A Flawed Model for Care 

Kaiser Permanente has been held up as a national model for healthcare, but critics contend that it routinely fails to adequately serve patients with mental health problems.

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An increase in funding could potentially give the DMHC the resources to more broadly enforce parity laws throughout the state and improve transparency within the agency. "When we look back, I'm really hoping that we'll be able to say that we helped a lot of consumers get access to services in a timely way and even better quality services than they would have without these efforts," Hagar said.

The Affordable Care Act threatens to intensify the challenges of providing mental healthcare. According to Kaiser internal emails, the HMO is expected to gain 52,000 Medi-Cal patients in the Northern California region alone this year. Overall in California, Kaiser has seen a 1 percent growth in membership, gaining about 86,000 new members through Covered California, according to Turner. "Wait times are only getting worse with the advent of Kaiser's participation in Covered California," said Andy Weiskoff, a former Kaiser social worker in Santa Rosa who recently resigned in protest of the mental health services and has been documenting his experiences on a blog.

Following the guidelines of the Paul Wellstone and Pete Dominici Mental Health Parity and Addiction Equity Act of 2008, the Affordable Care Act now mandates that coverage for mental health and substance abuse services cannot be any more restrictive than for medical services. These protections will expand mental health and substance abuse benefits and parity protections to more than 62 million Americans. According to the US Department of Health and Human Services, that growth represents the largest expansion of behavioral health coverage in a generation.

Although technically a nonprofit, Kaiser is growing at a rate unprecedented in the healthcare industry. In June, Kaiser announced first-quarter net revenues of $1.1 billion, up nearly 44 percent from a year ago. In July, Kaiser opened a new 12-story hospital in a $1.3 billion facility in Oakland that also includes a 100-office medical building and 1,200-space parking structure.

The questions raised about how Kaiser treats patients with mental health concerns are particularly troubling considering this rapid growth.

"I thought Kaiser would be cost effective but it turned out to be a fatal mistake," said Susan Futterman. "I want Kaiser to change its policy — Kaiser does not provide appropriate mental healthcare to its members."

Correction: The original version of this story misspelled Latika Malkani's first name.


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