# Harris County Hospital District v. Tomball Regional Hospital

> Texas Supreme Court · May 1, 2009

URL: https://www.frixlaw.com/law-library/cases/3008416

## Case

- **Court:** Texas Supreme Court
- **Decided:** May 1, 2009
- **Precedential status:** Published
- **Opinion:** Opinion
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/3008416

## How later opinions describe it (automated extraction)

- noting that the Constitution is the fundamental law of the State
- holding that a statute’s requirement that compensation “shall be made” does not alone waive immunity

## Opinion text

IN THE SUPREME COURT OF TEXAS
IN THE SUPREME COURT OF TEXAS
════════════
No. 05-0986
════════════
Harris County Hospital
District, Petitioner,
v.
Tomball Regional Hospital , Respondent
════════════════════════════════════════════════════
On Petition for Review from the
Court of Appeals for the Fourteenth District of
Texas
════════════════════════════════════════════════════
Argued December 4,
2007
Justice Johnson delivered the opinion of
the Court, in which Justice Hecht,
Justice Wainwright, Justice Medina , and Justice Green joined.
Chief Justice Jefferson filed a
dissenting opinion, in which Justice
O = Neill, Justice Brister , and Justice Willett joined.
In this case
we consider whether Harris County Hospital District is immune from suit by the
Tomball Hospital Authority to recover medical expenses for hospital care the
Hospital Authority rendered to indigent patients. We hold that the Legislature
has not waived the district = s immunity from suit either
by specific statutory language or by implication from a constitutional and
statutory framework.
I. Background
Tomball
Hospital Authority (THA) was created and organized pursuant to chapter 262 of
the Texas Health and Safety Code. Tex.
Health & Safety Code
ch . 262. [1] It owns and operates Tomball Regional Hospital (the hospital) in Harris County. From 2001 to 2002, the hospital
provided medical care to certain indigent patients who were residents of the
Harris County Hospital District (HCHD). THA sought payment from HCHD for the
care it provided, but HCHD refused to pay. THA sued HCHD in district court,
basing its claim on the Indigent Health Care and Treatment Act (IHCTA) and the
Texas Constitution. In a plea to the jurisdiction and motion for dismissal and
alternatively for summary judgment, HCHD asserted that (1) it had governmental
immunity from suit; (2) county courts had exclusive jurisdiction over the
matters; and (3) the Texas Department of Health had exclusive, original
jurisdiction over the claim. THA responded by alleging that jurisdiction was
proper in the district court and that Article IX, Section 4 of the Texas
Constitution and Health and Safety Code sections 61.002(6), 61.0045, 61.060, and
281.056(a), which require a hospital district to provide and pay for indigent
care, waived HCHD = s
governmental immunity.
The trial
court granted HCHD = s
plea to the jurisdiction and motion to dismiss. In an opinion predating this
Court = s decision in
Tooke v. City of Mexia , 197 S.W.3d 325 (Tex. 2006), the court of appeals
concluded that Health and Safety Code section 281.056(a) providing that boards
of hospital districts like HCHD may “sue and be sued” waived HCHD = s immunity from suit. 178 S.W.3d 244, 252-53 . The court of appeals also determined
that the Health and Safety Code did not vest exclusive, original jurisdiction in
either the county court or the Texas Department of Health. Id. at
254-55. The court reversed and remanded the case. Id. at
256.
In this
Court, HCHD challenges the court of appeals = holding that the “sue and
be sued” language in section 281.056(a) waives its governmental immunity. THA
argues the court of appeals is correct, but also contends that even if section
281.056(a) does not explicitly waive HCHD = s immunity to suit, its
immunity is waived by a framework of law that includes the Texas Constitution
and the Health and Safety Code. Additionally, THA argues that upholding
HCHD = s claim that it
retains immunity will lead to: (1) cities withholding taxes collected for
