In a letter to the California Attorney General, the California Hospital Association called for an investigation over “skyrocketing prices” charged by staffing agencies.

The association represents more than 400 member hospitals and said hospitals in the state are facing the worst staffing shortage since the beginning of the pandemic, according to its letter to the Attorney General.

“Under normal circumstances, hospitals turn to staffing agencies to help fill temporary gaps,” according to the letter. “But in recent weeks, it has become next to impossible for many California hospitals to obtain staff from contracted agencies due to increased nationwide demand. Desperate hospitals increasingly face unprecedented pricing due to the rates that some staffing agencies are charging. The skyrocketing prices affect hospitals in poorer communities and communities of color the most, as they are least likely to be able to afford these rates.”

In addition to unprecedented rates, some staff being sent do not have the skills they were represented as having or are unwilling to do the work they were engaged to do, according to the letter. It also said some temporary staff do not complete their assignments as agreed to by the staffing agency.

In a separate letter to Mark Ghaly, the secretary of the California Health and Human Services Agency, the hospital association also requested the state’s assistance in paying for extra staff. The letter said that staffing firms are quoting hospitals $300 per hour for staff that were only $200 per hour in January of this year.

“For 10 nurses at that rate for four weeks, a hospital would incur a cost of nearly half a million dollars ($480,000),” according to the letter. “Many hospitals cannot bear such a cost — the reimbursement from government or private payers will never cover that cost, and hospitals cannot allocate such substantial resources up front. For others, it will mean that the toll of this latest surge will be felt for years to come.”