The Arc of North Dakota v. State of North Dakota Lawsuit Collection

The Arc of North Dakota v. State of North Dakota case was brought before the United States (U.S.) District Court for the District of North Dakota's (ND) Southwestern Division in 1980. In this class action suit, Arc--previously known as the Association for Retarded Citizens of North Dakota--challenged the state’s treatment of people with developmental disabilities in state schools and hospitals. Specifically, the lawsuit was filed against Governor Arthur A. Link over the substandard conditions for residents at Grafton State School and San Haven State Hospital. The lawsuit was partly influenced by a 1979 “Observation Report” by Special Education professor Steven Taylor, which detailed the poor conditions and staffing issues he saw during his visits to the facilities. Specifically, Taylor highlighted severe overcrowding, a total lack of programming, unsafe furniture, a lack of privacy, and the overuse of physical restraints and sedation. Arc alleged that state officials, through action and inaction, deprived the residents of their constitutional rights, including the rights to privacy, substantive due process, and the right to be free from harm and undue restraint. They further alleged that the state was failing to provide appropriate treatment and care, educational and rehabilitative programs, and pathways to alternative living arrangements outside the institutions.

Grafton State School and San Haven State Hospital had both been providing care for those with developmental disabilities for decades. The former was established as the Institution for the Feeble Minded in 1904. Meanwhile, San Haven opened in 1912 as a tuberculosis sanatorium in the Turtle Mountain region just outside of Dunseith, North Dakota. In the 1960s, its mission shifted to housing “overflow” patients from Grafton, officially becoming a satellite campus under the authority of Grafton’s superintendent in 1973. While Grafton was initially intended to provide education and training, it quickly became a custodial institution where many patients remained for their entire lives. As the length of stays and the number of admitted patients increased, overcrowding and inadequate resources became ongoing issues. By the time of the lawsuit, there were around 850 residents at Grafton, while Judge Bruce Van Sickle argued that the maximum capacity should be only 378. This strain extended to San Haven, which was primarily used for elderly residents and individuals with high physical and medical support needs. San Haven’s outdated facilities and staffing shortages left it ill-equipped to provide safe or humane care.

Following the initial filing, the lawsuit unfolded over a sixteen-year period between 1980 and 1996, moving primarily between the District Court, the U.S. Court of Appeals for the Eighth Circuit, and the U.S. Supreme Court. Judge Van Sickle ruled in favor of the Plaintiffs in 1982, issuing a memorandum and order mandating that the state provide individualized rehabilitation plans, ensure appropriate care in a more private environment, and comply with federal Title XIX regulations and the standards established by the Accreditation Council for Services for Mentally Retarded and Other Developmentally Disabled Persons (ACMR/DD). The order strictly limited new admissions to Grafton and prohibited the use of physical or chemical restraints. In 1984, Judge Van Sickle expanded this into a 60-page order, detailing specific requirements for staffing provisions, fire safety standards, and goals for reducing the number of residents at both facilities.

In order to ensure ongoing compliance, Judge Van Sickle appointed University of North Dakota (UND) professor of medicine Robert Eelkema as Court Monitor in 1982. Eelkema’s duties were expanded in 1984 to resolve disputes and make recommendations to the court about compliance, resulting in a steady stream of Court Monitor reports. In 1985, the court ordered the Monitor to be more proactive, leading to numerous notices of state non-compliance over the following years. San Haven was ultimately closed in December 1987. After some deliberation in 1989 and 1990, an agreement was reached to terminate the Court Monitor position and shift the evaluation duties to the ACMR/DD—which was renamed the Accreditation Council on Services for People with Developmental Disabilities (ACDD) in 1987.

In 1992, after the Eighth Circuit Appeals Court redefined the standards of care mandated by federal law, the court created a Panel of Special Masters to evaluate the extent of state compliance. Chaired by UND law professor Randy Lee, the panel was tasked with reviewing evidence from both parties and determining whether the defendants were now meeting the standards of care outlined in the order. The Special Masters filed their final report in 1994, concluding that because the state had established internal systems to address remaining problems, the federal injunction should be dissolved. Judge Van Sickle issued the final court order in 1995, and the landmark case officially concluded in 1996.

Due to this case, North Dakota’s care for people with developmental disabilities has fundamentally changed. The state now focuses more on independence, self-sufficiency, and community-based group homes, while actively avoiding institution-based care. The Grafton facility now operates as the Life Skills and Transition Center and has moved toward providing temporary, stabilization care for a small number of short-term residents who live in group homes. The Arc, which officially changed its name in 1992, continues to advocate for individuals with intellectual and developmental disabilities today.