This report is the third in a series of statistical profiles on the Lutheran Services in America network of health and human service providers.  The information was gathered from the Lutheran Services in America 2000 • 2001 Annual Survey.  A total of 223 social ministry organizations completed the survey, yielding a response rate of 85 percent.

The findings indicate that in fiscal year 2000-2001, LSA members provided health and human services to 5.8 million unduplicated clients.  The types of services offered included developmental disabilities services, inpatient and outpatient hospital treatments, 24-hour residential care, short-term assistance, and social services.  Programs were staffed by 242,086 paid staff members, volunteers, and board members.  Annual revenues exceeded $7.6 billion, half of which came from program service fees.  In-kind contributions were valued at $25 million.  A full 99 percent of annual revenues were expended in the same year.

LUTHERAN SERVICES IN AMERICA ANNUAL SURVEY
After its formation in April of 1997, Lutheran Services in America commissioned FLYNN RESEARCH to design and administer an annual survey to collect timely data on the size and scope of the newly formed network of health and human service providers.  The unit of analysis is the social ministry organization (SMO), representing a set of geographic boundaries. In order to preserve the confidential nature of SMO-level data, only aggregate national-level data are presented in this report.

Respondents collected data on all of the services and programs within their respective SMO and submitted the collated data to Flynn Research for analysis.  Because not all SMOs are on the same fiscal or calendar year, the results are referred to as combined fiscal year 2000-2001 data.  Considerable effort was put into transcribing and cleaning up the raw data file to ensure that the information is as accurate as possible.  Transcription, logic, and reporting errors were flagged and corrected, using 1998 and 1999 baseline data and institutional knowledge of activities in the responding organizations.

The findings are organized in eight parts as follows:  (1) human resources, (2) developmental disabilities services, (3) inpatient and outpatient hospital treatment, (4) residential care, (5) short-term assistance, (6) social services, (7) public policy, and (8) finances.  Highlights are presented below in turn.

HUMAN RESOURCES
Lutheran Services in America achieves its vision and mission due to the work of a vast network of paid staff members, volunteers, and board members. In 2000-2001, almost a quarter of a million people were part of the LSA network.  Contributions of the 144,468 paid staff members ranged from providing direct services to clients, to maintaining physical structures and daily program operations, assuming leadership roles, raising funds, and advocating on behalf of the poor.  Half of the paid staff are professional and paraprofessionals, 58 percent are women, and 19 percent identify themselves as persons of color.

An estimated 93,796 people volunteered a total of 4.1 million hours of service for Lutheran social ministry organizations. An additional 3,822 people provided assistance and guidance as members of governing boards and/or boards of trustees.

SERVICES TO PEOPLE WITH DEVELOPMENTAL DISABILITIES
Members of the LSA network provided residential and non-residential services to children, adults, and older people with developmental disabilities. The primary diagnosis is mental retardation, however, some clients also have a diagnosis of cerebral palsy, muscular dystrophy, blindness, affective disorder, or schizophrenia. Multiple disabilities may require intermediate or skilled nursing care.

Lutheran social ministries served 8,784 people with developmental disabilities in 2000-2001. Services ranged from 24-hour residential care, to early intervention and prenatal care, spiritual development, and personal enrichment. Habilitative services offered individuals assistance with living skills necessary to make responsible personal choices, find a place for themselves in the community, and engage in social activities and employment.

HOSPITAL CARE
In 2000-2001, there were seven Lutheran hospital-based health care systems that reported serving 4.3 million patients. Overall, 249,708 people were admitted for acute inpatient care. Almost half of admissions (111,888) were for general medical care, followed by obstetrics and gynecological care (22,029), transitional rehabilitation (14,457), intensive care (13,923), pediatric care (5,700), and surgery (2,751).

More than 5 million procedures were provided through hospital-based outpatient care. The types of services included laboratory work, therapies, x-rays, emergency room treatments, surgery, and clinical care. LSA hospitals recorded over 4 million patient visits.

RESIDENTIAL CARE
With the increasing number of aging adults in the United States, families are faced with ever-changing needs for residential services, including assisted living, long-term care, and options for independent living. Lutheran Services in America members are responding to these needs with a variety of innovative programs.

In 2000-2001, Lutheran ministries provided residential care for 104,930 individuals. Care included lodging, three meals a day, medications, nursing care, assistance with daily living, social services, therapies, and more. Residential care programs are offered in 123 of the 223 social ministry organizations surveyed. Thirty-two social ministry organizations provide services as part of a campus-based continuing care retirement community (CCRC).

A total of 82,082 older people lived in Lutheran residential care facilities including long-term care (43,134 clients), independent living (12,395), assisted living (6,899), HUD-sponsored permanent housing (9,584), and non-HUD multi-family housing (9,160). An additional 10,629 children and youth were served in treatment and non-treatment facilities with 2,383 licensed beds, and 1,136 adults participated in transitional housing programs with 573 licensed beds.

