(Portland, OR) -- Kaiser Permanente workers in Oregon and Southwest Washington could hit the picket lines again next month. The group of employees who staged a three-day strike in six different states last week are now serving official notice to Kaiser Permanente that they will strike a second time if there isn't significant progress in ten days. The Union and Kaiser have been trying to reach a contract agreement for months. The sticking points remain understaffing, overcrowding, pay, and protection from outsourcing. The union says a strike is possible November 1st to November 8th.