What percentage of St. Jude’s expenses goes to program services versus fundraising and administration compared with peers?
Executive summary
St. Jude and its fundraising arm ALSAC report that roughly 82 cents of every dollar goes to patient care, research and program needs over recent years, while independent analyses and reporting show a larger share directed to fundraising and reserves — about 30% for fundraising and roughly 20% into reserves in one multi‑year breakdown (St. Jude/ALSAC claim 82% to programs; investigative sources report ~50% to programs, 30% fundraising, 20% reserves) [1] [2] [3].
1. Two competing pictures: St. Jude’s claim versus watchdog summaries
St. Jude’s public materials and FAQs state that 82 cents of every dollar received has gone to support treatment, research and future needs — and that 13 cents supports fundraising efforts — a figure repeated across its donor‑facing pages [1]. Independent reporting and academic summaries present a sharply different long‑term summary: since 2017, about half of contributions went to patient care and research, about 30% to fundraising, and about 20% into reserves, a split highlighted in ProPublica and in a medical‑journal overview [2] [4].
2. Where the differences come from: accounting structure and two organizations
Part of the divergence stems from St. Jude’s two‑entity structure: American Lebanese Syrian Associated Charities (ALSAC) is the fundraising affiliate that raises money and allocates funds to the hospital; the hospital reports its own consolidated functional expenses. ALSAC’s reporting shows large fundraising costs in absolute dollars and also substantial transfers to the hospital — numbers that can be framed either as program support or as fundraising expense depending on which totals are used in a ratio [5] [6] [7].
3. Recent headline numbers and examples from reporting
Investigations and third‑party breakdowns have cited concrete dollar flows: in recent years ALSAC reported revenue in the billions, with fundraising expenses in the hundreds of millions — one readout showed $836 million (about 31% of revenue) on functional/fundraising expenses, $1.4 billion (about 51%) transferred to St. Jude, and the remainder added to fund balances [6] [3]. Those figures underpin the “$100” style explainers that attribute roughly $30 of $100 to fundraising and a rising share to savings or reserves in some years [8] [3].
4. What watchdogs worry about: large reserves and family needs
ProPublica and academic commentators have flagged St. Jude’s multi‑billion‑dollar reserves as unusually large for a charity of its size, noting that while St. Jude meets some charity guidelines for reserves it holds several years’ worth of operating funds — an amount some nonprofit experts call “staggering” and say exceeds typical practice of one‑to‑two years of expenses [4]. That reporting also documents families of patients still seeking outside financial help, which fuels criticism that large reserves may not be matched to immediate family needs [4].
5. St. Jude’s stated operating rationale and strategic plan
St. Jude emphasizes that its operating model covers patient care without billing families and invests in long‑term research and global programs; its strategic plan through 2027 lays out major capital and program investments that the organization says justify sustaining reserves and multi‑year fundraising targets [7] [9]. Charity evaluators such as Charity Navigator continue to give high marks for financial health and transparency metrics in public facing scores, which St. Jude cites in its defense [1] [10].
6. Limits of available reporting and what’s not resolved
Available sources do not provide a single, uniform ratio that reconciles ALSAC’s fundraising expenses, St. Jude hospital’s program expenses, and changes to fund balances across every recent year; different disclosures use different denominators (total contributions, total expenses, or combined entities) and thus produce different percentages [5] [11] [1]. Exact peer comparisons are not provided in the supplied materials: available sources do not mention a direct, apples‑to‑apples program/fundraising/admin percentage comparison between St. Jude and specific peer hospitals or charities in the same years (not found in current reporting).
7. How to interpret the figures if you’re a donor or watchdog
If you prefer program‑expense ratios calculated as program expenses divided by total expenses at the hospital level, St. Jude’s public claims (82¢ per donated dollar to program and research) are the reference point [1]. If you examine aggregated flows across the fundraising affiliate ALSAC and the hospital, independent reporters show a more mixed picture with higher fundraising costs and large additions to reserves that lower the share of immediate program spending to roughly half over some multi‑year windows [2] [6]. Both approaches are supported in the record; which is more meaningful depends on whether you prioritize current-year program outlays or long‑term capital and research funding plans [9] [4].
Sources cited above: St. Jude/ALSAC financial pages and FAQs [1] [7] and ALSAC/St. Jude filings and analyses [5] [11], investigative reporting and summaries (ProPublica, academic review) [4] [2] [3] [6].