SoCal Kaiser Strike Interview with Jade November, 2024
This interview from mid-November 2024 aims to underscore the heart of the ongoing strike led by the National Union of Healthcare Workers (NUHW) in Southern California, now entering its fifth week. The strike involves over 2,400 mental health professionals, including therapists, social workers, and psychologists, who are fighting for equitable wages, better benefits, and systemic changes to improve patient care. In just six weeks, the temporary replacement workers—or “scabs”—brought in by Kaiser Permanente are earning more than many of their licensed therapists make in an entire year. Jade, a dedicated therapist and union member, shares the emotional toll of the strike, the systemic barriers to providing adequate care, and the collective resilience fueling their efforts to demand meaningful reform from Kaiser.
Mel: How are things going, first of all?
Jade: We just entered into week five of our strike. And we remain pretty united and strong as a union…and so does Kaiser. They've refused to come to the bargaining table, so that's been a little disheartening, but I think we expected that. That's their tactic, right? That’s their tactic, to wear us down and make us feel like our efforts are not making a difference.
Jade: That has been hard, but like I said, we have prepared each other for that. For the most part, people know what to expect, but it's still hard not having a paycheck, going into Thanksgiving and people are struggling, but most of us prepared for the strike financially, and we're taking care of each other, and so that's where we're at right now.
Mel: I'd love to also jump into some of the questions that we sent over if that's cool with you.
Jade: Absolutely.
Mel: If you could tell us a little bit about the current setting and the context of the strike, that would be wonderful.
Jade: Like I mentioned, we're in week five of our strike. This is with the National Union of Healthcare Workers at Kaiser Permanente in Southern California. It's about 2,400 members, and we are made up of therapists, social workers, and psychologists. These are all people who specifically work at Kaiser, not therapists contracted with Kaiser insurance, just to be clear. And there's three primary reasons why we are striking right now.
Jade: Number one is patient care. So that umbrella term means a couple of things. One is that as therapists, as social workers, we are really struggling to provide patients with the care that they deserve. What I mean by that is, seeing them on time and seeing them within a reasonable time frame. So if you call your therapist, and you need to talk to your therapist or social worker, you would expect maybe a phone call within a couple days, or maybe an appointment within a week or so. That's pretty reasonable. Right now, it's really hard for therapists to do that because they are so booked out. Any free time that they have, any appointment that is available gets automatically booked to you, even if it's not your own patient. It becomes a lot for the therapist, and they're getting burned out very quickly.
Jade: The caseloads are very high, and this is a common theme in mental health, that the case loads are high, but the therapists are getting burned out, and then a lot of therapists are leaving. They leave Kaiser because they can't manage the workload, and this also affects the patients, right, when you have a high turnover in therapists. I've talked to patients that have had three therapists or four therapists within a year or two. And it's just not good patient care. Yeah. So there's a lot of issues that are affecting us as therapists and we can't deliver the same quality of care that we would like to. And this is a huge issue.
Jade: Another is our benefits and our wages. And we want that to be equal to what our counterparts at Kaiser in Northern California already are getting, so this is nothing new, it's nothing that hasn’t already been done there - we're just asking for the same. All other Kaiser unions received a 20% wage increase for cost of living, and we have not.
Jade: And then the last thing is we want to restore our pension. The pension was taken away in 2014, and we are the only Kaiser employees without a pension. Just us. It's the mental health workers, the social workers, and a small group of pharmacists who do not have a pension. And again, this leads people to question, why do I stay here? If I'm a licensed therapist, why should I stay in a place like Kaiser when there's nothing keeping me here? A lot of people will leave to do their own private practice where they can make a lot more money, and this is why we have the problem with delivering good services to our patients - because of that high turnover that I mentioned. They took away our pensions, but they’re paying scabs $13,000 a WEEK.
Jade: So all of that is intertwined, but those three big platforms that we're striking over.
Mel: Wonderful. Thank you so much for telling us about this. Can you tell me more about the lead up to the strike and what prompted it to move into this current stage?
