134 | Health Services Research ABSTRACT Formerly Homeless and Other Stakeholder Perspectives of a Permanent Supportive Housing Program in Los Angeles County K. Kietzman 1 ; A. Palimaru 2 ; R. Basurto-Davila 3 ; N. Pourat 4 1 University of California, Los Angeles Center for Health Policy Research, Los Angeles, CA, United States; 2 RAND Corporation, Santa Monica, CA, United States; 3 Analytics Center of Excellence, Los Angeles County Chief Executive Office, Los Angeles, CA, United States; 4 University of California at Los Angeles, Fielding School of Public Health, Los Angeles, CA, United States Research Objective: In 2012, the Department of Health Services in Los Angeles County created the Housing for Health (HFH) initiative, which provides permanent supportive housing (PSH) and rental sub- sidies to homeless individuals who are among the highest utilizers of acute care overall and particularly under Medicaid. In addition to housing and rental subsidies, HFH provides intensive case manage- ment services and connects clients to a broad range of health, social, and income support services in the community. HFH is a partner of Los Angeles County Whole Person Care Pilot (WPC-LA), a program implemented under California's Section 1115 Medicaid Waiver fo- cused on providing care coordination and housing support services to enrollees with complex care needs. We used data from a mixed-methods evaluation of HFH between 2016 and 2018 that was designed to gauge HFH's effectiveness and its impact on health service utilization and outcomes in other public service sectors, such as social services, mental health services, and public health. We examined the perspectives of a broad range of PSH stakeholders from interviews on the impact of HFH. Study Design: Data were collected through semi-structured in- depth interviews with 14 key informants, and nine focus groups in which 42 formerly homeless tenants and 29 providers of PSH programs participated. Verbatim transcripts were independently coded by at least two research team members. Emerging patterns and themes were identified using a process of constant comparison analysis across and within distinct data sources. Population Studied: Study participants included current PSH ten- ants, direct service providers, housing and homeless services pro- gram administrators, and multisectoral agency leaders in both public and private sectors. Principal Findings: Stakeholders indicated positive impacts of HFH as it has expanded the reach and intensity of PSH. They commented on HFH's capacity to address housing needs including outreach, in- take, engagement, placement, and stabilization. Stakeholders said that HFH's multisectoral and collaborative approach and use of in- tensive case management services have enhanced continuity of care with positive effects on tenant outcomes. Reported challenges to HFH implementation were related to the context of extremely lim- ited housing inventory and a workforce not yet sufficient to meet in- creasing demand with frequent turnover. Systems-level facilitators, including enhanced communication and accountability practices, were cited as essential to support ongoing implementation and to ensure fidelity of the HFH approach. Conclusions: Stakeholders perceived that HFH was a catalyst for positive change in the administration and delivery of PSH programs and services in Los Angeles. Implications for Policy or Practice: Our findings from senior ad- ministrator perspectives point to the importance of cross-sectoral leadership, and the need to reconcile disparate organizational cul- tures through enhanced communication and inter-organizational accountability. Formerly homeless tenant and direct service pro- vider perspectives support the value of adopting person-centered approaches in the planning and delivery of services across sectors. Finally, the model of partnership provided by HFH and WPC-LA builds on long-standing and trusted community providers to support the sustainability of these efforts. Primary Funding Source: The Robert Wood Johnson Foundation. It's about Trust: Low-Income Parents’ Perspectives on How Pediatricians Can Screen for Social Determinants of Health D. Schleifer Public Agenda, Brooklyn, NY, United States Research Objective: Attempts to screen for social determinants of health in pediatrics should be grounded in an understanding of parents’ receptivity to discussing social needs and should be re- sponsive to their concerns about doing so. Yet little research has asked parents, particularly low-income parents, for their perspec- tives about social determinants of health and how screenings can be implemented successfully. This research seeks to explore questions including which social stressors concern low-income parents; what roles these parents think pediatricians could play in addressing so- cial needs; and how these parents think pediatricians should discuss social determinants of health with them. Study Design: Eight focus groups in New York City with low-income parents of children ages five years and younger. Each focus group lasted two hours. Two of the groups were conducted in Spanish and six in English. Focus groups were audio recorded and professionally transcribed and translated. The research team collaboratively de- veloped a coding scheme and coded the transcripts using Dedoose software. Population Studied: Low-income parents of children ages five years and younger in New York City. Principal Findings: First, parents in the focus groups cited a broad range of social stressors that affected their children's health and well-being, including some that screening tools for social determi- nants of health may not currently include. Second, the parents did not immediately identify pediatricians as sources of help with social stressors. They saw some topics, such as nutrition, education, and minor behavioral issues, as appropriate to discuss with pediatricians,