OAKLAND, Calif. (AP) — Tens of thousands of health care workers have ratified a new four-year contract with industry giant Kaiser Permanente following a strike over wages and staffing levels, the parties announced Thursday.

Of the 85,000 members in the Coalition of Kaiser Permanente Unions, 98.5% voted in recent weeks to ratify the contract, the coalition said in a press release. It runs retroactively from Oct. 1 through Sept. 30, 2027.

The deal includes setting minimum hourly wages at $25 in California, where most of Kaiser’s facilities are located, and $23 in other states. Workers will also see a 21% wage increase over four years.

The agreement also includes protective terms around subcontracting and outsourcing, as well as initiatives to invest in the current workforce and address the staffing crisis. The workers’ last contract was negotiated in 2019, before the COVID-19 pandemic.

The three-day strike last month involved 75,000 workers in California, Colorado, Oregon and Washington. Some 180 workers from facilities in Virginia and Washington, D.C., also picketed for one day. The strikers include licensed vocational nurses, home health aides and ultrasound sonographers, as well as technicians in the radiology, X-ray, surgical, pharmacy and emergency departments.

Oakland, California-based Kaiser has hospitals and clinics that serve nearly 13 million Americans, and union members said understaffing is boosting the hospital system’s profits but hurting patients.

Both sides said they prioritized patient health care during their talks. Steve Shields, Kaiser’s senior vice president of labor relations, said previously that the deal will not affect consumer rates.