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In 1866 the almshouse
began accepting the "pauper insane" becoming the state's first facility to specifically accept cases with the diagnosis of chronic insanity. By 1874 the facility had become diversified: 40% was used as a mental illness ward, 27% as a hospital ward, and 33% as an almshouse. The chronically ill population continued to grow, alcoholics were admitted for treatment, and programs providing therapeutic industrial and occupational therapy were added in the 1870's. A Home Training School for Nurses was established in 1894, and the school became a full-fledged three-year program in 1898.