State and local health officials are investigating complaints that Kaiser Permanente has made serious cuts to mental health staff at its Santa Rosa emergency department, despite having large numbers of patients in psychiatric reservations.
The union representing the striking mental health workers said staff cuts in the emergency department are leaving many mentally ill patients without care or supervision from midnight until 6 a.m.
The union has called on the state and county to investigate reports of at least two suicide attempts in the emergency department last weekend.
Kaiser officials dismissed the complaints as a labor tactic amid current contract negotiations. The health care giant said in a statement that state investigators are obligated to review all such complaints, regardless of their merit.
But the National Federation of Health Care Workers, which represents the striking mental health workers, insists that the complaints are genuine and that Kaiser is failing to provide 24/7 mental health care in the emergency department. Union workers strike for a month.
In some cases, psychiatric patients are held in the emergency department overnight until a qualified mental health professional is available for a psychiatric evaluation in the morning, said Farid Seifi, director of research at the consortium.
My sword said that when The strike began on August 16Kaiser relied on a “skeleton staff” of psychiatrists and on-call managers to handle psychiatric patients who came to the emergency department at night and in the early morning hours. When that didn’t work, he said, they took a tougher step in late August.
“Instead of doing the right thing and finding staff… they simply suspended care for those from midnight until 6 am,” he said.
Seavey added that Kaiser has since “downgraded the level of care” by reverting to virtual services, or “tele-psych” between 6 a.m. and 7:59 a.m. and between 6 p.m. and 11:59 p.m.
A screenshot of the call, obtained by the union from the emergency department manager, describes those periods and lists the period between midnight and 5:59 a.m. as “no psychic available”. The item is dated September 1.
Company officials said they would not comment on internal communications.
Union officials said emergency department staff reported that over the weekend of September 9, more than a dozen psychiatric patients were being held in the emergency department who did not receive proper care or supervision.
“Early on Saturday morning (September 10) two patients attempted suicide while they were inside (the emergency room),” Seifi said. “Circumstances related to these (attempted) suicides were noted – one apparently by hanging, the other with a cut in the throat … All of these things raise concerns about the adequacy of psychiatric staff in the emergency room.”
An emergency department employee separately confirmed the two cases, which occurred at a time without any mental health experts at work, despite having security guards on hand, according to the employee, who asked not to be identified for fear of possible retaliation.
Kaiser responded that it is not uncommon for hospital emergency departments to receive patients in a psychiatric emergency, and that their size at any one time is not dependent on staffing. Company officials said the current strike is making matters worse.
“Instead, the growing numbers have been driven by the crisis of rising mental care needs in our community and exacerbated by the shortage of mental health care providers across the state and nation, the ongoing COVID-19 pandemic and the consequences of wildfires in our community,” the company’s statement said.
Over the past several weeks, the union has called on the California Department of Managed Health Care, which oversees HMOs, to investigate Kaiser’s emergency department staffing levels. On September 11, the union raised concerns about reported suicide attempts with the Behavioral Health Division of the Sonoma County Department of Health Services.
Health Services Director Tina Rivera said last week that county employees had not received reports of suicide attempts from sources other than the union. But she said the county is studying the reports.
“We have been in discussion with the Kaiser leadership who have brought these allegations to their local, state and national leaders,” Rivera said in an email. “My understanding is that Kaiser is also in touch with the Department of Managed Healthcare.”
The state Department of Health Care is conducting a review of Kaiser’s mental health care services in response to previous union complaints that Kaiser was not providing timely mental health appointments during the strike. Rachel Arizola, a spokeswoman for the department, said the state’s “enforcement investigation” includes complaints about emergency department employees.