Darrington et al v. Missouri Department of Mental Health et al

1
IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF MISSOURI
CENTRAL DIVISION
DEBRA DARRINGTON, as next friend 	)
for M.R., et al., on behalf of themselves 	)
and others similarly situated 	)
)
Plaintiffs, 	)
)
v. 	) 	Case No. 2:25-cv-04268-MDH
)
MISSOURI DEPARTMENT OF 	)
MENTAL HEALTH, et al 	)
)
Defendants. 	)
ORDER
Before the Court is Defendants’1 Dr. Mina Charepoo, Dr. Kishore Khot, Brian D. Neuner,
Lynne Unnerstall, Jhan R. Hurn, Dennis H. Tesreau, and Teresa E. Coyan (collectively “MMHC
Defendants”) and Missouri Department of Mental Health (“DMH”) Motion to Dismiss the claims
against them for failure to state a claim, pursuant to Rules 12(b)(6). The Complaint contains four
Counts: Count I – Deprivation of Substantive Due Process for Evaluation Class; Count II –
Deprivation of Substantive Due Process for Restoration Class; Count III – Discrimination in
Violation of the ADA; Count IV – Discrimination in Violation of the Rehabilitation Act.
Defendants allege: (1) Plaintiffs lack standing against all Defendants in the claim raised in
Count I, and Plaintiffs lack standing against MMHC Defendants in all claims; (2) Sovereign
immunity bars Counts I and II against Defendant DMH; (3) Even if Plaintiffs had standing to sue
1 Defendant Valerie Huhn was dismissed without prejudice from this case after a Stipulation of Dismissal was filed
by the Parties (Docs. 38, 39). The stipulation reasoned she was dismissed “in light of the Department’s [DMH’s]
participation in this case as a named defendant.” Below, the Court rules DMH is protected under the Eleventh
Amendment’s sovereign immunity. The Court notes, in light of DMH’s absence, if Defendant Huhn’s participation is
central to the relief sought, the absence of the agency head may complicate enforcement, if any is appropriate, in this
case.
Case 2:25-cv-04268-MDH Document 82 Filed 04/07/26 Page 1 of 9

2
MMHC Defendants under Counts I and II in Plaintiff’s Complaint, MMHC Defendants have
sovereign immunity for the declaratory and injunctive relief sought because Ex parte Young’s
“Some Connection” requirement is not met; and (4) Counts I and II against MMHC Defendants
and Counts III and IV against Defendant Huhn should be dismissed as redundant.
The matter is now ripe for review. For the reasons stated herein, the Motion to Dismiss is
GRANTED in part and DENIED in part.
BACKGROUND
Plaintiffs filed this putative class action lawsuit to address wait times for forensic mental
health services in the state of Missouri. Plaintiffs and other similarly situated individuals who are
members of the proposed putative class (collectively, “Plaintiffs”) are either suspected of being,
or have already been deemed, incompetent to stand trial (“IST”) and are regularly housed in
Missouri’s jails while they await their court-ordered competency treatment. Defendants currently
maintain a waitlist for competency evaluations and restoration services. That waitlist is comprised
of hundreds of Missourians living with serious mental illnesses or other competency issues, all of
whom wait months or even years in jail before they receive court-ordered services. Plaintiffs argue
this practice is unconstitutional and inhumane and makes competency restoration more challenging
because of the decompensation that occurs when someone who is seriously mentally ill is housed
in a jail as opposed to a treatment environment. Plaintiffs argue these wait times, allegedly caused
by Defendants, deprive Plaintiffs of their due process rights protected by the Fourteenth
Amendment and violate Title II of the Americans with Disabilities Act of 1990 (“ADA”) and
Section 504 of the Rehabilitation Act of 1973 (“RA”). Plaintiffs seek declaratory and injunctive
relief from this Court to stop this practice.
Case 2:25-cv-04268-MDH Document 82 Filed 04/07/26 Page 2 of 9

