More than 85,000 Kaiser Permanente workers in several states are preparing for a national strike this fall.
Starting late July and into August, union members will be voting to authorize an unfair labor practice strike.
If the strike takes place, it would be the largest strike in the U.S. since 1997.
Employees say they want better worker-management partnerships, improved safety and better wages and benefits.
Kasier Permanente Hawaii says the strike will not have an immediate impact in Hawaii.
Kaiser union members in Hawaii would not be able to strike until next year since they all are under contracts.