Bremwood Lutheran Services and Lutheran Social Service of Iowa, two social ministry organizations of the Evangelical Lutheran Church in America, joined forces in 2003 to form Lutheran Services in Iowa. It serves more than 40,000 Iowans annually through residential treatment, services to families, home health care, early childhood programs, adoption services, refugee resettlement, services for people with disabilities, disaster response initiatives and mission prescriptions. LSI serves people of all ages, genders, nationalities, religions, ethnicities and sexual orientations and is affiliated with Lutheran Services in America and the three Iowa synods of the Evangelical Lutheran Church in America. With more than 700 employees at 15 statewide offices, LSI is the state's largest nonprofit social service agency. Established in 1864, Bremwood was a home for children orphaned by the Civil War. In 1953, it became the first accredited psychiatric residential treatment center for troubled youth in Iowa. Lutheran Social Service was established in 1870.