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Welsch v. Likins

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Children’s meal in Cambridge State Hospital

Children eat a meal in Cottage 7 of Cambridge State Hospital, ca. 1969. The image is a still from a digitized film reel in the Cambridge State Hospital audio-visual materials, 1923–1984 (State Archives, Minnesota Historical Society, St. Paul). The image appears at 38:22. http://www2.mnhs.org/library/findaids/gr00180/digital/gr00180-003_w.mp4

Welsch v. Likins (1974) was a landmark legal case for disability rights in Minnesota. It dealt with three issues fundamental to the disability community. First, it addressed the right to treatment under the Due Process Clause of the Fourteenth Amendment. Second, the case confronted the provision of care in the least restrictive of environments, including home and community-based services (HCBS). Third, it questioned whether institutional environments violate the Cruel and Unusual Punishment Clause of the Eighth Amendment of the Constitution.

The commitment of disabled Americans to publicly funded, state-operated, and privately owned institutions dates to the eighteenth century. Called “custodial” because they attempted to care for people while confining them, these hospitals, asylums, and schools aimed to train disabled individuals and assimilate them back into non-disabled society. The majority of inmates had developmental and psychiatric disabilities. Legal, medical, and professional changes at the turn of the twentieth century shifted the institutions’ purpose from education to lifelong custodial care.

By the 1940s, institutions had become overcrowded, critically short-staffed, and severely underfunded by state legislatures. As a result, they quickly devolved into human warehouses. Lawsuits against state institutions by disabled people in Pennsylvania and New York set in motion the deinstitutionalization movement—a push for the closure of most, but not all, custodial institutions in the United States, and a shift toward individualized HCBS.

By the 1960s, Minnesota custodial institutions like the Cambridge State Hospital had reached their capacity. Reflecting national trends, many were understaffed and underfunded while remaining overcrowded. Families of those committed grew concerned about the use of restraints—chemical and physical—and the lack of individualized attention their relatives received. Employees within the institutions often shared these concerns, but calls for systematic change typically went unheeded by state lawmakers.

After witnessing the deplorable conditions at the Cambridge institution, the parents of inmate Patricia Welsch obtained legal support from the Legal Aid Society of Minneapolis, which helps individuals with disabilities. Noticing similar conditions statewide, their lawyers, aided by the Arc of Minnesota, filed a class-action lawsuit for more substantial change.

In 1972, six inmates from six separate state custodial institutions in Brainerd, Cambridge, Faribault, Fergus Falls, Hastings, and Moose Lake filed a lawsuit in the US District Court. The plaintiffs in the case, Welsch v. Likins et al., were individuals with developmental disabilities. They argued that the institutional environment, with its prolonged use of restraints, overcrowding, and lack of educational opportunities, violated their constitutional rights. They maintained that the defendants (including Vera J. Likins, the Commissioner of Public Welfare, and individual administrators from each of the six state institutions), failed to provide adequate individualized care, education, and training to the inmates. The State argued that neither state nor federal law required specific forms of treatment.

A two-week trial was held in late 1973. While attention centered on the Cambridge institution, the trial addressed something broader: habilitation, a term for vocational training and rudimentary education designed to assimilate disabled people into nondisabled society. Much witness time was spent establishing the proposition that people deemed “mentally retarded” could develop even though they were believed to be severely handicapped.

On February 15, 1974, US District Court Judge Earl Larson issued his first opinion, ruling in favor of the plaintiffs. The ruling relied heavily on a recent series of lawsuits in Alabama and New York that recognized disabled people’s constitutional right to treatment. The Court disagreed with the State’s stance. It determined that both the US Constitution (specifically the Due Process Clause) and Minnesota state law (the newly amended Minnesota Hospitalization and Commitment Act) mandated that state institutions provide habilitation to their inmates. Judge Larson, however, deferred ruling on the issues relating to cruel and unusual punishment under the Eighth Amendment.

After protracted legal proceedings, the parties reached a settlement in the fall of 1987. The settlement aimed to reduce the use of chemical and physical restraints in custodial institutions, increase the number of direct care workers, and improve the processes for discharging inmates and evaluating them in the community. After these reforms, the case was dismissed in August 1989.

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Ben-Moshe, Liat. Decarcerating Disability: Deinstitutionalization and Prison Abolition. Minneapolis: University of Minnesota Press, 2020.

Bronston, William. Public Hostage, Public Ransom: Ending Institutional America. Conneaut Lake, PA: Page Publishing, 2021.

Burch, Susan. Committed: Remembering Native Kinship In and Beyond Institutions. Chapel Hill, NC: University of North Carolina Press, 2021.

Carey, Allison C. On the Margins of Citizenship: Intellectual Disability and Civil Rights in Twentieth-Century America. Philadelphia, PA: Temple University Press, 2009.

Chamberlain, Chelsea D. “Receiving, Sorting, and Disposing of Children: Institutions, Education, and Feeblemindedness in Progressive America.” PhD diss., University of Pennsylvania, 2022.

Disability Justice. “Welsch v. Likins.”
https://disabilityjustice.org/suits-involving-the-cambridge-state-hospital-cambridge-minnesota/welsch-v-likins

Granquist, Luther A. “A Brief History of the Welsch Case.” Presentation at the American Association on Mental Deficiency, Boston, MA, 1982.
https://mn.gov/mnddc/past/pdf/80s/82/82-granquist-history-welsch.pdf

Halderman v. Pennhurst (1978).
https://law.justia.com/cases/federal/district-courts/FSupp/446/1295/2130357

Harris, Jasmine E., Karen M. Tani, and Shira Wakschlag. “The Disability Docket.” American University Law Review 72, no. 1667 (2023): 1667–1730.
https://aulawreview.org/blog/the-disability-docket

Jensen v. Minnesota Dept. of Human Services (Filing).
https://docs.justia.com/cases/federal/district-courts/minnesota/mndce/0:2009cv01775/107575/224

Jirik, Katrina N. “American Institutions for the Feeble-Minded, 1876–1916.” PhD diss., University of Minnesota, 2019.

