By Rebecca Parr
February 25, 2015 

Kaiser Permanente has made it easier for patients seeking mental health care to get appointments, but it still is not meeting all their needs, a new state report finds in a follow-up to a highly critical 2013 report that resulted in a multimillion-dollar fine.

Some patients are still having to wait too long to be seen, and some are being given inaccurate and misleading information about their plans' mental health coverage, according to a state Department of Managed Health Care report released Tuesday.

"Although Kaiser has taken substantial steps to identify and monitor issues related to timely access to behavioral health services, significant and serious concerns remain," said Managed Health Care agency Director Shelley Rouillard in a news release. "Kaiser's actions have not been sufficient to ensure enrollees have consistent timely access to behavioral health services."

Kaiser has made significant improvements in accurately showing when appointments are requested and made, the agency found. The health care provider also has a new way to track and report appointment wait times. Those were two of four problems the state noted in a previous report that led the state agency to fine Kaiser $4 million in 2013 because patients often had to wait weeks to get appointments. It also said Kaiser violated state law requiring equal access for mental and physical health treatment, and that Kaiser's written description of its mental health services was complicated and misleading.

The penalty was the second largest in the department's history.

But the follow-up report found that in Northern California, 22 percent of Kaiser patients have to wait too long to be seen. State law requires that a mental health patient be seen within 48 hours in urgent cases, within 15 days for a specialist such as a psychiatrist and within 10 business days for nonurgent appointments.

Kaiser said it has made progress since the state's follow-up review.

"We have hired new mental health therapists in Northern and Southern California, and we currently are recruiting to hire more," the health-care provider said in a release.

It also has increased clinic hours, started video and telephone appointments and now moves physicians between medical centers as needed. Last year, Kaiser began referring some patients to outside mental health care providers.

Kaiser also needs to take immediate steps to ensure its staff stop giving out inaccurate information about mental health coverage, the report found. "That misleading health education information is disseminated verbally, and in writing, to patients by providers is of great concern to the department," the report read.

Kaiser said the cases the state cited were isolated examples that have been taken care of.

"We also agree that it is unacceptable for anyone at Kaiser Permanente to provide erroneous information ... about access to mental health care," it said in its statement.

The report was referred to the state agency's office of enforcement for more investigation and possible disciplinary action.

The health care provider's mental health clinicians have long complained of a staffing shortage and have been in a contract dispute with Kaiser for years. They staged a weeklong strike in January. The clinicians are represented by the National Union of Healthcare Workers, which has been highly critical of Kaiser.

However, union president Sal Rosselli struck a more conciliatory note in a statement Tuesday regarding the state agency's findings. "We are working with Kaiser on a collaborative method to fix the remaining problems," he said.

 

Kaiser Mental Health Services Improve, but More Needs to Be Done, Agency Finds [San Jose Mercury News]