Kaiser’s New Screening System: A Threat to Patient Care?
As a licensed clinical social worker at Kaiser Permanente’s psychiatry outpatient clinic in Oakland, California, Ilana Marcucci-Morris has seen a disturbing trend since the healthcare giant introduced a new screening process for first-time patients in January 2024.
The new system, which involves clerical workers asking scripted ‘yes’ or ‘no’ questions to assess the severity of patients’ conditions, has led to patients with high-risk cases waiting longer for care, while lower-risk patients are being fast-tracked to appointments with clinicians.
Marcucci-Morris joined about 2,400 northern California mental health professionals employed by Kaiser and represented by the National Union of Health Care Workers (NUHW) on a one-day strike on Wednesday to protest changes to the company’s patient screening processes.
The union is concerned that Kaiser’s new screening system is putting patients at higher risk by delaying their care, and that the company plans to use AI to replace licensed therapists for certain kinds of work.
Kaiser pushed back on striking workers’ claims, saying it delivers ‘timely, high-quality care to meet members’ needs’ and that AI and clerical staff are not conducting any assessments or making clinical determinations.
The Impact of Kaiser’s New Screening System
According to Marcucci-Morris, licensed professionals used to be the first point of contact for patients with behavioral health issues at Kaiser. However, since the introduction of the new screening system, she has noticed a change.
She believes that the new system is not only delaying care for high-risk patients but also clogging up the system with lower-risk patients who are being fast-tracked to appointments with clinicians.
Five licensed Kaiser therapists also reported seeing patients with high-risk cases wait longer for care since the new screening system was introduced.
The Role of AI in Kaiser’s New Screening System
The NUHW is concerned that Kaiser plans to use AI to replace licensed therapists for certain kinds of work. However, Kaiser has denied this, saying that AI is only used to support clinicians and reduce administrative work.
Despite this, many Kaiser workers are worried about the introduction of AI tools into their clinical practice. A 2025 internal survey of Kaiser’s mental health workers in northern California found that over one-third of employees reported that Kaiser has already rolled out AI or other technologies they fear could negatively affect their work or the care patients receive.
The Writing on the Wall
For Kristi Reimer, a licensed psychologist who used to do mental health triage assessments in Kaiser’s Walnut Creek facility, the writing was on the wall. She pre-emptively left her position because she saw the drastic change in the nature of Kaiser’s mental health assessment system.
Harimandir Khalsa, who does triage for Kaiser in Walnut Creek, California, is worried about her future. She loves using her decades of research and clinical experience to help a large number of people at a vulnerable juncture in their lives.
She worries that clerical staff and questionnaires are already doing a part of her job, even if she thinks they’re not doing it well. She can’t help but wonder: ‘Am I next?’ ‘What is my future?’
Why a Licensed Therapist Makes a Difference
A patient’s initial point of contact when seeking mental help can determine whether they see a licensed clinician at all, as well as the type of appointments they receive, according to the NUHW.
That’s why the union is so concerned about Kaiser’s recent patient assessment changes and is pushing for more information on how the company uses tech in initial assessments.
The NUHW’s southern California complaint with the California department of managed health care from last year alleges that Kaiser is using an algorithm to make triage decisions, in violation of state law.
Kaiser denies this, saying that its clerical staff are not making assessments or clinical determinations. However, the union suspects that an algorithm is also used in northern California, and Kaiser did not clarify.
Conclusion
Kaiser’s new screening system has raised concerns among mental health professionals about the impact on patient care. The union is pushing for more information on how the company uses tech in initial assessments and is concerned that AI could replace licensed therapists for certain kinds of work.
As a licensed clinical social worker, Ilana Marcucci-Morris believes that ‘human work needs to stay with human beings.’ She and many others are worried about the future of patient care under Kaiser’s new screening system.