Ladd-Taylor, Molly. Fixing the Poor: Eugenic Sterilization and Child Welfare in the Twentieth Century. Baltimore, MD: Johns Hopkins University Press, 2020.

Linnell, Breita, and Colleen Wieck. “Access to Justice: The Impact of Federal Courts on Disability Rights.” Federal Lawyer 59, no. 10 (December 2012): 48–53.
https://disabilityjustice.org/wp-content/uploads/FLDecember2012-Access-to-Justice-Article1.pdf.

Minnesota Department of Human Services. “Person-Centered Practices, Positive Supports and the Jensen Settlement Agreement.”
https://mn.gov/dhs/general-public/featured-programs-initiatives/jensen-settlement

Minnesota Governor’s Council on Developmental Disabilities. Exhibits at the Welsch Trial in 1973: Photo Gallery.
https://mn.gov/mnddc/past/1970s/gallery.html

⸻ . With an Eye to the Past.
https://mn.gov/mnddc/past/index.html

⸻ . Parallels in Time: A History of Developmental Disabilities.
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Minnesota Historical Society Library. State Hospitals.
https://libguides.mnhs.org/sh

PARC v. Commonwealth of PA (1972).
https://pubintlaw.org/cases-and-projects/pennsylvania-association-for-retarded-citizens-parc-v-commonwealth-of-pennsylvania-case-documents

New York Association for Retarded Children v. Carey (1982).
https://law.justia.com/cases/federal/district-courts/FSupp/551/1165/2365985

Rose, Sarah F. No Right to Be Idle: The Invention of Disability, 1840s–1930s. Chapel Hill, NC: University of North Carolina Press, 2017.

Rossiter, Kate, and Jen Rinaldi. Institutional Violence and Disability: Punishing Conditions. New York: Routledge, 2019.

Stenberg, Nathan R. “The Spectre of Institutionalization: Disability, Law, Performance & Policy at the Pennhurst State School & Hospital and Pennhurst Asylum.” PhD diss., University of Minnesota, 2023.

Tani, Karen M. “The Pennhurst Doctrines and the Lost Disability History of the ‘New Federalism.’" California Law Review 110, no. 4 (August 2022): 1157–1219.
https://www.californialawreview.org/print/the-pennhurst-doctrines-and-the-lost-disability-history-of-the-new-federalism

Welsch v. Likins (1974).
https://clearinghouse.net/case/462

Wyatt v. Stickney (1972).
https://law.justia.com/cases/federal/district-courts/FSupp/344/373/2303083

Related Images

Children’s meal in Cambridge State Hospital
Children’s meal in Cambridge State Hospital
Inmates in a recreation room
Inmates in a recreation room
Building at Cambridge State Hospital
Building at Cambridge State Hospital
Day room at Boswell Hall
Day room at Boswell Hall
Crib enclosure at Boswell Hall
Crib enclosure at Boswell Hall
Patients in a day room
Patients in a day room
Newsletter page with photograph of the Welsch family
Newsletter page with photograph of the Welsch family
US District Court Judge Earl R. Larson
US District Court Judge Earl R. Larson

Turning Point

On February 15, 1974, US District Court Judge Earl Larson rules that the Constitution requires states to provide disabled people who are civilly committed to custodial institutions with minimally adequate care, training, and education.

Chronology

1960

The number of people deemed “mentally retarded” existing in custodial institutions in Minnesota surpasses six thousand.

1970

The guardian of Ricky Wyatt, a person deemed living with a developmental disability, files a lawsuit against the Alabama Department of Mental Hygiene, alleging a lack of proper treatment at Bryce Hospital in Tuscaloosa.

1971

Over five hundred positions are eliminated in Minnesota’s ten operating state institutions due to budget cuts by state lawmakers.

1972

A federal judge issues an order in the lawsuit PARC v. Commonwealth of Pennsylvania that affirms the right of disabled children to a free public education.

1972

A federal judge issues an order in Wyatt v. Stickney detailing the standards for minimally adequate care as stipulated by the Constitution. The ruling concludes that institutionalization is a last resort and should meet individuals’ needs.

1972

Patricia Welsch, the mother of an inmate at the Cambridge State Hospital, files a lawsuit against the Minnesota Commissioner of Public Welfare, alleging the institution’s use of restraint infringes upon her daughter’s constitutional rights.

1973

The trial for the Welsch case begins, lasting two weeks.

1974

Judge Earl R. Larson issues his foundational ruling in the Welsch case.

1975

A complaint in the case names the Commissioners of Finance and Administration of Minnesota as additional defendants, expanding the lawsuit’s scope. A separate trial is conducted to assess compliance with Judge Larson’s initial order at Cambridge.

1975

The passage of the Education for All Handicapped Children Act (later renamed the Individuals with Disabilities Education Act—IDEA) legislates the right to public education for students with disabilities.

1976

Judge Larson issues two subsequent orders to further detail and refine his original order from 1974 in the Welsch case.

1977

A judge on the Eighth Circuit Court of Appeals upholds Judge Larson’s orders from 1976, rejecting the appeal by the State of Minnesota. The parties in Welsch approve a consent decree, reforming operating procedures at the Cambridge State Hospital.

1980

Plaintiffs in the Welsch case present their argument to extend the Cambridge consent decree to all institutions in Minnesota, highlighting the need for the development of HCBS resources. The court approves the decree in September.

1990

Congress passes the Americans with Disabilities Act.