Lutheran Services in America Annual Survey
Lutheran Services in America was formed in April 1997, to bring together the Evangelical Lutheran Church in America, the Lutheran Church-Missouri Synod, and their 280 social ministry organizations who serve in over 3,000 communities across America. As an alliance of these church bodies and Lutheran social ministry organizations, Lutheran Services in America provides health and human services through a unified system based on the following core values:

• Concern for the common good and justice for all people
• Lutheran faith commitment
• Flexibility and diversity reflected in the ministries
• Collaboration based on trust
• Responsible stewardship of human and financial resources
• Excellence, integrity and openness
• Innovation in programs and services.

In order to learn more about the various programs and services that are part of the newly organized service network, Lutheran Services in America (LSA) commissioned FLYNN RESEARCH to design a customized measurement tool that would help create a portrait of the LSA network. Two survey instruments were designed in the summer of 1998, pilot tested in the fall, and fielded in the winter. One survey was administered to facilities providing residential care (a 17-page survey) and another to organizations providing hospital care, social services and/or short-term assistance (a 33-page survey). The unit of analysis is the social ministry organization (SMO).

Detailed information was collected on human resources, including volunteers, staff and board members; long-term residential care facilities for the elderly, children and persons with disabilities; hospital inpatient and outpatient care; social services; short-term assistance, including disaster response, food, temporary shelter, and other crisis services; public policy initiatives; congregational social ministry; and finances during fiscal year 1998.

To avoid duplication, respondents were asked to list clients only once within each program category. For example, if a client participated in both education and pregnancy programs at a social service site, the person was recorded only under the primary service received. To measure multiple service delivery, additional information was gathered, including meals served, beds and units available, nights of shelter provided, and hospital procedures administered.

This report provides national-level results to preserve the confidential nature of social ministry organization information. Both quantitative and qualitative questions were fielded in order for respondents to provide as much information as possible about local programs and activities. The key findings are as follows.


Human Resources
The work of Lutheran social ministry organizations is performed by a dedicated group of volunteers, paid staff, and board members who provide leadership in their local social ministry organizations, training to fellow workers, and a multitude of services to clients. A total of 232,226 people worked in local social ministry organizations in FY 1998. Approximately 121,944 people served as volunteers, 107,285 as paid staff members, and 2,997 as board members. Given that board members are uncompensated, a full 54 percent of the people who worked with LSA members in FY 1998 volunteered their time and labor.

Volunteers were of all ages. Approximately 12 percent were children and youth, 42 percent were adults, and 46 percent were elderly. Volunteers spent over 3.7 million hours engaged in service in FY 1998.

Paid staff were employed in various capacities depending on the needs of local communities. Overall, one-third of the staff served as paraprofessional direct care staff and another 16 percent were credentialed professionals. Seventy-seven percent of paid employees were women, and 21 percent were persons of color. Approximately 31 percent of the staff were employed on a part-time basis and 69 percent on a full-time basis.

Thirty-four percent of the people who served on governing boards and/or boards of trustees were women, and 7 percent were persons of color. Together, the volunteers, paid staff, and board members provided the human wherewithal to meet the goals of LSA members in serving their clients through the programs described below.


Residential Care Facilities
Lutheran social ministry organizations maintained 1,440 residential facilities that provided long-term care to the elderly, children, and people with disabilities. Facilities for the elderly included nursing homes, assisted living accommodations, independent living facilities, multi-family housing, board and personal care, and Housing and Urban Development (HUD) projects. Residential programs for children and youth included residential treatment facilities, non-treatment facilities, and group homes. People with disabilities received intermediate, heavy and skilled nursing care. The aim of the residential care programs is to help people become as independent as possible by learning to do as much as they can for themselves.

Over two-thirds of the SMOs completing the annual survey sponsored and/or managed residential care facilities in FY 1998. Clients were offered a host of services ranging from shelter to medication management, meals, housekeeping assistance, therapeutic and structured environments, and group foster care.

Overall, 176,861 people resided in long-term care facilities maintained by Lutheran social ministry organizations. An estimated 1,391 residential facilities for children and the elderly provided care for 169,538 people, of whom 97 percent were elderly. The average occupancy rate in these facilities was 92 percent in FY 1998. An additional 7,323 people were served through 49 residential care facilities for the disabled, of whom 34 percent were infants and children.

Lutheran Services in America members also reached out to non-residents through programs sponsored by local residential facilities. The types of services available included outpatient therapy, hospice care, adult day care, home delivered meals, respite care for caretakers of the elderly, housekeeping and chore services, home health care, and transportation.


Hospital Services
In FY 1998, social ministry organizations maintained 5 hospitals that delivered services through licensed acute inpatient and outpatient centers and rehabilitation programs. Categories of inpatient care ranged from medical, to pediatrics, surgery, rehabilitation, obstetrics and gynecology, intensive care, coronary, and subacute care. Patients also sought outpatient care for therapies, laboratory work, emergency room care, X-rays, and clinical services.

