Striking Kaiser Permanente therapists say patients routinely wait months between appointments, and therapists are given unmanageable workloads.
, enacted in 2021, requires that mental health and substance use patients be offered return appointments within 10 business days, unless the treating therapist determines that a longer wait time is appropriate. If an appointment with an in-network provider is not available, insurers and HMOs are obligated to arrange for outside care at no additional cost to the patient.
that getting her younger daughter an appropriate diagnosis within the Kaiser system took so long that she was forced to pay out of pocket to go outside Kaiser. Once her daughter did have a diagnosis of borderline personality disorder, the only treatment she was offered within Kaiser was a series of classes — which were then canceled. After her daughter was hospitalized multiple times for self-harm, McDonald paid out of pocket again to get her the treatment she needed outside of Kaiser.
Chaumette said that in her experience, it’s often patients with less severe symptoms who do manage to get a referral for covered care outside the Kaiser system. “If I’m seeing somebody with depression and they’re having a difficult time getting out of bed, dressing, bathing, eating, they’re not going to have the energy to be on the phone with Kaiser fighting for an outside referral. This system disproportionately hurts the people with more severe symptoms,” she said.
In California, Kaiser contracts with Medi-Cal, the state’s Medicaid program, and its failures to deliver timely care disproportionately affect people who can’t afford to go outside the system. “Any marginalized community that has been unused to advocating for itself is not going to fight the system to give them a referral to an outside provider,” said Chaumette.