A union is accusing the company of understaffing its mental health unit, causing patients to face excessive delays before treatment. Last year, state officials fined the Oakland company $4 million for numerous violations related to patient access to mental health services.
"Kaiser has refused to invest in the staff required to provide the mental healthcare services that its members pay for," said Sal Rosselli, president of the National Union of Healthcare Workers, which represents about 2,500 of Kaiser's mental health workers in California.
On Nov. 20, the union said its psychologists, therapists and social workers had voted to authorize a strike if Kaiser does not agree to a series of improvements, including staffing increases. Negotiations are scheduled to resume in December.
Kaiser says it corrected the problems identified last year by the state; it blames the ongoing criticism on a labor dispute. The company increased its staff of California therapists 25% — from 1,105 to 1,378 between 2011 and early 2014, said John Nelson, a Kaiser spokesman.
The union's criticism "is almost entirely a bargaining tactic," Nelson said. "It's part of their effort to pressure us."
The California Department of Managed Health Care had faulted Kaiser for long wait times for its mental health patients and inaccuracies in its educational materials that could dissuade patients from seeking care.
"We believe we addressed all the issues in their 2013 survey," Nelson said. "We're a learning organization; we're constantly learning, constantly trying to improve."
With 9.5 million members, Kaiser is one of the largest nonprofit health plans in the United States. It consistently wins praise for its patient care and customer satisfaction.
In January, California's Office of the Patient Advocate awarded Kaiser a four-star rating — the only health plan in the state to receive that mark. The agency awarded Kaiser three stars for its behavioral care, ahead of many other HMO providers.
But the union is not alone in its criticism of Kaiser's mental health program.
Shirlee Zane, a member of the Sonoma County Board of Supervisors, has been pressing Kaiser to improve it's mental health services, an issue with deeply personal implications for her. Zane's husband committed suicide in 2011 while under the care of Kaiser's psychiatric department.
This year Zane questioned whether Kaiser properly assessed her husband's severe depression and suggested Sonoma County reconsider its contract with the health plan.
In September, a Los Feliz man filed a lawsuit that accused Kaiser of coercing parents into removing adult children with mental health issues from coverage, saying they'll receive better care at government-funded facilities. Without insurance, the mental health patients qualify for government-funded in-patient care, the lawsuit said.
"Kaiser no longer bears any financial responsibility," Douglas Kerr said in the lawsuit about his son's treatment. "His expenses — in their entirety — have been unlawfully shifted to the public taxpayer."
The lawsuit seeks financial damages and an order that would require Kaiser to re-enroll Kerr's son and any other mental health patients whose coverage was rescinded.
Kaiser denied wrongdoing.
"We disagree with the plaintiff's allegations, and we will vigorously make our case in this lawsuit," Nelson said. "Under no circumstances does Kaiser Permanente force or encourage severely mentally ill members to disenroll from their coverage in order to shift the cost of their care to government programs."
Kathryn Trepinski, a Beverly Hills attorney who represents Kerr in the lawsuit, said Kaiser does not have adequate facilities to provide long-term care for people who are severely mentally ill and prefers to shift the burden to local government programs.
"This is about greed," the attorney said. "They're dodging their obligation with their sick members, just when they need it most."
In a statement, Kaiser said it is dedicated to providing quality mental health care.
"We are committed to our mental health services being the same high quality as all care provided by Kaiser Permanente and we will be relentless in ensuring this is the case," the company said in a statement.