California Faculty Association halts telehealth therapy plan for Sac State students
Labor union’s concerns prevent virtual mental health counseling expansion
May 13, 2023
Sac State counseling, at a glance
Sacramento State students are currently offered counseling from a team of on-campus therapists available through the university’s Student Health and Counseling Services.
In February 2021, the CSU board partnered with Texas-based Timely Telehealth to provide virtual mental health care in the form of telehealth, hoping to alleviate an overburdened mental health staff.
Legna Saca, a fourth-year computer science major, has received in-person and virtual mental health counseling services currently offered at Sac State. She said that Sac State’s option to access counseling services virtually has proved to be convenient when she does not have time to be on campus.
“I work a lot. Being on campus isn’t something I’m doing,” Saca said. “I’ll be in my car and do a therapy session or at home in my room.”
The Associate Student Inc. President Salma Pacheco, due to the exacerbated demand for therapy because of the COVID-19 pandemic, said the waiting times for an available therapist have consequently increased
Saca, while finding virtual appointments useful, said she experienced difficulty when trying to schedule counseling appointments. The online portal would inform her that she had to go in person to schedule an appointment, only to be told there were no available times.
“Sometimes I would need help as soon as possible and they wouldn’t have time until later on,” Saca said. “I ended up not going the next week because I needed the help then. The next week I was like ‘whatever. Might as well not even do anything now.’”
According to the Director of Health Services, Dan Carsel, TimelyMD, a subsidiary of Timely Telehealth, would allow students to receive on-demand counseling services with licensed therapists when on-campus resources are not open. Carsel said this would grant students an average wait time of 10 minutes and the liberty to choose a counselor with a preferred background experience.
“With COVID-19 for the last several years, we’ve spent a lot of time doing telehealth with our doctors or with our therapists,” Carsel said. “If you look at it right now with our counseling staff here, half of their appointments are telehealth.”
Carsel also said that TimelyMD would be beneficial to out-of-state students because of state regulations that restrict them from receiving counseling from counselors at Sac State.
California’s Board of Behavior Services has outlined the laws regarding out-of-state practices. According to the California Code of Regulations, the Board of Behavior Services requires therapists to be licensed in California if they provide telehealth to clients in California.
In response to the adoption of TimelyMD at Sac State, the California Faculty Association has filed an unfair practice charge with the California Public Employment Relations Board against Sac State over its decision to sign the $1.4 million contract.
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The charge was filed because the university did not consult CFA as mandated through their contractual agreement, “especially when there’s impact on work for our counselors,” Sac State’s CFA Chapter President Margarita Berta-Avila said.
In a PERB complaint issued against the campus Nov. 8 2022, Sac State failed to notify CFA of the contract with TimelyMD therefore violating the Higher Education Employer-Employee Relations Act (HEERA).
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Get full access to the contract here.
Let’s talk therapy
Students for Quality Education, a statewide student-led organization within the CSU system, have also voiced opposition to contracting TimelyMD. According to an Instagram post by @sqestatewide, TimelyMD offers faith-based counseling through contracted counselors that could potentially harm queer and trans communities.
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“As we started learning more about TimelyMD, those were the major concerns that our coms and research departments found,” Berta Avila said. “The values, beliefs and who the founders are connected with.”
However, ASI President Salma Pacheco claims that faith-based counseling does not only apply to Christianity and Catholicism.
“When we talk about cultural competence and diversity, that means that I have access to my religion, my ethnicity and any other identity I would like to see present in a counselor,” Pacheco said. “Just because someone holds different values doesn’t mean they don’t deserve access to mental health.”
Pacheco said that Student Health and Counseling Services would ensure that preventative measures would be implemented to avoid harmful interactions students could potentially have with counselors, with surveys and forms.
“There’s a program here that could potentially help and we can’t use it because someone has a political idea or is trying to do something legislatively because they are thinking long term,” Pacheco said. “I’m thinking right now because right now there’s a problem and we have a way to maybe help.”
Pacheco also said the services provided by TimelyMD would help alleviate the involuntary psychiatric commitment of individuals, also known as 5150.
The solution, according to Berta-Avila, is to hire more counselors.
“But not through formats like TimelyMD,” Berta-Avila said. “Let’s invest in our centers. Let’s have those tenure-track lines. Let’s have more counselors. Let’s put those resources in instead of spending a million dollars.”
Pacheco said the money had already been spent on the service. Until PERB determines the validity of CFA’s concerns, the program sits unavailable to Sac State students, and the money goes untouched.
“Let’s say we lose PERB; then we would have to pay the contract in full even if we didn’t use the program, “ Pacheco said. “Then that means the $1,404,000 that we spent on the program would be lost and no students would have had access.”
According to Janeth Rodriguez, a CFA field representative for Sac State, there are concerns over a lack of oversight of TimelyMD counselors.
Rodriguez said that from CFA’s perspective, TimelyMD consists of contracting third-party counselors who are independent contractors, similar to how a company like Uber or Lyft hires employees.
“We don’t know the quality of these counselors,” Rodriguez said. “We don’t know what training these counselors have received as it relates to anti-racism, social justice and working with students in the CSU….What is the quality of mental health that you are going to be getting through an app?”
According to Carsel and Pacheco, any counselor in California must undergo the same certification program as an in-person counselor.
“It would be illegal for them not to have a set of qualifications and serve Californians,” Pacheco said.
TimelyMD counselors must be certified under the same parameters as the counselors from Health and Human Services, as with any counselors who see patients in California.
“Students who are originally out of state and go back home and need service in their state, [counselors] can also provide that,” Pacheco said.
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Carsel said that TimelyMD comes with flexibility. Students from out of state who go back home for Spring break can see a TimelyMD counselor, but because school is not in session, the counselors from Health and Human Services are not available in-person.
“I think we have some of the same goals in mind,” Rodriguez said. “We are coming at it from our own labor perspective but a lot of the concerns have been about how students get the best quality mental health within the CSU.”
Carsel said that he hopes the TimelyMD services will be available soon.
“We’re in a mental health crisis here,” Carsel said. “The fact that we’ve been having this conversation is sad for our students. There is a fundamental disagreement between the CFA and the administration as to what’s best for students.”
TimelyMD Director of Mental Health Operations Seli Fakorzi said that the services are available to over 1.5 million students across the country, many of whom are students in the local Los Rios community college district.
For Fakorzi, the services are important because of its support for escalating mental health cases.
“We’ve seen that the mental health crisis is something that has definitely increased,” Fakorzi said. “Quality care is for [students] having access any time of the day or night, wherever they are, whenever they need.”
Regarding issues raised about the loss of jobs for campus counselors, Fakorzi said counseling centers across the country are doing everything they can and that Timely MD is just “an extension of care that they provide to students.”
In the contract that Sac State signed with TimelyMD, it would provide 12 counseling sessions for students, faculty and staff with services available at any time. Counseling fees are set at $79 per session after the 12th session.
Pacheco says the University has lost $351,067.50 of state grant funds provided for mental health services because of the PERB hold that CFA placed on the contract with TimelyMD.
“In July of next year, we’ll lose $700,000 of money that could potentially be saving lives. I’m pissed when I say I’m upset,” Pacheco said. “We need something to help our students now. And they’re saying no.”