ENID, Okla. — The Oklahoma Department of Human Services confirmed $16 million has been set aside for the Robert M. Greer Center in Enid, but just how it will be spent, and for what, the department is still trying to decide.
"We're working with the governor's office and the legislature to determine how exactly we will go forward," DHS spokeswoman Terri Watkins said.
Operating in the northeast corner of the defunct NORCE campus, the Greer center provides care for individuals who are both intellectually disabled and potentially dangerous, to themselves or others.
First dedicated in 1988, it has fulfilled this task on behalf of the state for decades. Many of the facilities and much of the infrastructure it relies on are just as old, and in some cases older, according to the director of the Greer center, Hugh Sage.
"Most buildings on campus were built in the 30s, 40s, 50s, and the infrastructure, water lines, everything buried, has not been kept up very well," Sage said.
Administration has installed itself in one of the only new structures available, erected a decade back for use by NORCE.
Greer staff was forced to relocate two years ago, after the waterline to their previous administrative offices went out. The structure was a 1950's build, and while the waterlines were newer, they hooked into lines much older, he said.
So far, the residential buildings that house the clients haven't experienced any major breakages, and with 16 beds each, it's a good thing.
DHS has done well maintaining Greer's modest section of the campus, Sage said, "but they're very much concerned about the water lines, the electric lines, and everything that's been in the ground for three decades now."
Routine care and maintenance can't cure old age.
"So we're running against the clock," he said. "How long before the next water line goes out?"
The Robert M. Greer Center was state run at the start. A short-term treatment facility, it was intended to take in intellectually disabled clients with dangerous behaviors, stabilize them, fix their behaviors, and place them in a supervised community alternative.
Later on, DHS decided to contract out the work of the Greer center, entrusting Liberty of Oklahoma Corporation with the task. When LOC first took the reins in 2000, the average length of stay for clients of the short-term program was 7 1/2 years, Sage said. The average is now 9 months.
"A primary reason they decided to outsource it was they couldn't accomplish the objectives that had been set up," he said. "It was supposed to be a short term placement program ... it had been two and a half years from the time we took over that the last placement had been made."
During LOC's 20 year run so far, 191 placements have been made in community alternatives.
At the 52-bed center, there are four residences, holding 16, 16, 16, and 4. The 4 live under the same roof, and were inherited by LOC when the state handed over the keys.
"They're not very much fun for the direct care staff to be around," Sage said.
Not all clients are easily placed, but most can make great progress with proper treatment.
Most residents of the Greer Center are between 18-25 years old, and each is intellectually disabled to some extent, but about half are only "marginally" so, Sage said, "and a good number of those folks are pretty street smart."
"They've had run-ins with the law, they might have charges pressed against them. Some of them have been found competent to stand trial, stood trial and then convicted, gone to prison, gotten out and reoffended," he said.
Common histories among the more aggressive might include vehicle theft, or assault, against family members, community members, caregivers, police officers.
For some residents, harmful behaviors are aimed inward.
Personalities and problems vary, but they're all at Greer for the same purpose.
"In any case, our job is to change the behavior ... so they can function more normally in a community setting."
Traditional forms of therapy, such as counseling, are generally ineffective. They lack the skills needed to glean insight through self-reflection.
At least a third are affected by some mental illness or personality disorder, and the majority, Greer staff recently discovered, have spent time in the custody of child welfare.
"We're talking about a lot of kids that grew up in miserable conditions and miserable home environments ... so it's not surprising that they didn't acquire more normal behaviors, and did learn abnormal ones," Sage said.
Brett Hemstreet is a clinical manager at Greer. From his office, in the middle of a 16-bed residence, he's accessible to his 15 current clients. He's responsible for their wellness, and he's responsible for their therapy. He gets to know them well.
From what Hemstreet has learned, 12 of his 15 are mentally ill, or have an underlying personality disorder.
"We didn't use to look at personality disorders as mental illness, but they are because they're one of the most problematic kinds of diagnostic conditions that confront mental health," he said, adding they can also be the hardest to treat.
There are those with antisocial personality disorder, characterized by a lack of remorse or concern for others.
Some clients have borderline personality disorder, and suffer from emotional instability and often unpredictable, impulsive behavior.
The kind of therapy offered at Greer works better for these populations than what's available elsewhere, where time and resources may be more limited.
There is a tendency at certain types of facilities, like psych hospitals, to identify a problem behavior and medicate it, Hemstreet said.
"When you do that, you don't teach them something different," he said. "If you remove the medicine, they go right back to doing what they learned in the first place."
Hemstreet might apply a minimal dosage in cases, but his focus is on teaching his residents to do different things than they've always done. He replaces their behaviors. He can also teach them safer coping mechanisms than what they've taught themselves, if they need them.
Clients are given jobs on campus and out in the community, and learn to better work and interact appropriately with others. It also shows them how to get the things they want in life through honest effort.
"They have to learn skills in the community so they can go live in the community," Hemstreet said.
Recidivism among former clients is rare. According to Sage, only two percent of all placements have had to return within a year of leaving the center, due to their behavior.
To insure it can continue its rehabilitation efforts into the future, Sage says new facilities and infrastructure are needed. He hopes the $16 million DHS has put aside for the program will accomplish just that.
Talk about improving Greer isn't new, he said. Following the closure of NORCE in 2014, the state's attention shifted to the center, and discussion between the two has been ongoing since.
There was even talk early on of moving the whole operation to Oklahoma City or Tulsa, but that was shot down.
"Programs are about people ... those 150 staff that we have. It's a 24-hour operation dependent entirely on the quality of our staff," Sage said. "Building a culture like we have here takes years."
Some of the ongoing correspondence has been back and forths from Sage and DHS' architect, sending blueprint proposals.
The plan as it exists now, requires a 20-30 acre patch just south of Greer's current administration buildings, which Sage said they would continue using.
In that patch would go three new residential buildings, still 16 beds each, but more spacious and ADA accessible, and equipped with storm shelters. Nearby the residentials, a recreation center and a kitchen. Existing supply and maintenance structures are also to be replaced, Sage said.
From the time any similar plan were greenlit, it would likely take close to 30 months to carry out, he's been told.
"Given all the steps one has to go through for a project of that size, it's not unreasonable," he said.
Sage is hopeful for an improved Robert M. Greer Center, but despite the talk, and despite the $16 million, hope is all he's allowing himself.
"We're optimistic, but until construction actually begins, we can just hope."