Mental health clinicians at Kaiser Permanente called off a strike set to begin Monday throughout Northern California after the National Union of Healthcare Workers reached a tentative agreement over the weekend with the nation’s largest HMO.

Former California State Senate President Darrell Steinberg mediated negotiations over the last 48 hours that resulted in an agreement for a three-year contract that includes scheduling, pay and patient advocacy provisions, which union members must now vote to ratify in coming weeks.

Amendments to this contract settled significant components of a dispute that kept Kaiser mental health employees at odds with their employer for the past five years. “It is a positive first step,” said Clement Papazian, regional president of the union, in a statement announcing the accord.

Kaiser clinicians, including psychologists, psychiatric social workers and marriage and family therapists, will no longer be under threat of discipline or discharge for advocating for their patients, the union release said. Mental health worker contracts will now include a third party resolution for any future clinicians’ conflicts, a strategy that “allows further protection for folks to be constructively critical,” said the union’s president Sal Rosselli.

The HMO also agreed to implement a 1:4 ratio of new-to-returning patients that the union had sought, which is meant to allow clinicians enough space in their day to schedule appointments for returning patients, and to ensure timely access to ongoing care for mental health patients.

Kaiser representatives said in a statement that this provision allows for more return appointments in therapists’ schedules, coupled with an expectation that therapists will meet an increased standard for the amount of work time spent seeing patients in individual appointments.

Kaiser also agreed to resume wage increases. “After four years of no wage increases, wages will increase six percent in year one of the contract, four and a half percent in year two, and four and a half percent in year three,” company representatives said in a statement, versus the six percent, three percent, and three percent per year respectively in the offer made by Kaiser management in the preceding bargaining. This equals roughly a 12 percent increase over the next three years, achieving a compromise between the union’s previous asking amount of roughly 19 percent and Kaiser’s original stance to provide no increase.

Both the union’s and Kaiser’s statements said the agreement confirms Kaiser’s ability to use outside or referral resources to ensure timely access to mental health care for patients in cases of overflow.

Kaiser said the union reached out to the HMO after being unsatisfied with initial bargaining, in hopes of averting the strike.

“We’re pleased,” said union president Rosselli, adding the agreement is a sign Kaiser wants to involve its therapists and psychologists in helping to achieve parity in pay and treatment of mental health staff and medical staff. “We’re hopeful this is a new day and there will be a more collaborative effort with the people who provide the care to improve Kaiser’s mental health system,” said Rosselli.

Gregory A. Adams, president of Kaiser Permanente in Northern California, said in a statement that “This agreement is aligned with our commitment to improve our quality and affordability and to lead a 21st century model for mental health care in the nation.”