Sawyer Ekberg is a spark of activity, running around and chatting with anyone within earshot.

On Thursday afternoon the towheaded 2-year-old was chasing a big ball around his living room and talking and laughing at his mom Nicole Ekberg and his helper, Christa Tescher.

The terrible twos, it seems, aren’t so terrible. Nicole Ekberg knows they could have been much worse.

Sawyer was born with Aarskog Syndrome, a rare genetic disorder that affects a child's development of facial features and bone structure. It can also affect speech and other cognitive developments. 

A year ago, Sawyer was behind on most of his developmental mile markers. As a 1-year-old, he should have just been walking and speaking his first words. Instead, he was barely crawling and was still just making small noises.  

Now, he's speaking more than most 2-year-olds and running around like the free-spirited toddler he is. And its in large part due to Tescher, a family support specialist paid through Medicare Part C funding. 

“If we weren’t with the program, he’d be way behind," Ekberg said. 

But that program is in limbo, one of hundreds of proposed budget cuts statewide that could throw families like the Ekbergs into turmoil.

The cuts are necessary because Montana is bringing in significantly less money than expected through taxes. Revenues are still increasing, but at a slower rate than projected in the budget lawmakers adopted in the spring. For the fiscal year that ended in June, the state brought in $75 million less than expected in general fund revenue.

Projections from the governor's office estimate collections this fiscal year will be $131.3 million lower than estimates adopted by the Legislature and $144.8 million the following year. Those figures are large enough to trigger mandatory budget cuts required by law to keep the state's budget in balance.

Cuts in Montana will hit the three departments that make up 85 percent of general fund spending the hardest. Those are the Department of Public Health and Human Services, the Department of Corrections and the Montana University System.

The health department will trim $105 million over two years, which would result in a loss of $136 millionTrea in federal funds, too. The department has become the public face for many of the cuts because it provides so many direct services that many Montanans find critical, like child protection services, public assistance and programs for the disabled.

The Department of Corrections would make $40 million in cuts over the next two years and eliminate 45 full-time positions with the possibility of eight being reallocated to other positions within the agency. The state university system could have to make $43 million in cuts, leading to likely tuition increases.

Some hope cuts can be avoided through tax increases. Families who receive services on the chopping block filled legislative hearings in the past weeks begging lawmakers to come back to Helena for a special session to raises taxes and revenues. Last week Democratic legislators took up the call, making their arguments through editorial pages in newspapers statewide.

Gov. Steve Bullock, a Democrat, has said a special session will be necessary — at some point before the 2019 regular session — to address paying for the most expensive fire season the state has ever seen. But he's been less than clear about how he'll act on calling a special session to deal with the proposed budget cuts.

It's unclear if there is any Republican support for tax increases, with one of the most prominent members of that party and a key architect of the budget penning another letter to the editor this month that made clear he doesn't support any tax increases.

A Republican-dominated Legislature also shot down nearly all the tax increases the governor pitched at the start of the legislative session last spring.

Under the law, the governor has the authority to cut state agency budgets, except those headed by elected officials, by up to 10 percent. Departments led by someone voters picked, such as the Office of Public Instruction and Department of Justice, would be cut by the average amount of all the other proposed cuts. The programs or reductions on the chopping block would be decided by the agency’s head.

Bullock could implement the cuts as early as the end of next week if he doesn't choose to call a special session. A majority of legislators can also vote to hold a special session, though it's never happened. The longer the wait for action, the more will have to be cut as agencies continue to spend over what the state can afford to pay.

Reductions need to total $229 million in general fund money, though but the overall picture is worse because it puts millions of federal money that matches state spending at risk.

The crux of disagreement is over whom the cuts will affect most. Those calling for a special session point statewide, saying the budget will be balanced on the backs of the poor, elderly, children and other vulnerable groups. The other side of the debate argues the state must, like the private sector, live within its means. They argue it isn't fair to ask business or taxpayers for more to reduce impacts to government employees and services.

The Eckbergs are caught in the middle.

Tescher's home visits are designed to help Sawyer's parents learn how best to help him develop and progress. She visits the home during the week, working with Sawyer and then training Ekberg and her husband. 

"Regular parenting just doesn't work," Tescher said. "We have other strategies and resources."

Tescher said vital specialists like her intervene early. Much of the crucial neurological development happening in a child's brain is locked into place between ages 6 and 8. If therapists can work with these children while they're still toddlers and small children, they can change lives.

It also saves money. Tescher said 67 percent of the kids with whom they work leave the program not needing any special education services. Without the intervention, most if not all of these kids would need special education once they start school, which is exponentially more expensive for the state, she said. 

