FULTON, Mo. - Columbia police arrested Rudy Perez, Jr. for brutally killing Robert Hill at the Truman VA Hospital in February.
Just days before Perez's murder trial in September, he discovered prosecutors had accepted his plea of not guilty due to reason of insanity.
That means instead of going to a prison in the Department of Corrections, Perez is now in the Fulton State Hospital and specifically, the Biggs Forensic Center.
Biggs is the only maximum security psychiatric facility in Missouri and is part of the oldest state psychiatric facility west of the Mississippi River.
Inside its doors is the most dangerous work environment in the state. Not only because of the approximately 140 clients like Rudy Perez, but also because of a building that was built before World War II.
The Biggs Forensic Center opened in 1937 and the advancements in the study and treatment of mental health since then are a stark contrast to the facility where those new skills are practiced.
Because of state rules, officials would not allow ABC 17 News to bring in a video camera during a tour of the facility. The Department of Mental Health, however, did provide video they filmed.
The first thing people will notice are the long and narrow hallways with cinder blocks on both sides. There are also sharp, blind corners where someone can go unnoticed before it's too late.
There are ceiling that someone of an average height of 5'10" can easily reach, and in some cases, rip down if they decided to.
Also, parts of the building are patched together because they are coming apart at the seams, and literally falling away from the structure.
"The gym right above us is no longer in service because of the asbestos," said Sandy Dreyer, the director of Dietary Services at Fulton State Hospital.
She oversees a department tasked with feeding nearly 450 people three meals a day, but not necessarily the same meal.
Each client has a specific diet: Maybe a pureed meal, or a vegetarian meal, or one without tomatoes. The trick comes in how to make a modern menu with seemingly ancient obstacles.
"We have a number of pieces that came off a decommissioned warship from the Korean War," Dreyer said. "This is an original cooler. See the big hole down here? It's pretty hard to fix. I'm proud of my staff, they work hard, but it's far from ideal. It's the 1930s."
Rep. Jeanie Riddle's (R-Mokane) legislative district includes Callaway County. She says she tries to go to Fulton State Hospital anytime a senator or representative wants to take a tour because it is an important issue. Every time she visits, she says she sees hurting in a multitude of areas.
"Why don't we have a new facility?" she asked. "It costs a lot of money to build one, that's number one."
Two years ago, she was able to pass legislation on the session's last day to limit the number of hours a Fulton State employee can work during a given shift.
"Support is there, we need a new facility," Riddle said. "Obviously, if you look at it from a client standpoint, it's not a place to get better."
"There was a big push in the last general assembly to replace Biggs [Forensic Center]," said Sen. Kurt Schaefer (R-Columbia). "About $210 million to build a new hospital to replace Biggs. There was a lot of momentum to get that done. Unfortunately we got part of it but not all of it."
"Part of it" was $13 million for planning and design for the replacement of the Fulton State Hospital.
Over the summer, Gov. Jay Nixon withheld that money when he had questions about the state's financial situation.
According to an email from Nixon's budget director Linda Luebbering, "the governor released $2 million to begin the planning and design work for replacing Fulton State Hospital. Additional spending may be released at a later time."
When asked when that would be, Nixon's press secretary told ABC 17 News, "the remainder of the funding may be released during the course of this fiscal year as more indicators come in regarding the state's financial situation."
So, will a new facility be built?
"It has to be built," said Schaefer. "It's not a question of if it will be built, it has to be built."
"People have priorities where the money should be spent, and a new mental hospital for people who have been committed is not one of them," said Riddle.
Riddle added the new hospital should not just be built for the people housed there, but for the people who work at the facility.
"The population that serves those clients have a very difficult job," said Riddle. "It is arguably the most dangerous place to work in the state of Missouri."
Fulton State Hospital employs nearly 1,200 people. According to data from the Office of Administration, that's about two percent of state employees.
And according to the Missouri Labor Department, state employees filed 810 workers' compensation claims in 2009. Fulton State Hospital employees filed 170 of those.
That means a facility that employees just two percent of the state's employees accounted for more than 20 percent of the state's workers' comp claims.
So far this year, that number is 13 percent.
Martin-Forman says a new facility needs to be considered, not only for the staff, but also for the clients.
"The clients in Biggs are considered 'maximum security clients' the circuit courts commit to us," said Marty Martin-Forman, the chief operating officer at Fulton State Hospital. "They have to have committed a certain level of crime to be in Biggs. They've had to have committed a high level of crime to be in Biggs."
Rep. Riddle says Missouri law doesn't allow the state to set money aside each year until it saves up enough to build a new facility.
"It's going to require a tax increase or a bond, and people don't want to do that," she said. "But at some point, we can't kick the can down the road. We have individuals who work there having their lives destroyed by working there."
Martin-Forman has been working at the facility for more than three decades. The reason she stays, she says, is because of the work the facility and its employees do.
"This hospital is amazing, what it is able to do in terms of treatment and to help individuals recover from mental illness," she said. "Despite the buildings and the physical campus, the treatment technologies here are incredibly good."
Since word of this story first began circulating, ABC 17 News has received numerous phone calls and emails from people associated with the Fulton State Hospital.
That includes a letter from the former Missouri Director of Public Safety, Charles Jackson. He said as director, he was responsible for a number of agencies, like the Missouri State Highway Patrol, Water Patrol and Capitol Police, yet no employees with those agencies compare to Fulton State Hospital workers.
"These agencies all were engaged in high risk duties, yet their combined rate of workers' comp didn't come close to the state hospital," Jackson wrote.