Pastoral care programs have grown and matured in the 10 years since The Catholic Hospital Association and the National Association of Catholic Chaplains issued their "Guidelines for Establishing a Department of Religion in a Catholic-Sponsored Hospital." CHA's 1979 survey of 370 institutions points out that while pastoral care departments are recognized as important, budgets for personnel and programs are unrealistic. The shortage of pastoral care personnel is an acute challenge to Catholic facilities, and alternative staffing methods must be sought.