Behavioral health clinicians from Kaiser Permanente met with the SF Board of Supervisors Tuesday to discuss language in the company\u2019s contract demands that would allow them to expand AI use for mental health care while laying off more employees.<\/p>\n
Tuesday’s Board of Supervisors hearing examined a series of proposed contract changes that Kaiser Permanente clinicians said would fundamentally change how the company delivers behavioral health care, prompting questions about patient care and oversight, as KQED reports<\/a>. <\/p>\n According to the National Union of Health Care Workers<\/a>, the proposals \u2014 dubbed the \u201cTerrible Three\u201d \u2014 would allow Kaiser to expand AI in behavioral health care without guaranteeing it won’t replace therapists, lay off clinicians while referring more patients to outside contractors, and take sole control over behavioral health policies and clinical care models. Therapists argued the changes would weaken patient access to integrated care while limiting clinicians’ independent professional judgment.<\/p>\n KQED reports that the latest dispute comes after the union filed a complaint Monday with the California Department of Managed Health Care, alleging Kaiser is violating state law by relying on automated algorithms and unlicensed clerical staff \u2014 rather than licensed clinicians \u2014 to determine the level of mental health care patients need.<\/p>\n The union notes that Kaiser has already been utilizing AI tools to record therapy sessions and algorithms that help triage patients seeking mental health care. As CalMatters reported<\/a> last month, Kaiser began rolling out an AI-powered documentation platform called Abridge in 2024 that records patient appointments to generate clinical notes. While Kaiser says patients must consent before recordings begin and that the technology reduces administrative work, some behavioral health providers say they have received little information about how recordings are stored, who can access them, or how the data is managed. <\/p>\n They also contend clinicians have been pressured to use the technology to keep up with growing caseloads and avoid disciplinary action, while patients may feel compelled to consent because the tool is presented as a way to reduce therapists’ workloads rather than with a full explanation of how their recordings and data are handled. Per CalMatters, Kaiser says recordings are retained for no more than 14 days, and they comply with HIPAA requirements and are not used to train AI models.<\/p>\n The proposed changes would also reportedly undo patient care protections included in the agreement that ended a 10-week strike in 2022<\/a>. Kaiser remains under state and federal monitoring after investigations into delays in mental health and substance use care resulted in settlement agreements with regulators, including $200 million in 2023<\/a> and $31 million earlier this year<\/a>.<\/p>\n KQED reports that Supervisor Chyanne Chen, who called the hearing, plans to introduce a resolution next week urging the company to commit to using AI to assist clinicians rather than replace them, while abandoning proposals that would expand referrals to outside contractors. <\/p>\n \u201cThe surest path for Kaiser to improve its mental health services is to work with its clinicians, not try to silence them,\u201d Chen said, according to the National Union of Health Care Workers.<\/p>\n Kaiser executives reportedly declined to attend the hearing, though the company said it does not use AI to diagnose patients or make clinical decisions and remains committed to reaching a fair contract agreement.<\/p>\n \u201cTheir nonpresence suggests to me that the picture that\u2019s being painted by the workers is pretty accurate,\u201d Supervisor Rafael Mandelman said, referring to the 39,000 city employees and retirees covered by Kaiser, per KQED. \u201cWe do not want to be subjecting our employees and our retirees to a situation where they can\u2019t actually get the care that they need.\u201d<\/p>\n