The S.C. Department of Mental Health is a shadow of its former self these days, as are many state government offices after legislators trimmed more than $1.5 billion in state spending over the past 1 1/2 years.
The nation's recession has forced lawmakers to slash the size of state operating budgets, mowed down the number of state workers and, in some cases, put new limits on the pool of residents who can get agency services.
This week, lawmakers return to Columbia facing more budget dilemmas at virtually every state agency.
For example, the Department of Mental Health budget was cut to $161 million in December 2009 from $220 million in June 2008.
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Republican Gov. Mark Sanford, driven by gloomy forecasts of a still-stagnant economy, asked that the agency's budget be cut an additional $10 million this year in his executive budget.
If granted, that cut would leave the agency down nearly $70 million since June 2008.
"We're not the only ones affected, of course," said Mark W. Binkley, the department's general counsel. "In a way, we have been luckier than some other agencies."
The General Assembly gave the agency a one-time $5.3 million appropriation last year and an additional one-time $19 million shot-in-the-arm this year, Binkley said. The agency will use the money to bridge some gaps caused by the cuts.
"In other words, even though (the department) has lost over 27 percent of its base state appropriation since June 30, 2008, it hasn't reduced its work force or its services by 27 percent," Binkley said.
But this year the Legislature might not be able to fill the agency's gaps with one-time money, Binkley said.
South Carolina is facing a $500 million budget hole as the legislative session starts. The state also faces the loss of federal stimulus aid in the next budget cycle, and it must plan now for the loss of billions of dollars in federal aid for health care, education and law enforcement agencies.
A House-approved bill that has cleared a Senate panel would make the Department of Mental Health a cabinet-level office under the governor.
It is not clear whether the proposed change will help with the agency's budget problems. However, Sanford, who has pushed for agency restructuring in a bid to improve efficiency, supports the proposal, spokesman Ben Fox said.
'A CHALLENGING YEAR'
Many lawmakers want to restore services, when and where possible, though the state's economic climate demands agencies live within their means. Some lawmakers want state agencies to justify each proposed expenditure.
Lawmakers say the key to sustaining state services is turning the economy around.
But even as the economy shows positive signs, with a small uptick in real estate sales and corporate earnings, the state's 12.3 percent unemployment rate likely means sales and income tax collections will remain soft.
"Jobs, jobs, jobs" is the answer, said Senate Majority Leader Harvey Peeler, R-Cherokee. "It's going to be a challenging year - perhaps the most challenging of any year so far in the Senate." said Peeler, who was served in the body since 1981.
Senate President Pro Tempore Glenn McConnell, R-Charleston, said his reading of the economy is that "good economic times are not ahead" and the choices confronting lawmakers consist of "a menu of what we are going to do without."
But budget cuts can make a big difference in the lives of those who seek services from state agencies, said Cheryl Krumholtz, 43, a client affairs coordinator with the Columbia Mental Health Centers who also is being treated for bipolar disorder at the agency.
"It took an extra two years for me, with a new therapist, to be able to open up and deal with issues from earlier in life that had to do with my treatment and recovery," said Krumholtz.
Smaller budgets forced Mental Health to lay off psychiatrists, therapists and other health care personnel with whom patients had built up trust, she said. She's worried her therapist will be laid off, too, because of the next round of budget cuts.
Krumholtz also said the cutbacks have caused havoc, forcing more hospital visits for the agency's clients.
Registered nurses working for the department earn 20.2 percent below market wages, while more experienced nurses earn 17.2 percent below market, according to the state Office of Human Resources.
Licensed practical nurses working for the department earn nearly 14 percent below market wages, and limited cost-of-living increases cause the gap to widen even more, the statistics show.
"The budget cuts have significantly impacted all facets of Department of Mental Health operations, including administrative, in-patient and out-patient functions," Binkley said.