Kaiser vs. AI — The Projection

2026-07-23 — “Unacceptable”: the hearing gets a second wave

Coverage of Tuesday’s SF Board of Supervisors hearing crested a day late — Kaiser no-showed; Supervisor Walton called it “extremely disrespectful,” Supervisor Chen called the testimony “infuriating, concerning and unacceptable.” NUHW’s “Terrible Three” framing crystallized: AI expansion without a no-replacement guarantee, layoffs paired with outside-contractor referrals, and Kaiser taking sole control of BH clinical policy. (KQED) ⟨daily 2026-07-23⟩
No firm mediation date yet — per Kaiser’s own labor-relations page, NUHW indicated it’s “not available until August,” so Tuesday’s hearing pressure hasn’t produced a locked session date. ⟨daily 2026-07-23⟩

NUHW’s formal DMHC/DOL complaint went public — 29 pages alleging the E-Visit tool generates care recommendations in ~2 seconds despite a claimed 4-hour clinician-review window, and that only high-school-diploma clerical staff conduct the screenings. (SF Standard) ⟨daily 2026-07-22⟩
The SF Board of Supervisors hearing happened — Kaiser skipped it — the board unanimously passed a resolution demanding “full parity for mental health patients”; both sides have now agreed to pursue mediation, with Kaiser denying the AI/clinical-decision allegations. (KALW) ⟨daily 2026-07-22⟩

2,400 Kaiser BH clinicians kept up the pushback on AI in care decisions — with San Francisco’s Board of Supervisors holding a hearing; BHB’s lead that day, caught by the coverage critic (the sweep missed it — Kaiser wasn’t on the watchlist; critic-add applied same day). (Behavioral Health Business) ⟨daily 2026-07-21⟩

NUHW filed a 29-page formal complaint to DMHC + US DOL — the “E-Visit” auto-triage tool and unlicensed TSR phone triage as illegal unlicensed triage; instant unreviewed AI referrals documented with dated screenshots. (complaint PDF) ⟨crawl 2026-07-22⟩
The SF hearing was a formal Committee of the Whole (File 260747, Sup. Chen; clinician + expert panels; Kaiser declined to present; procedural “heard and filed”). (SF Board agenda) ⟨crawl 2026-07-22⟩

~2,400 clinicians struck for one day (92% authorization; ~23k CNA nurses in solidarity) on the ULP charge over Kaiser’s unilateral triage overhaul — days after Kaiser’s $31M DOL parity settlement (02-10). (NUHW) ⟨crawl 2026-07-22⟩
Bargaining then stalled on the “Terrible Three” — AI replacement at will, outsourcing, “sole discretion” over clinical decisions; Kaiser’s 06-04 counter was a non-binding quarterly AI committee (“toothless” — NUHW). Mediation set for ~August. ⟨crawl 2026-07-22⟩

The AI at issue is specific: late-2023 “E-Visit” questionnaire (partial PHQ-9/GAD-7) auto-generating referrals + Jan-2024 unlicensed TSR phone triage — replacing licensed triage clinicians. (KQED) ⟨crawl 2026-07-22⟩
Regulators were already on the field: $200M DMHC settlement (2023); DMHC’s 02-2025 survey citing failed suicide-risk screening in triage; Kaiser signed “AI will assist, not replace” with its SoCal union then deleted it from the NorCal proposal. (DMHC survey) ⟨crawl 2026-07-22⟩
The legislative echo: NUHW-co-sponsored SB 903 (bar AI-only screening by health plans) passed the CA Senate — cross-ref state-therapy-chatbot-bans. ⟨crawl 2026-07-22⟩