Jade: So for context, we have 45 minute sessions, and we have to do all of the stuff we would normally do outside of our time with clients in our sessions instead, so patients are feeling disconnected and dropped. There aren’t enough therapists,, and there isn’t any space in our schedules for patient advocacy or coordinating with the rest of the people on their treatment team (such as psychiatrists, case managers, etc) because they keep taking that time away to add people to our caseload, which means I’m sitting there typing away and messaging other providers while also trying to provide therapy. Add that on top of everything else I’ve mentioned, and our union has been trying to advocate for changes to Kaiser for a while now. I think that the month leading up to it, we found that Kaiser was just not moving forward with any proposals. For example - and I can't speak too much to what happens in the bargaining sessions because I'm personally not there – but what was explained to us was that our union would come prepared with counterproposals and Kaiser would just have… nothing. They would not have a response.
Jade: So for the second to last session, they sent one person when usually it's a panel of around 12 people, and for the very last one, they sent one. And that one person in with two assistants were all not prepared, they did not want to negotiate any further. After all of our counterproposals that we had put out, their only response was no. Besides offering just a 25 cent raise for bilingual pay.
Mel: Yeah, that's very disheartening.
Jade: Yeah, it feels very disrespectful when they treat us that way at the bargaining table. It just shows that they don't want to make actual progress. So we’re going to be on strike indefinitely until they come to the bargaining table.
Mel: It's insulting, honestly. And this was just before you guys went on strike? Or are you talking about during these last five weeks during the strike?
Jade: We've only had one week where we still had bargaining during the strike. So that was during the first week.
Mel: Got it. Were there any other immediate asks or demands that your union was making?
Jade: Those are the three top ones, right? There's lots of little things that fall under those umbrellas, but here's just like another small example that is only for our union specifically in Southern California.
When I go to Kaiser to go see my doctor or urgent care, I have a $20 copay. It's really not that bad, but every other Kaiser employee has a $5 copay. So again, it's just the inequalities, all these little things, right? When we talk about benefits, when we talk about caseloads, when we talk about the time that we need to see our patients, it's all those little factors that are added up, but I use those big umbrella terms to explain patient care and our benefits and our wages.
Mel: What is the current required caseload - how many patients must you see a week?
Jade: It's infinity. There is no cap to the caseload. So the messaging is that you have to terminate people quicker so that way you can manage the incoming caseload.
Mel: And you don't get to say, no, I can't take on any more clients. They just add them to your schedule.
Jade: Correct. So minimum, I think most therapists are getting five intakes a week. Minimum. And so you can just do the math of what that would look like over the course of a month, over six months. It's never ending. And you have to manage that caseload, so the only way to survive that as a therapist is to terminate people, which sometimes comes at a price of discharging people prematurely, because you're just overwhelmed. You think to yourself, I have to, if I don't discharge people, I have five more people coming in this week, how am I going to see them all?
Jade: So that's the pressure that the therapists are under. And then people come back. They're still your patient, by the way. You discharged them a month ago because you felt that if you didn't discharge them, you’ll collapse under the caseload, so you discharge them, but the patient obviously was not well, so they come back a month or two later, or six months later. They still count as under your caseload for two years. If you saw that patient within two years, and if they come back at any point they're technically your patient. So you have five intakes, plus any patients that are returning, plus one transfer a week.
Mel: What are your hopes for the long-term impact of the strike and hope for setting things up for the future?
Jade: I really feel like Kaiser has the ability to be the leader in mental health. They have the ability to do it, and I hope that we can change mental health in that way. I hope that our therapists can last at Kaiser. There's longevity that people see - a future, a career, and a retirement at Kaiser. I would love that for the therapist. And I would also love for us to be able to really treat our patients with the care that they deserve, and for us to not feel so much pressure to discharge them prematurely, to not feel I can't see my patient because I just got booked with another intake. I really want therapists to feel like they're doing good work, helping people get better, and feel like they can stay at Kaiser.
Mel: How do you hope that the strike will impact mental health labor struggles in general? Do you have any future vision of how this strike will inspire other mental health workers or impact the future of mental health labor struggles?
