The committee used its most direct language to discuss the future of its corps of chaplains who work outside of the military, in nursing homes and hospitals, and on college campuses, among other assignments.

One of the largest social service networks in the United States, working in areas ranging from adoption to disaster relief, faces a shakeup because of Lutheran divisions over the Bible and homosexuality.

The Lutheran Church-Missouri Synod, a theologically conservative denomination, said Wednesday that direct work with its larger and more liberal counterpart, the Evangelical Lutheran Church in America, has become “difficult if not impossible,” because of doctrinal conflicts, including the 2009 decision by liberal Lutherans to lift barriers for ordaining gays and lesbians.

Neither denomination would discuss the potential financial impact Wednesday. Many Lutheran-affiliated agencies receive substantial state and federal grants that would not be directly affected by any split. However, similar to Catholic Charities, Lutheran agencies are some of the biggest service providers in their communities.

Just one of the joint Lutheran agencies, Lutheran Services in America, said on its website that it encompasses more than 300 health and human services organizations with a combined annual budget of more than $16 billion.

“We recognize that this is a difficult issue. It’s complicated,” said the Rev. Herb Mueller, first vice president of the Lutheran Church-Missouri Synod, based in St. Louis. “We’re trying to take a nuanced and caring approach to all of these situations that’s also faithful to what the Bible teaches on these issues.”

The Rev. Donald McCoid, an ecumenical officer for the Chicago-based Evangelical Lutheran Church in America, said, “we are deeply concerned about the ministries of care that may be challenged by the recent action of The Lutheran Church-Missouri Synod.”

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