LUTHERAN SERVICES IN AMERICA FY 1999 ANNUAL SURVEY

The Lutheran Services in America FY 1999 Annual Survey collected detailed information on: (a) human resources, (b) 24-hour residential care facilities for people with and without developmental disabilities, (c) short-term assistance, (d) social services, (e) hospital care, (f) new and discontinued services, (g) public policy initiatives, (h) congregational social ministry, and (i) finances, including revenues and expenditures.

The information was provided directly from LSA member organizations, known as social ministry organizations (SMOs), which is the unit of analysis for this research study. The executive director of each SMO was asked to collect information from all of the programs within their jurisdiction, ranging from a single program to over 100 programs. The collated SMO-level data were submitted by mail for entry, clean-up and analysis.

The survey design, data collection and statistical analysis was conducted by FLYNN RESEARCH, a basic and applied research firm that designed and implemented LSA’s first comprehensive survey in 1998. The survey instrument is 34 pages in length and includes both quantitative and qualitative questions. In order to preserve the confidential nature of social ministry organization information, only national level results are reported.

The survey results enable LSA members to identify their roles, functions and contributions to society as 501(c)(3) not-for-profit organizations. Specifically, the results allow LSA and its member organizations to describe who they are, what they do, who they serve, and in what capacity. In the lexicon of statisticians, the survey provides rigorous, cross-sectional empirical data on key inputs, outputs and outcomes related to the LSA network of health and human service providers.

The findings are summarized below in the sequence presented in the report, beginning with staffing, then programs and finances.

Human Resources
To achieve its ministries of service and justice, Lutheran Services in America members rely upon a vast network of paid staff, volunteers and board members. The network is comprised of 269,103 individuals who served as paid staff members (138,428), unpaid volunteers (126,855) and board members (3,820). Their contributions range from providing direct care through residential, health, social service, and emergency assistance programs, to maintaining physical structures, providing leadership, and raising funds. Volunteers and board members spent over 5.2 million hours engaged in service in 1999.

Residential Care Facilities
The Lutheran Services in America Annual Survey collects information on all levels of residential care from birth through old age. Services for the elderly include long-term skilled care, independent living, assisted living, HUD and non-HUD housing, and assistance with daily living. Transitional housing is available for adults. Treatment and non-treatment facilities and group homes are available for children and teenagers. The findings identify the number and types of facilities maintained by level of care, characteristics of facilities (e.g., bed size and staffing requirements), characteristics of clients (e.g., age), and special programs (e.g., therapy, education, employment, training, and community integration of services).

In FY 1999 social ministry organizations provided 24-hour residential care to 104,826 residents. Eighty-seven percent of respondents (197 out of 226 SMOs) maintained residential facilities that offered skilled health care services, meals, adult day care, rehabilitation, case management, transportation, housekeeping, and personal care services. Almost 20 percent of these facilities are "continuing care retirement communities" providing elderly residents access to care at all levels to accommodate changes in needs over time.

An estimated 10,053 people in residential care facilities have developmental disabilities. These clients have a primary diagnosis of some form of physical disability (e.g., cerebral palsy, muscular dystrophy, quadriplegia, or multiple sclerosis) or mental disability (e.g., mental retardation or Down’s syndrome). Thirteen percent were children and youths (ages 7 to 17), three-quarters were adults (ages 18 to 54), and 11 percent were over the age of 54.

Programs and services for the disabled include rehabilitative and restorative nursing care, pastoral counseling, physical therapy, and occupational therapy to improve physical and cognitive abilities and attain the highest level of independence in daily activities. One-quarter of the residential facilities for disabled clients had 15 or more beds, 30 percent had 6 to 14 beds, 23 percent had five or fewer beds, and 23 percent were supportive living facilities.

Short-term Assistance
Lutheran ministries provide various types of short-term assistance to individuals and families during times of crisis. Assistance takes the form of disaster response due to floods, fires and other natural disasters; food services (e.g., food banks and pantries, soup kitchens, Meals on Wheels, and congregate meals); temporary shelter; and other crisis services (e.g., clothing, medication, and financial assistance).

