Reinstitutionalization Is Not The Answer
This letter to the editor, by John Krizek, appeared in the Hudson Star Observer on August 7, 2025.
President Donald Trump signed an executive order urging states to criminalize and institutionalize individuals experiencing homelessness, addiction, and mental illness. This approach signals a troubling return to outdated and harmful models of care that society has spent decades trying to move beyond.
During the 1980s, I served as County Administrator in Dunn County, Wisconsin. One of my key responsibilities was oversight of the county institution, which housed adults who had often been placed there as infants or young children. Over time, these individuals became institutionalized and, as adults, were diagnosed with developmental and intellectual disabilities. Many of them worked on the “County Farm,” tending cattle and cultivating worms in manure piles for sale to local fishermen.
In 1981, the federal government formally ended the classification of these facilities as “mental hospitals” and eliminated their eligibility for Medicare and Medicaid funding. This decision, while grounded in a broader movement toward deinstitutionalization, created immediate and profound challenges for county governments.
Recognizing the shifting landscape, I recommended the sale of the County Farm—a decision that initially faced opposition from local officials who believed the farm provided therapeutic benefits. Eventually, however, the farms were sold, and we began the process of assessing residents for placement in community-based group homes, which offered a more humane and integrated model of care.
At that time, there were few private providers of group home services. To meet the demand, new agencies had to be developed, often from the ground up. In parallel, many counties established sheltered workshops, allowing residents to contribute meaningfully while generating income to help offset their care costs and reduce the financial burden on property taxpayers.
This transition led to a steady decline in institutional populations. Once-bustling county facilities became oversized and underutilized. As services were reduced, counties faced significant financial strain in maintaining these buildings, which relied heavily on inadequate Medicare and Medicaid reimbursements.
Initially, federal revenue-sharing funds helped bridge the gap. But when this funding was eliminated in 1985, amid high inflation, counties like Chippewa, Dunn, and Eau Claire each experienced annual property tax increases of approximately $1.5 million.
Over time, Chippewa and Eau Claire Counties exited the nursing home sector entirely. Dunn County shuttered its large institution and now operates smaller, decentralized facilities that reflect a modern, community-based care model.
Calls to return to large-scale institutionalization reflect a misguided and regressive vision. Facilities like those of the past no longer exist—and for a good reason. Warehousing individuals with complex needs is neither humane nor effective. It impedes efforts to support recovery, dignity and reintegration into society.
Such proposals reflect a broader political impulse to “remove” vulnerable people from public view rather than address root causes. Homelessness, addiction, and mental illness cannot be solved through confinement. They require compassionate, evidence-based solutions—not a retreat to the failed institutions of the past.
The current model of providing housing, supervision and outpatient therapy has been extremely successful. We do not need Alligator Alcatraz facilities just to clear the streets of human beings who need help.