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Study: Western States Eliminate Race Gap on Key Health Measures

Researchers looked at how effectively patients had their blood pressure, blood sugar and cholesterol controlled. (Getty Images)

Researchers looked at how effectively patients had their blood pressure, blood sugar and cholesterol controlled. (Getty Images)

A major new study looking at health disparities across the U.S. finds that significant gaps in managing heart disease and diabetes persist — except in Western states, where the gap has been eliminated.

‘It’s possible to eliminate deeply ingrained racial disparities.’
Researchers at the University of Michigan and Harvard University looked at 100,000 Medicare patients who were enrolled in HMOs, called “Medicare Advantage” plans, from 2006 to 2011. While management of blood pressure, cholesterol and blood sugar improved overall, blacks “substantially” trailed whites everywhere except the Western U.S., an area from the Rocky Mountains to the Pacific, as well as Alaska and Hawaii.

“We were certainly hoping we would see indications of progress in eliminating disparities in the country as a whole,” said lead author Dr. John Ayanian, who heads the Institute for Healthcare Policy and Innovation at the University of Michigan. He said that while it was “disappointing” that disparities persisted, “it’s also heartening to see that … in the West, the disparities had been eliminated, and that was both surprising and encouraging.” Continue reading

Kaiser Mental Health Clinicians Authorize Strike

Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED)

Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED)

A union of 2,500 mental health clinicians at Kaiser have voted to authorize a strike, just one week after Kaiser’s nurses went on strike for two days.

In September, Kaiser agreed to pay a $4-million fine levied by state regulators. The Department of Managed Health Care found patients were subject to excessively long wait times to get a therapy appointment, or were shuttled into groups when they wanted individual therapy.

Psychiatric social worker Clement Papazian says various fixes, like after-hours appointments, still aren’t meeting demand. Continue reading

Kaiser Nurses Plan 2-Day Strike: Premature Move or Strategic Step?

Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED)

Kaiser’s Oakland Medical Center. (Lisa Aliferis/KQED)

As many as 18,000 Kaiser Permanente nurses are preparing for a two-day strike that will start Tuesday. Nurses plan to leave their posts at 7 a.m. and picket outside 21 medical centers and clinics across Northern California.

The placards nurses carry and the chants they repeat will say little about salaries or pensions. No economic proposals have even been put on the bargaining table yet.

“This seems awfully quick to go to a strike,” says Joanne Spetz, an economics professor at the UC San Francisco School of Nursing. “I can’t recall a situation where a strike has come up where there has not been some kind of disagreement about wages and benefits as part of the package.” Continue reading

Ebola Now an Issue in Nurses’ Contract Bargaining

(Centers for Disease Control via Getty Images)

(Centers for Disease Control via Getty Images)

Nurses’ calls for better hospital preparation around Ebola have landed on the bargaining table. California’s powerful nurses’ union has been bargaining with Kaiser Permanente for months over a new contract, and is now adding to its list of demands better training, protection, and insurance coverage for nurses who may treat patients infected with Ebola.

Diane McClure, a nurse at Kaiser’s South Sacramento facility, says nurses still had no meaningful training more than a month after a patient was admitted to the hospital for a potential Ebola infection, though he later tested negative for the virus.

“Kaiser felt all they had to do was pull up some CDC flyers and put them on the lunchroom tables or up in the bathrooms,” she says. Continue reading

Kaiser Agrees to Pay $4 Million Fine Over Mental Health Care

Kaiser Permanente's lower rates on the California health exchange for 2015 may be meant to attract customers. (Ted Eytan/Flickr)

Kaiser had been fighting the fine, levied last year by the California Department of Managed Health Care. (Ted Eytan/Flickr)

Kaiser Permanente agreed to pay a $4 million fine over claims that it did not provide adequate access to mental health care services for its patients.

The state’s Department of Managed Health Care levied the fine last year, citing survey results that indicated patients had to wait excessively long periods between therapy appointments, and that they were effectively dissuaded from seeking individual treatment.

