## Facts

- In 2015, E.J.K., a minor, left her mother Anmarie Calgaro’s home and obtained a legal aid letter stating her parents had “given up custody” and that she was emancipated.
- Minnesota law required a court order for emancipation; the letter did not legally emancipate E.J.K.
- E.J.K. used the letter to obtain public assistance and housing benefits from St. Louis County.
- E.J.K. presented the letter to Park Nicollet Health Services for gender-transition-related treatment and to Fairview Health Services for prescription medications.
- Park and Fairview allegedly did not know the letter lacked legal effect and treated E.J.K. as able to consent to her own care.
- When Calgaro requested E.J.K.’s medical records, Park and Fairview refused to provide them.
- Calgaro sued St. Louis County and a county public health and human services official under 42 U.S.C. § 1983, alleging interference with her parental rights under the Fourteenth Amendment.
- Calgaro also sued Park and Fairview under § 1983, alleging their treatment decisions and denial of records interfered with her parental rights.
- Calgaro sought declaratory and injunctive relief preventing defendants from providing services to her minor children without her consent.
- By the time the district court ruled, E.J.K. had turned 18.

## Issues

1. Whether the complaint plausibly alleged municipal liability under § 1983 by identifying a county policy, custom, or final policymaker act that caused a deprivation of Calgaro’s parental rights.
2. Whether the complaint stated an individual-capacity § 1983 claim against the county official by alleging personal involvement in the asserted constitutional deprivation.
3. Whether the private medical providers acted under color of state law when they treated E.J.K. and refused to provide records, making them subject to § 1983 liability.
4. Whether requests for declaratory and injunctive relief presented a live controversy after E.J.K. reached age 18.

## Decision

- The Eighth Circuit affirmed dismissal of all § 1983 claims.
- The court held the municipal-liability claim failed because the complaint did not plead nonconclusory facts showing a county policy, custom, or final policymaker action causing a constitutional deprivation.
- The individual-capacity claim against the county official failed for lack of allegations of personal involvement.
- Park and Fairview were not state actors; the complaint did not plausibly allege a basis to treat their conduct as action under color of state law.
- The claims for prospective declaratory and injunctive relief were moot because E.J.K. was an adult and no ongoing controversy was shown.

## Legal Principles

- Municipal liability under § 1983 requires allegations tying the alleged constitutional injury to an official policy, a widespread custom, or an action by an official with final policymaking authority; respondeat superior is unavailable.
- Conclusory assertions that a municipality acted pursuant to a “policy or custom,” without supporting factual content, do not state a plausible Monell claim.
- Individual-capacity liability under § 1983 requires personal responsibility for the alleged constitutional violation; supervisory status alone is insufficient.
- Private entities are liable under § 1983 only if their conduct is fairly attributable to the state (e.g., exclusive public function, state compulsion, or close nexus/joint action); providing medical care and applying ordinary privacy rules generally does not satisfy state-action tests.
- Requests for prospective relief require an ongoing case or controversy; claims directed at conduct affecting a particular minor become moot when the individual reaches majority absent a concrete likelihood of recurrence.

## Conclusion

The Eighth Circuit affirmed dismissal because Calgaro did not plausibly plead a county policy/custom or personal involvement supporting § 1983 liability, the private medical providers were not acting under color of state law, and prospective relief became moot once E.J.K. turned 18.


Calgaro v. St. Louis County, 919 F.3d 1054 (8th Cir. 2019)