hospital districts in order to offset debts owed by districts to the cities for
indigent care resulting in suits against the cities to recover the withheld
taxes; (2) bankruptcies of cities and municipal hospital authorities; and (3)
violations of Texas Constitution Article III, Section 52(a) by cities in that a
public benefit does not result from expenditures of public funds benefitting indigent parties not entitled to care by the
cities. Disagreeing with THA = s positions, we reverse the
judgment of the court of appeals and dismiss the case.
II. Standard of Review
A party
asserting governmental immunity to suit challenges the trial court = s jurisdiction.
See
State v. Holland , 221 S.W.3d 639, 642 (Tex. 2007). A
motion or plea asserting such immunity involves a question of law that we review
de novo. Id. Further, THA = s assertions require review
of both Texas
constitutional and statutory provisions which involve matters of law and are
reviewed de novo. See City of San Antonio v. City of Boerne , 111 S.W.3d
22, 25 (Tex. 2003); Tex. Nat = l Guard Armory Bd. v. McCraw , 126 S.W.2d 627, 634 (Tex. 1939) (noting that
the Constitution is the fundamental law of the State).
III. Analysis
A. Construction
In construing
the Constitution, as in construing statutes, the fundamental guiding rule is to
give effect to the intent of the makers and adopters of the provision in
question. Cox v. Robison , 150 S.W. 1149, 1151
(Tex.
1912). “We presume the language of the Constitution was carefully
selected, and we interpret words as they are generally understood.” City of Beaumont v. Bouillion , 896 S.W.2d 143, 148 (Tex. 1995). We
rely heavily on the literal text. Stringer v. Cendant
Mortgage Corp. , 23 S.W.3d 353, 355 (Tex. 2000). However, we may consider
such matters as the history of the legislation, Harris v. City of Fort
Worth , 180 S.W.2d 131, 133 (Tex. 1944), the conditions and spirit of the
times, the prevailing sentiments of the people, the evils intended to be
remedied, and the good to be accomplished. See Dir. of the Dep = t of Agric. & Env = t v. Printing Indus.
Ass = n of
Tex. , 600 S.W.2d 264, 267 (Tex. 1980).
In construing
a statute, our objective is to determine and give effect to the Legislature = s intent. State v.
Gonzalez , 82 S.W.3d 322 , 327 (Tex. 2002); see also Tex. Gov = t Code § 312.005; Am. Home Prods.
Corp. v. Clark , 38 S.W.3d 92,
95 (Tex.
2000). We look first to the “plain and common meaning of the
statute = s words.”
Gonzalez , 82 S.W.3d at 327 (internal quotation marks omitted) (quoting
Fitzgerald v. Advanced Spine Fixation Sys., Inc. , 996 S.W.2d 864, 865
(Tex. 1999)).
We determine legislative intent from the statute as a whole and not from
isolated portions. Id.
B. Governmental Immunity
Governmental
immunity protects political subdivisions of the State from lawsuits for damages.
See Reata Constr . Corp. v. City of Dallas , 197 S.W.3d 371, 374 (Tex. 2006).
Hospital districts have such immunity. See Martinez v. Val
Verde County Hosp.
Dist. , 140 S.W.3d 370, 371 (Tex. 2004). Governmental
immunity, like the doctrine of sovereign immunity to which it is appurtenant,
involves two issues: whether the State has consented to suit and whether the
State has accepted liability. Wichita Falls
State Hosp. v. Taylor , 106 S.W.3d 692, 696 (Tex. 2003).
Immunity from suit is jurisdictional and bars suit; immunity from liability is
not jurisdictional and protects from judgments. Tex. Dep = t of Parks & Wildlife
v. Miranda , 133 S.W.3d 217, 224 (Tex. 2004). Immunity is waived only by clear
and unambiguous language. See Tex. Gov = t Code § 311.034 (“[A] statute shall
not be construed as a waiver of sovereign immunity unless the waiver is effected
by clear and unambiguous language.”); Tooke ,
197 S.W.3d at 328-29 .
C. “Sue and be sued”
The board of
managers of a hospital district “shall manage, control and administer the
hospital or hospital system of the district.” Tex. Health & Safety
Code § 281.047. Section
281.056 is entitled “Authority to Sue and be Sued; Legal Representation” and
provides that “[t]he board may sue and be sued.” The court of appeals held that