Jade: My belief is that unions can make a big impact in any industry, and they set a standard for how other people build their model, right? When unions come in, raise the wages for their workers, we start to see that other people around start to say, “Okay, yeah, we need to raise the wages for our workers, too.” And hopefully Kaiser starts to realize that, “yeah, we need to treat our mental health care professionals and our social workers with better benefits. And we need to give them time in between their patients so that they can work on the treatment plan.”
Jade: And when they honor those things, they can be a role model. Kaiser Permanente can be a role model for everybody else, and they have the power to show how good it could be and that you don't need to work people like a workhorse. How I see it is that I really do believe that we're fighting for the greater good of mental health care. Right now it's at Kaiser, but I truly hope and believe that this will have a ripple effect everywhere.
Mel: I know you said you're not on the bargaining team, but do you have any other insights that you can offer on how the bargaining is going?
Jade: The only thing I know is that bargaining is at a standstill. They haven't met in four weeks. And the invitation from our end from our union remains open, we've asked them for dates, Kaiser has not responded, and that's all there is. At this point we just have to wait for Kaiser to be ready.
Mel: What’s your read on the current situation, as of week five, and how the company's responding?
Jade: Right now, there is an investigation by the Department of Managed Health Care, the DMHC which is the organization in California that acts as regulators of HMOs, and they make sure that the HMO is following the law and providing services in the way that they're supposed to provide. The DMHC actually fined Kaiser 50 million about two years ago. That was from the strike in Northern California. So now that they’ve gotten wind of our strike, they've already started to investigate Kaiser. That much is public information, that the DMHC is already investigating Kaiser and there are concerns that Kaiser is not providing adequate mental health care while we're on strike.
Mel: Is Kaiser itself responding with any repression? Besides blocking the food distribution that we touched upon earlier.
Jade: I've seen some ads floating around on social media from Kaiser, and it's a picture of a sad woman, and then it has a lettering that says that your therapist is choosing to block you or go on strike instead of seeing you or something like that. Just really passive aggressive stuff. Others say something like they're putting pickets before patients, things like that. It's been these kind of jabs from Kaiser in that regard.
Jade: Also— I want to say this was maybe like the second or third week—e had picketers over at Baldwin Park, one of the Kaiser medical offices, and Kaiser turned on the sprinklers on the picketers during the day. And usually the sprinklers are not on during the day in California - we still only turn on sprinklers at nighttime and only on certain days of the week due to water usage restrictions, but they did that purposely and they did it twice within two hours.
Jade: I also know there's been times where they've called the police on us, including the day in Los Angeles, on Friday when the Los Angeles Labor Federation was distributing food, they called the police. They also called the police one of the days that I was at Anaheim picketing. The officer was confused as to why he needed to be there - he left shortly after he was like, “I don't really see why I'm here.” So yeah, things like that.
Jade: Another time, I was helping one of my colleagues, and we had to sit down on a bench on Kaiser property, and we were told that we were not allowed to sit down. Like, why can't I sit here?And I was told “Because you're wearing your union shirt.”
Jade: There's also been reports of a Kaiser member that stopped by our picketing booth and wanted to support us. We gave her a t-shirt, she put it on, and then she walked up to Kaiser to go for her appointment. And she told us later they started to give her a hard time, saying “Oh, what are you doing? You can't come in here like that.” I think that they probably thought she was like a striking member, but Kaiser employees are also still Kaiser patients at the end of the day - if I break my arm or something, I still have to go to the emergency room as a Kaiser patient, so you can't tell me that I can't be on the premises.
Mel: This leads into my next question – is there any movement on the side of the clients or their reaction to the strike as far as you can tell? Either supporting or against the strike?
Jade: For the most part, we've gotten a lot of support from patients. There's been a trend on social media of Kaiser patients expressing their support for their therapist, and saying that they will refuse to work with an external therapist or a scab who’s being paid to cover for us in the interim. A lot of patients are on social media saying, “I'll do whatever it takes, I will wait it out, I support my therapist, I do not want to see somebody else.”
