesday by the California Department of Managed Health Care. The state issued its first report and imposed the fines in 2013.
Kaiser said in a statement it continues to hire more mental health providers and is contracting with other mental health care providers to provide timely care. It has implemented several improvements, both before and after the follow-up survey was completed between 2013 and 2014, Kaiser said.
“We are committed to continuing to improve,” Kaiser said. “We acknowledge there are still some areas where we need to continue making progress, and do better for our patients.”
The not-for-profit health plan's apparent inability to provide timely care has been the crux of an ongoing conflict with the National Union of Healthcare Workers, which represents about 2,500 Kaiser mental health care workers in California. The workers went on a weeklong strike in January to protest understaffing of Kaiser's mental health facilities.
A NUHW spokesman said the union is currently in negotiations with Kaiser and hopes to come to an agreement over the next few days, though the two parties have not been able to agree on a contract since the union was founded in 2009. NUHW President Sal Rosselli said the union is reviewing the Department of Managed Health Care report and is “working with Kaiser on a collaborative method to fix the remaining problems.”
Kaiser said that time spent bargaining with the NUHW has kept it from fixing some of the problems identified by the union.
“We need union leadership to work constructively together with us to remove obstacles and solve problems more quickly, including making the best use of our partnership with high-quality community providers when we need those providers to help us meet our patients' immediate needs,” Kaiser said in a statement.
In Kaiser's Northern region, which is essentially Northern California, 22% of the medical records reviewed by the Department of Managed Health Care in its follow-up investigation showed that patients were not provided with an appointment within the regulatory time frame of 10 business days. This was the case with 9% of the medical records reviewed in Kaiser's Southern region, which is essentially Southern California.
“While the department understands the unique hurdles the plan continues to face in recruiting adequate staff and in using externally contracted providers, these challenges do not relieve the plan of its statutory obligation to take effective action to correct access and availability problems,” the agency stated in its report.
Kaiser has corrected marketing materials that previously suggested that the health plan doesn't cover long-term psychotherapy, which was in violation of the state's mental health parity law. But health records reviewed by the Department of Managed Health Care upon follow-up still show that providers are not effectively and consistently communicating that patients can be seen as often as medically necessary.
The department said the unresolved deficiencies in Kaiser's mental health services have been referred to its Office of Enforcement for further investigation and possible disciplinary action. The agency's next routine review of Kaiser, which includes medical and mental health care, is expected to commence in late 2015.
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