Kaiser Permanente has reached a tentative agreement on a national, four-year contract with the union representing nearly 1,000 Hawaii nurses.

The nurses are a part of 85,000 unionized health care workers in 11 local groups under the Coalition of Kaiser Permanente Unions, which reached a tentative agreement after nearly five months of bargaining. Workers also affected by the contract include optometrists, pharmacists, maintenance and service workers and hundreds of other job positions.

The contract guarantees annual wage increases through 2023 in Hawaii, California, Oregon, Washington, Colorado, Virginia, Maryland as well as Washington, D.C., and also creates a program to reduce the national shortage of health care workers. It also preserves an existing pension plan and other retirement benefits and prevents Kaiser from outsourcing or subcontracting certain jobs.

“If ratified, the agreement will position Kaiser Permanente — including its members, employees and local communities — for a sustainable future as the organization works to make its high-quality, integrated model of care even more affordable and accessible in all its regions,” Kaiser said in a news release.

In July, the Hawaii Nurses Association, representing mostly registered nurses, said it was preparing to strike in the fall after stalled negotiations with the state’s largest health maintenance organization — both a health insurer and medical provider.

The coalition bargained for raises and pensions for local workers in a national contract that expired a year ago. The Hawaii Nurses Association also has local contracts that expire on different dates for things such as shift differentials.

The contract, if ratified, will take effect on Tuesday. Voting is expected to conclude by the end of October.