3
STANDARD OF REVIEW
A complaint must contain factual allegations that, when accepted as true, are sufficient to
state a claim of relief that is plausible on its face. Zutz v. Nelson, 601 F.3d 842, 848 (8th Cir. 2010)
(citing Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009)). The Court “must accept the allegations
contained in the complaint as true and draw all reasonable inferences in favor of the nonmoving
party.” Coons v. Mineta, 410 F.3d 1036, 1039 (8th Cir. 2005) (internal citations omitted). The
complaint’s factual allegations must be sufficient to “raise a right to relief above the speculative
level,” and the motion to dismiss must be granted if the complaint does not contain “enough facts
to state a claim to relief that is plausible on its face.” Bell Atl. Corp v. Twombly, 550 U.S. 544, 545
(2007). Further, “the tenet that a court must accept as true all of the allegations contained in a
complaint is inapplicable to legal conclusions. Threadbare recitals of the elements of a cause of
action, supported by mere conclusory statements, do not suffice. Ashcroft, 556 U.S. at 678 (citing
Twombly, 550 U.S. at 555).
DISCUSSION
I. 	Article III Standing – Count I
A plaintiff bears the burden of establishing Article III standing by showing “(i) that [the
plaintiff] suffered an injury in fact that is concrete, particularized, and actual or imminent; (ii) that
the injury was likely caused by the defendant; and (iii) that the injury would likely be redressed by
judicial relief.” Ojogwu v. Rodenburg Law Firm, 26 F.4th 457, 461 (8th Cir. 2022). The Court
addresses standing first because it is a jurisdictional requirement. See Hekel v. Warfield, Inc., 118
F.4th 938, 941 (8th Cir. 2024).
Case 2:25-cv-04268-MDH Document 82 Filed 04/07/26 Page 3 of 9

4
Defendants argue Plaintiffs lack standing against all Defendants in the claim raised in
Count I because the only named class representative, Plaintiff D.W., did not establish an injury in
fact. Plaintiff argues D.W. had Article III standing at the time of filing because he faced imminent
and substantial harm by being subject to Defendants’ waitlist practice and even if D.W. now lacks
standing to bring Count I because he has been evaluated, his claim is “capable of repetition yet
evading review.”
To satisfy Article III, a plaintiff must demonstrate that at the time of filing he had an injury
that was “concrete, particularized, and actual or imminent; fairly traceable to the challenged action;
and redressable by a favorable ruling.” Clapper v. Amnesty Int’l USA, 568 U.S. 398, 409 (2013)
(emphasis added). “At the pleading stage . . . general factual allegations of injury . . . may suffice.”
Lujan v. Defenders of Wildlife, 504 U.S. 555, 561 (1992); Iowa League of Cities v. E.P.A., 711
F.3d 844, 869 (8th Cir. 2013).
Plaintiffs allege DMH has kept a long-standing, statewide waitlist for court-ordered
competency evaluations and restoration services. According to the Plaintiffs, people often wait six
months or more just to be evaluated, and about half are then found incompetent to stand trial—
after which they may wait an additional 14 months or longer for treatment. The system does not
prioritize individuals based on the severity of their symptoms, and these delays have persisted for
years. Given this pattern, the Plaintiffs argue there is no reason to believe D.W. would be treated
any differently; he would simply join the end of an already overcrowded line. Thus, Plaintiffs
argue as long as he remains in this dysfunctional system, the risk of serious and imminent harm
continues. At the pleading stage, these general factual allegations of injury suffice to withstand a
motion to dismiss.
Case 2:25-cv-04268-MDH Document 82 Filed 04/07/26 Page 4 of 9

