1. Giraldo, Paula BA
  2. Hsu, Heather E. MD, MPH
  3. Ashe, Erin M. MPH
  4. Buitron de la Vega, Pablo A. MD, MSc
  5. Losi, Stephanie PMP
  6. Silverstein, Michael MD, MPH
  7. Lasser, Karen E. MD, MPH


Most states prohibit utility companies from terminating service to low-income households when occupants present a medical letter confirming a household member has a chronic serious illness. It is unclear how many patients receive these letters and whether screening for health-related social needs (HRSN) identifies these patients. We analyzed characteristics of adult patients at a safety-net hospital with a utility shut-off protection letter 2009-2018. A total of 2973 patients received a letter; most were non-Hispanic black, and had government insurance. Among patients who received a letter in 2018, 70% were screened for HRSN. Among these, only 16% screened positive for difficulty paying utility bills.