In FY 1999, short-term assistance was provided to 415,562 unduplicated persons. Approximately 23 percent of clients were children, 63 percent adults, and 14 percent elderly. Respondents estimated that 80 percent of clients receiving short-term assistance were living in families with average incomes below the federal poverty line ($17,028 for a family of three in 1999). Moreover, 41 percent of short-term assistance clients identified themselves as persons of color.

Disaster response programs assisted 23,279 people, the majority of whom incurred damages due to flooding. Food services reached 263,391 people, primarily through food banks, pantries and soup kitchens. Over 5 million meals were served (excluding meals served in residential care facilities). Temporary shelter assisted 11,823 people who were provided more than 145,000 nights of safe and secure shelter. Other emergency services such as clothing assistance, referrals, financial aid, and case management assisted an additional 117,069 people.

Social Services
The provision of social services is an ongoing part of the activities of 40 percent of LSA member organizations. The goal is to help individuals maximize their potential and find balance in their lives.

In FY 1999, LSA member organizations provided social services to 782,825 unduplicated clients. Approximately 4 percent of clients were infants (under age 5), 15 percent children and youth, 67 percent adults, and 14 percent elderly. Thirty-one percent of social service clients were persons of color, and 65 percent lived in families with incomes below the federal poverty line.

Clients participated in a range of services, including social support services (42 percent of clients), education (21 percent), counseling (17 percent), socialization (5 percent), refugee/immigrant services (5 percent), foster care (3 percent), permanent housing (3 percent), pregnancy services (2 percent), and adoption services (2 percent).

LSA members assisted with 2,908 completed adoptions of whom 1,136 were special needs children; provided day care for 2,043 children of whom 44 percent were from families with low incomes; and managed 14,402 housing units. Moreover, 14,560 women received pregnancy services of whom 13 percent were under the age of 18; over 11,000 people received employment assistance, including job training; and 1,387 people with the HIV/AIDS virus were served through LSA members’ social service programs.

Hospitals
In 1999, Lutheran Services in America members operated nine hospitals that provided care to 1,874,735 people. Outpatient facilities served 1.66 million patients in need of laboratory work, emergency room care, x-rays, therapies, and outpatient clinic care. The total number of procedures administered through outpatient facilities was 5,361,913. Inpatient facilities served an additional 211,415 patients through general medical care, OB/GYN services, intensive care units, pediatric care, rehabilitation units, and inpatient surgery.

Finances
Total income in FY 1999 received by LSA member organizations exceeded $6.9 billion, including cash and in-kind contributions. Revenues totaling $6,898,371,479 were received from program service fees (52 percent), government funds (39 percent), investment income (4 percent), community support (2 percent), plus unrelated business income, the Lutheran Church, and United Way/Combined Federal Campaigns. An additional $26.5 million was received by local organizations in the form of in-kind salaries and donated supplies, equipment and space.

LSA social ministry organizations expended 94 percent of funds received in FY 1999. Expenditures comprised primarily salaries (60 percent), direct program services (28 percent), capital expenditures (10 percent), and fundraising (<1 percent). The figures reflect financial activities in 80 percent of LSA member organizations.

METHODOLOGICAL NOTES
Three methodological notes are key to interpreting and using the survey results. First, to avoid duplication, respondents were asked to list clients only once within each program category. If a client received more than one type of social service, for example, the person was recorded under the primary service received. Unduplicated totals, however, do not capture the multiplicity of services that a person may have received in a given year. To assess multiple service delivery, additional information was collected such as the number of meals served in soup kitchens, beds available at residential care facilities, nights of lodging available at local shelters, and number of procedures administered in hospitals.

Second, 80 percent of LSA member SMOs completed the FY 1999 survey, up from 68 percent in FY 1998. The goal of LSA is to encourage all members to complete the survey as confidence in the integrity and utility of the questionnaire and its findings grows. Hence, no effort was made to weight the data to estimate activities in 100 percent of member organizations. Moreover, since a comprehensive survey of LSA members has never been achieved, no information is available on the universe of services and activities from which to design a weighting scheme.

Third, considerable effort was put into cleaning up the raw data file by FLYNN RESEARCH and the LSA staff to ensure that the information is as accurate as possible. Transcription, logic and reporting errors were flagged and corrected, using FY 1998 baseline data and institutional knowledge of activities in the responding organizations.