5
The Court finds that Plaintiff D.W. presents factual allegations that show he faced
imminent and substantial harm by being subject to Defendants’ waitlist practice. Therefore, named
Plaintiff D.W. has Article III standing. The Motion to Dismiss for Lack of Standing is hereby
DENIED.
II. 	Sovereign Immunity - Defendant DMH
Defendants argue Plaintiffs’ claims against Defendant DMH, in Counts I and II, are barred
by the Eleventh Amendment and sovereign immunity. Plaintiff argues DMH is not entitled to
sovereign immunity because Plaintiffs seek only declaratory and prospective relief, not damages.
Defendants further argue that, as an agency, DMH is entitled to immunity because Ex parte Young
only applies to officials, not agencies.
Ex parte Young is an exception to state sovereign immunity. It allows a plaintiff to sue state
officials, in their official capacity, for prospective (future‑looking) injunctive relief, to stop an
ongoing violation of federal law. Ex Parte Young, 209 U.S. 123, 28 S.Ct. 441, 52 L.Ed. 714 (1908).
But it does not allow suits against the state itself, or a state agency. See Monroe v. Arkansas State
Univ., 495 F.3d 591, 594 (8th Cir. 2007)(“While under the doctrine set forth in Ex Parte Young,
209 U.S. 123, 28 S.Ct. 441, 52 L.Ed. 714 (1908), state officials may be sued in their official
capacities for prospective injunctive relief without violating the Eleventh Amendment, the same
doctrine does not extend to states or state agencies.”). States and state agencies remain immune
under the Eleventh Amendment. Id.
The Court agrees with Defendants that DMH is entitled to immunity. While Plaintiffs are
correct that they only seek declaratory and prospective relief, not damages, it is clear to the Court
that the Department of Mental Health is a state agency and thus remains immune under the
Case 2:25-cv-04268-MDH Document 82 Filed 04/07/26 Page 5 of 9

6
Eleventh Amendment. Claims against Defendant DMH, in Counts I and II, are barred by the
Eleventh Amendment and sovereign immunity. Therefore, the Motion to Dismiss Counts I and II
against Defendant DMH is GRANTED.
III. Article III Standing – MMHC Defendants
Defendants argue that Plaintiffs failed to plead sufficient facts to establish that any of the
MMHC Defendants individually caused Plaintiffs’ injury.
MMHC (comprised of the MMHC Defendants) is responsible for appointing the Director
of DMH and they also play an important and more substantive role in developing and
implementing a competency program in the state of Missouri. Mo. Rev. Stat. § 630.015. The statute
requires them to participate in the development of “all phases of department practices,” including
management of programs and facilities (among other things). Mo. Rev. Stat. § 630.015.2.
MMHC’s direct involvement in overseeing the delivery of competency services in Missouri
supports their inclusion in this case for Article III purposes. Therefore, Defendants’ Motion to
Dismiss MMHC Defendants for lack of Article III standing is hereby DENIED.
IV. Sovereign Immunity - MMHC Defendants
Defendants argue that even if Plaintiffs had standing to sue MMHC Defendants under
Counts I and II in Plaintiffs’ Complaint, MMHC Defendants have sovereign immunity for the
declaratory and injunctive relief sought because Ex parte Young’s “some connection” requirement
is not met. Defendants argue Plaintiffs failed to establish that MMHC Defendants exercised any
control over the management of competency evaluations or restoration services. Plaintiffs argue
MMHC Defendants should not be dismissed from this case in light of their responsibility for
managing DMH facilities and operations, including its delivery of competency restoration
Case 2:25-cv-04268-MDH Document 82 Filed 04/07/26 Page 6 of 9