Jade: And also, that's not how building a therapeutic relationship works, right? Clients say, “it took me a long time to build trust with my therapist. I don't want to see somebody just filling in for them. I want my therapist back and I'm going to wait.” So that's really nice that our patients support us and that they're going to wait for us.
Mel: That's great. How is your strike informed by past strikes? Were you inspired by any other strikes such as Kaiser strikes, other strikes in healthcare, or mental healthcare?
Jade: Yeah. Kaiser in Hawaii went on strike for six months, and that was also our union, the NUHW, specifically the mental health workers. They really toughed it out. And then the following year, it was Northern California. They went on strike for 10 or 12 weeks. Those experiences helped us understand how strikes can be effective by showing us that our colleagues were successful. It was hard, but they got through it. And so can we. That’s what has inspired us.
Mel: Has the NorCal branch of the union provided you guys with any support? How are they showing up through all this?
Jade: Yeah, they're definitely supportive. They've been donating to our hardship fund. And they were giving us some tips on how to get through the strike and how to organize. Even before we went on strike, they were telling us, “this is what you're going to need to do in order to make your strike successful.”
Mel: How do you see your strike in relation to broader labor struggles?
Jade: We've gotten a lot of support from other unions as well, and that has been great. We've had unions reach out to us. In fact last Tuesday, there was this conference in San Diego, and at the end of the conference, Kaiser hosts this reception where they invite other labor partners to tell them thank you for choosing Kaiser, so we went to picket at that location in front of Petco Park, which is a Major League Ballpark in San Diego. When the unions arrived for what they thought was going to be a reception, they were all dressed up nice, and they saw us picketing so they stopped and asked us, “what's going on here?” And of course we told them that we're on strike, and they said, “oh hell no, we are not going in.” They refused to cross the picket line. Many of them picked up picket signs and marched with us, and many of them donated to our hardship fund. It really showed me that unions are together. We support each other.
Jade: Unions have to support each other. Because they know that if one of us falls, or if a corporation takes rights away from one of us, it emboldens these companies to do it to somebody else. It feels really good to know that we have this support from other unions.
Mel: Is any other important information or details that you feel like would be helpful for others to know about?
Jade: Right now, we just have to wait it out until Kaiser is ready to work with us. We're sticking through it. And like I said, we're taking care of each other and everybody's helping each other out. So I know that we're going to get through it. The good things in life, they come at a cost, right? It's a sacrifice. That's what we're all telling each other. We know that this is hard, but we're going to look back on this one day and we're going to say, we did that. We did that for this many months, so that we could really hopefully change mental health and how it's provided in California, how it's provided by Kaiser.
Mel: Is there anything else that would be supportive to your efforts that would help sustain you through the work you're doing?
Jade: if there's anybody that reads this interview and says, “Hey, wait a minute, I'm a Kaiser member and I haven't seen my therapist in a long time” or “I'm having a hard time getting an appointment,” people can call the Department of Managed Healthcare. As I said earlier, the DMHC is launching an investigation into Kaiser to try to see if they’re still following the rules, because Kaiser says, “We’re gonna follow the rules,” and we all know that they're not.
Jade: So if a patient says, “hey, I haven't seen my therapist and I need to see somebody,” they can call this number, 888-466-2219, and let the Department of Managed Care know, or file a complaint with Kaiser Member Services by calling 800-464-4000. They can also contact our union and share their story with our union if they feel comfortable doing that on https://kaiserdontdeny.org or sign our petition to support us here at https://kaiserdontdeny.org/form/.
Jade: People can also donate to our hardship fund if they’re interested - https://nuhw.org/kaiserhardshipfund/
Jade: At this point, I think what would help us the most, though, is if there's any information of any wrongdoing by Kaiser - if they're not following the rules, if you're not getting an appointment, we need that information to be reported. We need that information to be shared so that it can be looked into, it can be investigated, and Kaiser can be held accountable. We’ll touch base again if anything new happens or Kaiser starts to come to the bargaining table.