Sawyer will graduate from the program next month. The progress he's made in the last year has brought him up to speed with peers and when he starts kindergarten in a few years, he'll be able to enter the class as just another kid. During that time, Ekberg will continue to work with Sawyer, using the skills and tools Tescher trained her to use.

"I can't imagine not having the support," Ekberg said. 

The state of Kansas may be a place Montanans can look to see the outcome of wide-sweeping cuts. Though the cause of that state's situation — a tax reduction plan championed by Republican Gov. Sam Brownback meant to reduce the size of government — was different, a list of what Kansas cut is similar to what's on the table in Montana.

“We cut Meals on Wheels,” said Annie McKay, president and chief executive officer for Kansas Action for Children & Voices for Children Foundation. “There isn’t any kind of area of life or population or part of our state that didn’t feel this in some way. This isn’t about recovery in a decade,” McKay said. “This is about hopefully recovering within a generation.”

Schools in Kansas saw budgets slashed to the point where some districts couldn't finish out the year in 2015. In Montana, some school funding is protected by law, but the Office of Public Instruction still must trim its budget 9.57 percent.

The office proposed cutting payments to local school districts by about $5.8 million over the next two years, saying the impact "will be severe as the districts have already budgeted this amount and cannot replace this money from any other source." The Montana Digital Academy, an online learning resource meant to target rural districts, would see a reduction in what it's able to offer students. 

Because the Office of Public Instruction is led by an elected official, its budget must shrink by the average reduction to the rest of state government and the governor cannot dictate what programs are included in cuts or protected.

McKay argued that regardless of the scope or size of cuts, when any chance for education is lost, the the effect will linger for generations.

“It’s lost opportunities for Kansas learners. Those are the things when we talk about the programs that had been cut that directly affect kids, those are years you don’t get back. It’s not like repairing a road where it’s going to just cost you more in the future. But even then, it is going to cost us more in the way of criminal justice activity, safety net programs and more.”

Though Kansas has voted to replace some of what has been lost, it’s not like flipping a switch, McKay said.

“We have undercut the infrastructure in these serves and these programs,” she said. “To get these lost investments back is going to be costlier than it would have been to maintain them.”

Some agencies in Montana have pitched the idea of increasing fees to help make up for the loss of state funds; for instance, asking grain producers and grain elevator operators to pay more for sampling by the State Grain Lab to make up for to 10 percent reductions. Tuition increases at the Montana University System could also be on the table.

“We masked some of this by increasing fees,” McKay said, adding that in her state, motor vehicle registration fees increased, the sales tax rose twice and tuition was raised at college campuses. 

Budget hawks recognize some cuts are difficult to stomach, but say others are necessary to bring state government spending back to what they say is a more appropriate size.

Revenue growth has not matched pace with the growth of government spending, something the Montana Policy Institute's Brent Mead said needs to be brought back in alignment.

“When we look at some of the agencies, within DPHHS, some of the cuts we don’t have a lot of heartburn about because it’s things like, ‘Well, let’s exercise oversight over utilization of imaging services for Medicaid.’ That’s something that should be done anyway.”

Mead also pointed to other cuts within the agency he said would eliminate redundancy, such as no longer having desk phones for Child and Family Services employees who also have cell phones.

“Those are things that should occur anyway. When we’re going through this process it’s important to separate out, there are some cuts that, in a vacuum, in a good budget year, we should still be doing.”

Choosing to expand programs, like Medicaid or preschool opportunities, forced the state to be in a situation where it must choose to raise the cost of things like higher education and reduce money for local school districts, or have the Legislature vote to increase taxes, he said.

The Montana Policy Institute opposed the expansion of Medicaid under provisions in the Affordable Care Act during the 2015 Legislature, saying it would not save the state money.

While the state argues that, in addition to extending coverage to nearly 84,000 Montanans, expansion has saved $30 million general fund money, Mead counters that starting up and administering the program entailed costs that took away from other needs.

“If that’s one program, you can carry that out to all the other new (program) starts,” Mead said. “From our perspective, why are we creating new programs when we are cutting things like senior living? It doesn’t make a whole lot of sense to us.”

Mead said he thinks the way some of the cuts were crafted were designed to maximize the impacts on the state to spur a political action for tax increases.

“I think there are other places the government could cut, but it’s pretty clear with his budget (the governor) introduced last year that he wanted about a half billion in new taxes. And the Legislature said no to that.”

General fund revenue was $1.9 billion in fiscal year 2008 and dropped steeply by 2010, but has generally risen since then. At the end of fiscal year 2017, it was $2.1 billion. In 2008, general fund and state special revenue spending was $1.8 billion and by 2016 it was $2.2 billion, according to legislative records.

“When you add it up, you have a structural imbalance,” Mead said.

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