7
services, and because of their direct responsibilities with respect to the overall provision of
competency restoration services in Missouri.
State officials who may be sued in their official capacities for injunctive or declaratory
relief are proper defendants so long as they have “some connection” to the alleged unlawful
conduct. Ex parte Young, 209 U.S. at 157. This is not a demanding standard: “[the] connection
does not need to be primary authority to enforce the challenged law,” and the official need not
“have the full power to redress a plaintiff’s injury in order to have ‘some connection’ with the
challenged law.” 281 Care Comm. v. Arneson, 638 F.3d 621, 632-33 (8th Cir. 2011). Where, as
here, the law involved is an affirmative constitutional obligation of the State itself, a state official
is a proper defendant under Ex parte Young if he has a responsibility to “give[] effect” to the
obligation. L.A. Cnty. Bar Ass’n v. Eu, 979 F.2d 697, 704 (9th Cir. 1992). “For purposes of the
Eleventh Amendment and Ex parte Young, a state official’s requisite connection with the
enforcement of a statute may arise out of ‘the general law’ or be ‘specially created by the act
itself.’” Calzone v. Hawley, 866 F.3d 866, 870 (8th Cir. 2017) (quoting Ex parte Young, 209 U.S.
at 157).
As stated above, MMHC (comprised of the MMHC Defendants) is responsible for
appointing the Director of DMH and they also play an important and more substantive role in
developing and implementing a competency program in the state of Missouri. Mo. Rev. Stat. §
630.015. The statute requires them to participate in the development of “all phases of department
practices,” including management of programs and facilities (among other things). Mo. Rev. Stat.
§ 630.015.2.
The Court agrees with Plaintiffs that MMHC and the MMHC Defendants had the authority
to enforce or implement changes to DMH policy, procedures, or operations and that authority is
Case 2:25-cv-04268-MDH Document 82 Filed 04/07/26 Page 7 of 9

8
clear from the face of Section 630 itself. Even if the MMHC Defendants are not exclusively
responsible for the due process violations alleged in the Complaint, partial responsibility is
sufficient to satisfy the “some connection” requirement. 281 Care Comm., 638 F.3d at 632-33. The
MMHC Defendants’ direct involvement in overseeing the delivery of competency services in
Missouri supports their inclusion in this case for Article III purposes.
Plaintiffs’ general factual allegations that MMHC Defendants exercised control over the
management of competency evaluations or restoration services are enough to satisfy the “some
connection” requirement under Ex parte Young at the pleading stage. Therefore, the Motion to
Dismiss Counts I and II against the MMHC Defendants is hereby DENIED.
V. 	Redundant Claims
Defendants argue Counts I and II against MMHC Defendants are redundant because they
are duplicative of the claims against the State agency and its Director, making MMHC Defendants
inclusion unnecessary for any injunctive or declaratory relief. As the Court ruled above, DMH, as
a state agency, is immune under the Eleventh Amendment on Counts I and II. Thus, Counts I and
II are not duplicative against the MMHC Defendants. Therefore, the Motion to Dismiss Counts I
and II against the MMHC Defendants is hereby DENIED.
Defendants further argue Counts III and IV against Defendant Huhn should be dismissed
as redundant. Defendant Huhn has previously been dismissed without prejudice from this case.
(Doc. 40). Therefore, the Motion to Dismiss the claims in Counts III and IV against Defendant
Huhn is hereby DENIED as moot.
CONCLUSION
Case 2:25-cv-04268-MDH Document 82 Filed 04/07/26 Page 8 of 9

9
The Court finds that Plaintiffs have Article III standing to bring these claims. The Court
also finds that Defendant DMH, as a state agency, enjoys sovereign immunity for the Due Process
claims in this case.
It is ORDERED that Defendants’ Motion to Dismiss for Lack of Article III Standing is
hereby DENIED.
It is FURTHER ORDERED that Defendants’ Motion to Dismiss Counts I and II against
Defendant DMH is GRANTED.
It is FURTHER ORDERED that Defendants’ Motion to Dismiss MMHC Defendants for
lack of Article III standing is hereby DENIED.
It is FURTHER ORDERED that Defendants’ Motion to Dismiss Counts I and II against
the MMHC Defendants is hereby DENIED.
It is FURTHER ORDERED that Defendants’ Motion to Dismiss the claims in Counts III
and IV against Defendant Huhn is hereby DENIED as moot.
IT IS SO ORDERED.
Date: April 7, 2026
/s/ Douglas Harpool_____________
DOUGLAS HARPOOL
UNITED STATES DISTRICT JUDGE
Case 2:25-cv-04268-MDH Document 82 Filed 04/07/26 Page 9 of 9