Because the state and the courts deem it a restrictive setting, a committee in the division considers other options such as a group home before placing a person in the center. The goal is to find the least restrictive environment possible. It only receives a few applications each year, and many placements now are deemed temporary to stabilize a medical or behavioral problem, Kelner said.

Medicaid and state funds account for the center's $31 million annual budget. It costs about $377 a day to care for an individual.

"Basically, we want them to have the best quality of life they can and be as independent as they can," said Anita Rutledge, a qualified mental retardation professional or QMRP who oversees Roger's care.

Individuals at the center have a full slate of activities and therapies that keep them busy all day long and a dedicated support team to get them through it.

Rise and shine

Getting Roger ready for the day is no small task. It starts about 6 a.m. when he wakes in the room he shares with another man. Roger's side of the room is well-adorned with figurines and pictures of Jesus, train knickknacks of every sort, toy trucks and decorative mailboxes. He is a campus mailman.

Roger has three identical wall clocks. One above his bed, one above his dresser and one over the door. All three picture a locomotive rushing down the tracks toward a railroad crossing sign. The alarms are set to sound on the hour, about 30 seconds apart.

As the big hand ticks to the top of the hour on a recent morning, No. 1 goes off with a chug-chug-chug and a train whistle. Red lights on the sign blink on and off. No. 2 follows, and then No. 3. And then Roger goes off.

"Whoo, whoo!"

Roger can't walk. He has limited use of his arms and hands, which sometimes flail spastically. A worker dresses him in bed, places him in a mechanical sling to transfer his 138-pound body to his wheelchair. He watches TV for a half hour before breakfast.

The meal consists of whatever is on the menu that day, only Roger's food is blended to the consistency of pudding whether it's French toast or scrambled eggs. He is fed one mouthful at a time with a spoon coated in rubber to keep him from chipping his teeth. Sometimes it takes two gulps to swallow one bite. He sucks down milk or juice through a straw.

A worker then combs his salt-and-pepper hair, brushes his teeth and gives him a shave, if necessary. By 8:30 a.m. he's wheeled to his daily activities.

Pooling around

Nine bodies float aimlessly in the 96-degree hydrotherapy pool on a Monday morning. Colorful kites and streamers hang from the ceiling. Rock 'n' roll oldies blare from the radio.