The number of clients receiving services through Lutheran hospitals was 247,486. A total of 16,601 people received inpatient care, and 230,885 received outpatient care. Hospital staff administered an estimated 1,648,582 procedures.

Social Services
Lutheran social ministry organizations provided a number of social services, including social support, education and family support, counseling and mental health care, refugee resettlement and immigration services, permanent housing, foster care, adoption, socialization, recreation and neighborhood services, and pregnancy services.

A total of 552,850 people participated in social service programs. Five percent of the clients were infants, 13 percent were children and adolescents, 67 percent were adults, and 15 percent were over the age of 64. An estimated 58 percent of social service clients were living in families with incomes below the 1998 federal poverty line of $16,450.

Social ministry organizations also provided detailed information on selected social service programs such as child day care, services for children at risk of abuse or neglect, employment services, non-residential services for the elderly, addiction programs, and HIV/AIDS services.


Short-term Assistance
The staff and volunteers of social ministry organizations also provided short-term assistance during times of crisis. In FY 1998, an estimated 265,276 people received emergency assistance, of whom 79 percent lived in families with annual incomes below the federal poverty level.

Food programs reached 184,057 people through Meals-on-Wheels services, congregate dinners, soup kitchens, food banks, pantries, and disaster response programs. Local SMOs served more than 7.7 million meals. An additional 6,076 individuals received temporary shelter and shelter assistance through the network of Lutheran Services in America social ministry organizations, of whom 90 percent were runaway children and adolescents under the age of 18. A total of 111,082 nights of shelter were provided.

Other crisis services reached 75,143 people in the form of clothing, medication and financial assistance. Disaster response assistance was provided to an unknown number of persons in response to 30 fires, 27 tornadoes, 17 floods, and 6 hurricanes. Local social ministry organizations helped fulfill the most basic needs required for members of their communities to lead lives of dignity.

Public Policy
The mission of Lutheran Services in America is to foster a valued Lutheran identity, an integrated system of services, strengthened services, and nurtured partnerships among the Evangelical Lutheran Church in America, the Lutheran Church-Missouri Synod, churchwide Districts and Synods, and congregations. Social ministry organizations also strive to have a unified voice through public policy initiatives and community development programs that advocate for sound and compassionate policies on behalf of the people they serve.

In FY 1998, the three primary legislative issues of concern at the local, state and national levels were housing, Medicare/Medicaid, and health care availability. Community programs developed and/or maintained by LSA members included housing corporations, senior citizen centers, neighborhood organizations, health care centers, economic development corporations, and credit unions.


Congregational Social Ministry
Lutheran congregational social ministry programs help members respond collectively to human needs. The goal of congregational social ministry is to involve congregations in the work of direct service, advocacy, community organizing, and public education on social issues. One hundred social ministry organizations provided information on their congregational social ministry efforts in FY 1998. A total of 342 people were dedicated to congregational social ministry work, 30 percent on a full-time basis and 70 percent on a part-time basis.

New Services
Over one-third of social ministry organizations developed new services in FY 1998, half of which were housing and social service programs. Other new programs provided needed education and training for staff and clients, clinical services, ministry, and emergency assistance.

Approximately 14 percent of respondents indicated that they dropped services in 1998. Over half of the discontinued programs provided social service assistance such as child day care, homemaker services, home visitation, phone check-in, adoption, respite care, guardianship programs, senior center programs, and self-esteem building programs. About one-third of the discontinued services were clinical services such as counseling, in-house case management, intensive family preservation services, early child interventions, and youth offender programs. In 57 percent of the cases, services were discontinued due to a lack of funding, and thirty percent were dropped due to a lack of clients. Over half of social ministry organizations maintained waiting lists for services (other than adoptions) primarily for long-term residential care and clinical services.


Finances
Lastly, social ministry organizations that were members of Lutheran Services in America received $3.68 billion in cash and in-kind contributions in FY 1998. Cash contributions totaled $3.66 billion. Sources included the following: government (53 percent), program service fees (28 percent), investment income (4 percent), community support (3 percent), United Way and Combined Federal Campaign (<1 percent), the Lutheran Church (<1 percent), unrelated business income (<1 percent), and unspecified sources (11 percent). In-kind contributions, valued at $20.8 million, were received in the form of voluntary labor (73 percent), supplies and space (19 percent), and unspecified sources (8 percent).

Social ministry organizations expended $3.54 billion in FY 1998 to cover personnel expenses (49 percent), program services (18 percent), management and general overhead (8 percent), fund raising (<1 percent), and other unspecified expenditures (24 percent). A full 97 percent of income received in FY 1998 was expended within the same year.