Kaiser had contested the fine, calling it “unwarranted and excessive.” The two parties were scheduled to give opening statements before an administrative law judge on Tuesday in Kaiser’s appeal, but Kaiser faxed a letter to the court Monday evening saying it will pay the full fine, and asked the judge to dismiss the case. Continue reading

Kaiser Therapists, Patients Allege Long Waits for Mental Health Care

Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED)

Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED)

One month, three months, even five months.

That’s how long some Northern California Kaiser patients wait to see an individual therapist — according to many Kaiser patients and therapists.

KQED’s Jon Brooks has reported extensively on this issue over the last two months. He talked to close to two dozen therapists and patients who said that they were experiencing long wait times. One therapist whose specialty is geriatric care told him that she had written to her superiors saying, “I can’t tell a patient that has six months to live that I’ll see them in five months.” Continue reading

Therapists, Patients Criticize Kaiser Over Long Delays for Therapy

Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED)

Kaiser Permanente’s newly opened medical center in Oakland. (Lisa Aliferis/KQED)

This is the second of two parts about mental health services at Northern California Kaiser.

In January 2013 a woman named “Nina” had a terrible falling out with her father. Soon after, she found out he had incurable cancer and was going to die. In the ensuing weeks, she tried to patch things up, but with the pressures inherent in the last months of a dying man, was unable to attain any form of closure. Some six months after their fight, he was gone.

“People are suffering, and I fear some of my patients will commit suicide for lack of ongoing treatment.”

“Nina,” who did not want us to use her real name for reasons of privacy, had been prone to depression. Zoloft had helped, but the now irreparable family rift left her severely depressed, with occasional thoughts of suicide. “I was in a state of constant emotional pain and confusion,” she says. “It was affecting all aspects of my life.”

She went for an intake appointment at the psychiatric department at Kaiser Permanente’s Oakland Medical Center, with the expectation she’d be able to see a therapist for individual appointments during this severe emotional crisis. She requested those sessions, but the intake therapist told her Kaiser only offered group therapy.

“I said I’m not comfortable talking about my situation with a bunch of strangers,” Nina says. “She very kindly tried to make me aware of the value of group therapy. But I knew in my heart it wasn’t where I wanted to be.” Continue reading

Kaiser, Nurses Union Brace for Upcoming Contract Battle

(April Dembosky/KQED)

Members of the California Nurses Association rallied in Sacramento in May to raise awareness around what they say are patient care concerns in California hospitals. (April Dembosky/KQED)

Going to a nurses union meeting is a little bit like going to an evangelical church service.

Contract talks begin next week on new four-year contract.
“We all have to stand up, and it’s a struggle,” says nurse Veronica Cambra, reporting a grievance at Kaiser Hospital in Fremont as though she’s giving testimony. “And we will overcome this, okay?”

The rest of the nurses respond with the passion of a devout congregation, humming “Mmm hmmm,” and “That’s right,” through the series of speeches.

The union heads at the front of the room interject now and then to rally the group around a unifying message.

Continue reading

Sonoma Co. Supervisor Takes Issue with Kaiser over Mental Health Services

(Ted Eytan/Flickr)

(Ted Eytan/Flickr)

This is Part 1 of a series on issues surrounding Kaiser Permanente’s mental health services.

Sonoma County Supervisor Shirlee Zane is frustrated with Kaiser Permanente.

“Kaiser better change the way they do business when it comes to mental health services.” — Shirlee Zane, Sonoma Co. Supervisor

“I can tell you I have heard a lot of stories within the last few days about these types of incidents over and over again,” she says, “of people who were so wronged by their treatment, by either being referred out of the system or by saying, ‘We don’t have the appointments.'”

She’s referring to allegations of long delays for mental health services at Kaiser Permanente, accusations the health plan has been dealing with for several years. Now, Zane is trying to leverage a very personal tragedy — the suicide of her husband — into pressing Kaiser on reforming its mental health practices. Continue reading