COLUMBIA--George Gintoli, director of the South Carolina Department of Mental Health, told Gov. Mark Sanford on Tuesday that his organization is working closely with other state agencies to tackle common problems.

Gintoli may someday soon be working even closer with those agencies, if the governor gets his way.

As the administration starts the process of developing next year's budget, one that may be cut for a fourth straight year, Sanford signaled strong support to the notion of merging different state agencies that deal with health care into a single department.

In making his case for consolidation rather than mere collaborations at a meeting with Gintoli, Sanford cited the potential that four or five case managers, each from a different agency, all visit the same family. Each individual case manager then deals only with issues related to his or her department.

"We have a very disjointed system," Sanford said. "The administration as a whole is biased toward integrating health care services so people aren't treated like a ping-pong ball."

The hearing was one of a series Sanford has held with different state agencies since the end of the legislative session to understand the needs of each department heading into what is expected to be another tough budgeting cycle.

One of the ways Sanford believes money can be saved is through restructuring government, and Tues-day was not the first time the notion of merging departments has come up.

Sanford mentioned the idea at previous budget hearings with other health-related departments, such as the Department of Health and Human Services.

In January, the Legislative Audit Council recommended merging the state's eight health and human service agencies into one department with a single cabinet member. Those agencies include DMH, plus the departments of Alcohol and Other Drug Abuse Services; Disabilities and Special Needs; Health and Environmental Control; Health and Human Services; Social Services; Vocational Rehabilitation; and the Commission for the Blind.

Such a proposal was included in a Medicaid reform proposal during the past session of the General Assembly, but the legislation never made it to Sanford's desk.

"We've been talking about these things in this state for the past 15 years," said Fred Carter, Sanford's chief of staff. "Now is a good time to move on it."

Mental health advocates attending the hearing generally endorsed the concept.

Gintoli himself agreed that, given the state's budget problems, South Carolina could save administrative costs if it merged DMH and the department of Alcohol and Other Drug Abuse Services.

During a presentation to the governor, Gintoli also said the state could save money by privatizing mental health services. He said South Carolina was one of the few states in the country that still runs its own mental health department. Most states have a private system, which Gintoli said has proven to be the most efficient model. Sanford had no reaction on that suggestion.

Merging the departments and their functions would take time. Until then, the department must still grapple with a mental health crisis, especially the problem of patients waiting hours or even days in emergency rooms for available treatment.

DMH has seen its budget cut by nearly $37 million, more than 17 percent, over the past three years and its workforce in that time has fallen from 6,007 to 5,139. The department serves some 63,000 adults and 33,000 children at 17 community mental health centers and two inpatient hospitals. It has a budget of $345 million.

About half of that money comes from the state, the balance from the federal government and other sources.

Because of the funding cuts as well as an effort to care for more people in the community where they live rather than in a state hospital setting, the department has in recent years closed 250 beds. Yet the department has not had the money to improve services in those communities.

"We have a system that you can very strongly argue is outdated," Sanford said.

Correcting the problem, he said, will cost money that may be hard to find.