A coalition of unions representing thousands of Kaiser Permanente health care workers warned they will walk off the job again next month if a deal is not reached with their employer.

In California, Washington, Oregon, Virginia, and Washington DC, Kaiser facilities have threatened to strike again if a new labor contract is not reached by November 1, after a contract for 3,000 more Kaiser employees in Seattle expires.

According to the coalition, the second strike would involve more employees and be longer than the first, running from November 1 to November 8.

In a statement, Caroline Lucas, executive director of the Coalition of Kaiser Permanente Unions, said Kaiser executives failed to listen to feedback from frontline healthcare workers about the need for executives to follow the law in negotiations and the impact that Kaiser short staffing is having on patients.

Following an expiration of an employment contract for 75,000 Kaiser employees, the first strike began on October 4 and ended on October 7.

Kaiser Permanente’s first national strike effort and the largest health care worker strike in US history took place across multiple states. Due to the October strike, patients were unable to make appointments or had their care postponed.

Kaiser has promised union representatives that it will aggressively hire new employees. The company has already hired 10,000 workers for union-represented positions so far in 2023.

Furthermore, outsourcing emerged as a major sticking point in negotiations, according to the coalition.