Other types of care offered to both residents and non-residents in Lutheran residential communities ranged from congregate dining, to medication assistance, transportation, 24-hour oversight, chaplaincy, personal care/activities for daily living, incontinence assistance, Alzheimer’s assistance, housekeeping/chores, rehabilitation, transportation, hospice, case management, adult day services, respite care, and home health care.

SHORT-TERM ASSISTANCE
The staff and volunteers of Lutheran ministries helped fulfill the most basic needs required for members of their communities to lead lives of dignity during times of crisis. Forty social ministry organizations offered short-term assistance services to 593,175 unduplicated clients in 2000 - 2001.

Crisis services, which reached 297,266 people, took the form of clothing assistance, financial aid, utility assistance, referrals, medications, case management, and services for abused persons. An estimated 277,195 people came to Lutheran ministry programs for food assistance. More than 5.2 million meals were served in soup kitchens, congregate dining, and meal-on-wheels programs (excluding meals served in residential facilities).

A total of 9,852 individuals received 78,492 nights of safe shelter through Lutheran ministries. Disaster response services reached 8,862 people in the wake of 67 fires, floods, tornadoes, and earthquakes.

Respondents reported that approximately 79 percent of the clients who received short-term assistance were living in families with incomes below the federal poverty line. In 2000, the U.S. Government’s official poverty line for a family of four was $17,601. Two-thirds of short-term assistance clients identified themselves as people of color.

SOCIAL SERVICES
Lutheran ministries provided social services to 780,708 children, adults and older people in 2000-2001. As distinct from short-term assistance, social service programs help clients build the long-term skills to function at their full potential. Refugees and immigrants received language education, housing placement, and legal services to help them become settled in the United States. Pregnant women sought prenatal and postnatal care, along with parenting classes. The unemployed received interview skill training and job search assistance. Homeless persons moved into suitable permanent housing. Children attended summer camps and sports programs.

One-quarter of social service clients (193,782) came to Lutheran programs for social support services such as child and adult day care, respite care for care givers, homemaker services, legal aid, transportation, employment services, phone reassurance and friendly visits for the homebound, independent living assistance, case management, and referrals. One-quarter of clients received education and family support (170,549).

Foster care assistance was provided to 127,672 clients. Staff members counseled 106,116 people and provided socialization, recreation, and neighborhood services to 53,106 people. An additional 44,348 refugees and immigrants received services through Lutheran ministries. An estimated 25,817 individuals and families turned to LSA members for help to either stay in their homes and/or move into suitable permanent homes and home ownership.

Social ministry organizations managed 12,729 housing units that provided housing for 13,802 individuals or families. Lutheran ministries assisted in the completed adoptions of 2,768 children and provided pregnancy-related services to 12,351 to include pregnant women, birth fathers, and affected family members. More than 24,000 unemployed persons received job search assistance through Lutheran employment programs.

Respondents indicated that 64 percent of the 780,708 clients who received social services were living in families with incomes below the federal poverty line. Approximately 39 percent of social service clients identified themselves as people of color.

PUBLIC POLICY AND ADVOCACY
The members of Lutheran Services in America are committed to supporting and strengthening Lutheran health and human services ministry and public policy advocacy. LSA, in concert with its members, assumed a leadership role in shaping health and human service policy at the local, state, and national levels on behalf of the 5.8 million clients served through the LSA network and beyond.

The primary public policy tool was letter writing to keep legislators informed about ongoing activities in social ministry organizations, community concerns, and the impact of public policies on clients. Members also consulted with elected and/or appointed public officials about public policy issues. Staff served on government commissions, committees, or boards, often in coalition with other human service organizations. Staff and volunteers also participated in church-wide committees, helped develop policy regulations, and provided testimony on policy issues.

REVENUES
Total cash income in fiscal year 2000-2001 was $7.6 billion. Almost half of the cash revenues ($3.7 billion) came from program service fees comprised largely of non-government third-party payments and direct client payments.

Public agencies purchased $2.8 billion of services from LSA member organizations in 2000-2001, representing 37 percent of total revenues. Three-quarters of public funds were from the federal government, reflecting the long-standing history of collaboration between the United States Government and private charities. Support from the U.S. Department of Health and Human Services was valued at $1.85 billion to include Medicare and Medicaid programs. Other major support was received from the Departments of Housing and Urban Development ($28 million), Labor ($27 million), Education ($13 million), Justice ($9 million), Agriculture ($4.8 million), Corporation for National and Community Service ($2 million), and the Federal Emergency Management Agency ($1.2 million).

Other financial support was provided by the community (e.g., individual, corporate, foundation, United Way, and Combined Federal Campaign), unrelated business income, investment income, and the Lutheran Church.

In-kind contributions were valued at $25 million and included the value of volunteers’ time ($18 million) and supplies, equipment and space ($7 million).

EXPENDITURES
Over 99 percent of the $7.6 billion in cash income received in fiscal year 2000-2001 was expended in the same period. Salaries of employees and contractors comprised the largest type of expenditure (57 percent), followed by program services (30 percent), capital costs (7 percent), fundraising (< 1 percent), and unspecified sources (6 percent).