Kaiser mental health workers bring contract fight over AI to San Francisco City Hall hearing

Artificial intelligence is at the center of a contract fight between Kaiser Permanente and some of its mental health employees.

A group of licensed therapists say the company needs to be careful about how it uses AI and make sure technology itself doesn't replace the human connection patients need.

In March, Kaiser workers in Northern California held a one-day strike; protesting what they say was the company's decision to leave out contract language that would protect therapists and supporting nurses from potential AI replacement in the future.

Then on Tuesday, that same fight made its way to San Francisco City Hall as Kaiser employees spoke before city supervisors during a hearing about their ongoing contract negotiations with their employer.

Tianna Lui, a mental health therapist for Kaiser who spoke on Tuesday, says the company has not committed to making sure the human touch remains at the center of mental health care.

For Lui, there isn't a more important commitment to make.

"As therapists, we are trained to read things like body language, non-verbal cues," Lui added. "We learn to pick up tone and read between the lines and assess for risk."

Ilana Marcucci Morris, who also spoke at Tuesday's hearing, raised concerns that Kaiser is already using technology the wrong way in the mental health care.

Specifically, claiming the initial health screening patients take to determine if they need treatment is being determined by technology, rather than licensed professionals.

"It goes through a series of questions. Less than two seconds, a clinical treatment plan and recommendation is spit out," Marcucci-Morris said.

One of the biggest questions raised by supervisors during Tuesday's hearing was why no one from Kaiser was there to answer questions from the board, with Supervisor Shamann Walton calling it "extremely disrespectful."

"When this board of supervisors makes a request for an employer to attend a hearing, they most certainly should make sure they are in attendance," Walton stated.

Ini a statement, a spokesperson with Kaiser said the company has invested over $2 billion since 2020 to expand mental health services, facilities, clinician training, and provider networks, and disputed claims it uses AI to diagnose patients. 

"Our behavioral health e-visit tool helps connect members to care more quickly and was developed with input from therapists and NUHW representatives. It is an additional path to getting care-not the only path," the spokesperson said. "On every screen throughout the e-visit process, the patient is provided a phone number that they can call at any time to talk to a live person. It does not use AI to diagnose patients, make clinical decisions, or determine medical necessity. Clinical decisions remain with licensed health care professionals. Clinicians can work with patients directly and jointly determine the care plan."

The statement added, "We disagree with the union's characterization of our behavioral health processes. Our focus remains on providing timely, high-quality mental health care for our members while reaching a fair agreement with NUHW that supports our clinicians, our patients, and the communities we serve. We respectfully submitted a letter to the Board of Supervisors for the record in the spirit of partnership and shared commitment."