Hummingbird eggs in a nest outside my kitchen window.
Hope you have a good weekend everybody!
HAPPY PIC
Photo credit: Regan Joiner
KAISER MENTAL HEALTH CLINICIANS SAY "ENOUGH" by Sal Rosselli
June 1, 2019
Dear friend,
On Friday afternoon, we gave notice for 4,000 Kaiser Permanente mental health clinicians and health care professionals to begin an open-ended strike on June 11, all across California. NOTE: THIS STRIKE DID NOT TAKE PLACE
This is not an action our members took lightly. For the past decade, Kaiser psychologists, therapists, social workers and psychiatric nurses have been fighting management to fix its badly broken mental health system, which forces patients to wait weeks and even months for care. And these caregivers are committed to working around the clock over the next 10 days to find immediate solutions to address this crisis without a strike.
But the situation at Kaiser has become untenable for both patients and clinicians.
Last Tuesday, Kirstin Quinn Siegel, a Kaiser therapist, told Berkeley council members that she had a patient in one of her group sessions who recently had to defend her three children from an intruder in their home. “She’s clearly in distress,” Quinn Siegel told council members. “Her next appointment with an individual therapist is in July.”
Wait times are even longer in Southern California.
Tanya Veluz, a Kaiser therapist in Pasadena, told USC Annenberg Media last month that her patients have to wait three months for an appointment even if they’ve lost a loved one or have bi-polar disorder.
“It's extremely disheartening to sit there and tell someone you can't see them — And you watch them not getting better,” she said. “We do everything possible. We stay late, we call patients, we try, but definitely it's heartbreaking and burns people out."
Kaiser mental health clinicians sounded the alarm in December with a five-day strike. But Kaiser still refused to address the problem. Now appointment wait times are longer than ever. While we have seen some movement from Kaiser during recent negotiations, Kaiser’s most recent proposals won’t stem the crisis.
Kaiser’s proposal to add clinicians dedicated to doing intake appointments would help it meet regulatory requirements for new patients, but wait times for return appointments would grow even longer. Dedicated intake specialists would bring in more new patients faster, but Kaiser has no plan to increase staffing as needed to provide these patients with reliable and consistent ongoing care.
Adding appointment clerks won’t keep clinicians from having to use their lunch time and evenings -- all without pay -- to squeeze in calls to desperate patients who can’t be seen. These clerks won’t have the clinical training to know when patients need urgent attention and should go straight to the front of the line. Clinicians never asked for appointment clerks because they knew it would just create one more bureaucratic obstacle for patients trying to connect with qualified caregivers.
Kaiser is struggling to hire full-time therapists willing to accept its relentless working conditions. It surely won’t be able to hire enough temporary clinicians to significantly increase appointment availability in a system that staffs just one full-time equivalent therapist for every 3,000 Kaiser members.
Neither will Kaiser’s under-staffing of its mental health clinics be alleviated by dedicating more recruiters to fill those jobs. It can only be alleviated by Kaiser budgeting for more positions and improving working conditions to reduce turnover.
Our members have proposed real solutions that are focused on improving access to care.
We are proposing a requirement that Kaiser must hire new clinicians to fill its newly-constructed office spaces. This would avoid a repeat of what happened this year in Fairfield, where Kaiser built new office space for 38 mental health clinicians but didn’t hire any new staff.
We are proposing that Kaiser establish crisis teams at all locations, so new patients in crisis can get the care they need without clinicians having to cancel appointments with their current patients.
We are proposing that clinicians be given the right to convert appointment slots that have been set aside for new patients to serve returning patients who need immediate care.
We are proposing that clinicians get 20 percent of their time to meet patient care responsibilities that include answering email messages from patients, calling patients in need, charting, and communicating with a patient’s relatives or social service representatives. This work, which is critical to ensure the effectiveness of patients’ treatment, is often done during lunch breaks and after-hours, which leads to burnout and clinicians leaving for other jobs.
We are proposing a formalized, focused, and facilitated committee process in which labor and management would work together to expedite development and implementation of systemic reforms to address Kaiser's mental health crisis. Management instead wants only a loose committee process with no structure, no timelines, and no accountability to reach solutions to Kaiser's pressing problems.
Now, as before, when it comes to mental health care, Kaiser’s proposed “solutions” never get to the root of the problem, and often serve to obscure it.
Kaiser touts its newly constructed clinics, but never mentions that it primarily staffs them with its existing workforce.
Kaiser touts hiring hundreds of new clinicians without mentioning that at the same time, many over-burdened clinicians are leaving and tens of thousands of new members are enrolling, so that staffing ratios stay fundamentally the same.
Kaiser touts its tele-psychiatry program without mentioning that telephone assessments are far shorter and less thorough than the face-to-face assessments it used to provide.
Kaiser claims a statewide shortage of mental health clinicians impedes it from improving care, but never mentions that it is undercutting its own recruiting efforts by denying mental health clinicians the same raises given to every other unionized employee and singling out many recently hired mental health clinicians by eliminating their pension benefits, while all other Kaiser employees still receive them.
Kaiser’s mental health “innovations” are really shortcuts. Its initiatives are too often geared toward improving its image rather than its mental health care. Now, its clinicians and patients are at a breaking point.
This is a problem we need to fix now. Patients and clinicians have waited long enough.
In Solidarity,
Sal Rosselli, President
National Union of Healthcare Workers
HAPPY PIC
Photo Credit: Carol Lefkov
Why is the ibis crossing the road?
Hope you have a good weekend everybody?
SOONER THAN TOMORROW - A MOTHER'S DIARY: INTRODUCTION by Dede Ranahan
Patrick and me in 1969
Above all, I have been a sentient being,
a thinking animal, on this beautiful planet,
and that in itself has been an enormous privilege and adventure.
Oliver Sacks
SOONER THAN TOMORROW
A Mother's Diary
by Dede Ranahan
INTRODUCTION
Welcome to my world.
My story is written in diary format. I wrote it from June 15, 2013, to June 15, 2014. I’ve always wished I’d uncovered a diary or letter written by one of my relatives a hundred years ago. With so much interest in ancestry right now, I decided to pay it forward for my children and grandchildren, and leave a time capsule for them from the deep, dark past of today.
What I didn’t know, as I was writing, was that I was capturing the last year of my son’s life. Pat died, unexpectedly, on July 23, 2014, on a hospital psych ward where I thought he was safe. Suddenly, my diary morphed into a more poignant record than I’d anticipated.
I like stories where I can extrapolate from the singular to the universal — that is where I can identify with a common denominator in another person’s experience. One early reader of my diary said, “Your story is so relatable.” That’s what I hope other readers will say.
You may relate to my story if...
You have a child (children) you love more than your own life.
You have an adult child who lives with and suffers from serious mental illness.
You’ve lost a child — no matter what age.
You're a member of the sandwich generation.
You’re trying to live more in the moment, be more observant, and find joy in each day.
You treasure conversations with children — especially when they’re your grandchildren.
Your cat or your dog is in charge of your household.
Your bones are beginning to creak. Turning 70 was the catalyst for my writing.
You wake up each morning with a huge hole in your heart but you know, somehow, someway, you have to get up and put one foot in front of the other.
You enjoy reading the other side of history — about ordinary people and their daily lives.
You’ve been thinking of leaving something for your descendants — a letter, story, diary, song, painting or poem — but you haven’t gotten around to it. Maybe my diary will spur you on.
A couple notes about format:
I've added a Before section (Scenes from the Trenches). Going in, I want the reader to know “Yes, Houston, we really do have a problem.”
After he died, I discovered Pat had been making regular posts on FaceBook. I decided to add his comments to my own.
I’ve divided my diary into quarters - Summer, Fall, Winter, and Spring. I introduce each with one of Pat’s poems.
I end with an After section that I didn't see coming.
I hope you'll make reading my diary an interactive experience and leave comments for each of us to consider — about themes you relate to or how your experiences differ from mine. I'm blogging my book because I'm motivated by reach and I believe, through word of mouth and social media sharing, my story will reach more than a book sitting on a shelf. I want my story and Pat's story to put faces on serious mental illness. To personalize it.
As I was writing, I didn't know, from day to day, what stories were unfolding. I learn, right along with the reader, what will happen next. We're all on a journey. Thank you for going on this journey with me.
P.S.
Akamai (ah-ka-my) is Hawaiian slang for wit and wisdom. In spiritual numerology, 777 is a lucky number, a number of God. “Akamai777” meaning “Wit, wisdom, and a big hug from the universe,” was a favorite saying of my son’s. I don’t know if he made it up or found it somewhere.
Pat, in your honor, I’m noting your phrase and passing it on. I love you forever. Mom
Finalist: 2016 San Francisco Writer's Conference Memoir Contest
Finalist: 2016 Writer's Digest Writing Competition