this language waived immunity from suit. 178 S.W.3d
252 -53. In its brief predating this Court = s decision in Tooke , THA cites Missouri Pacific Railroad Co. v.
Brownsville Navigation District , 453 S.W.2d 812, 813-14 (Tex. 1970), and
Tarrant County Hospital District v. Henry , 52 S.W.3d 434, 448 (Tex.
App.—Fort Worth 2001, no pet.), in support of the court of appeals = decision. HCHD discounts
Missouri Pacific and Henry because they were decided before Tooke . We agree with HCHD.
When an
entity = s organic
statute provides that the entity may “sue and be sued,” the phrase in and of
itself does not mean that immunity to suit is waived. Tooke , 197 S.W.3d at 337 .
Reasonably construed, such language means that the entity has the capacity to
sue and be sued in its own name, but whether the phrase reflects legislative
intent to waive immunity must be determined from the language = s context. Id. Thus, section
281.056(a) does not in and of itself waive HCHD = s immunity. See id.
at 334, 337 . Nor does section 281.056(a ) = s
language indicate a waiver of HCHD = s immunity when considered
in context with the remainder of section 281.056 which specifies who will
represent the district in civil proceedings. This section anticipates the
district = s involvement
in civil proceedings of some nature at some point, but it does not address
immunity from suit. See id.
Likewise, the
other sections of chapter 281 do not, in context, reflect legislative intent to
waive immunity. For example, section 281.050 authorizes a district, in broad
terms and subject to approval of the commissioners
court, to construct, acquire, and maintain property and hospital facilities to
provide services. Section 281.051 grants authority, again subject to approval of
the commissioners court, to contract or cooperate with various governmental and
private entities to fulfill a district = s duties and to enter
contracts to provide for medical care of certain classes of needy individuals.
Section 281.055 authorizes districts to accept gifts and endowments to be held
in trust and to administer them.
The context
in which section 281.056(a) is found shows that the Legislature intended to
invest districts with powers and authority necessary to conduct their business,
subject in large part to approval of the county commissioners court. There is,
however, no indication that by use of the “sue and be sued” language the
Legislature clearly intended to waive districts = immunity from suit. We
conclude that section 281.056(a) does not, either by itself or in context,
clearly and unambiguously waive HCHD = s immunity to suit.
Next, we turn
to THA = s claim that
HCHD = s immunity is
waived by the framework of law created by the Texas Constitution and certain
sections of the Health and Safety Code.
D. Constitutional Provisions
Article IX,
Section 4 of the Texas Constitution was proposed and adopted as an amendment in
1954. It provides that if a hospital district is legislatively authorized and
created, “such Hospital District shall assume full responsibility for providing
medical and hospital care to needy inhabitants of the county and thereafter such
county and cities therein shall not levy any other tax for hospital purposes.”
Id. At
the time the amendment was proposed, city-county hospitals were supported by
both city and county taxes. The amendment was meant to address the issue of city
residents being taxed by both cities and counties to support the hospitals,
while non-city residents paid only county taxes. Dallas = Stake Big in Hospital
Vote , Dallas Morning News , Oct. 24, 1954, at pt.
VII, p. 6. At that time, the common-law doctrine of sovereign immunity that
A no state can be sued
in her own courts without her consent, and then only in the manner indicated by
that consent” had been established in Texas for over one hundred years. See Tooke , 197 S.W.3d at 331 (internal quotation marks
omitted) (quoting Hasner v. DeYoung , 1 Tex. 764, 769 (1847)). The constitutional
language as it was proposed and adopted did not address waiver of a hospital
district = s immunity.
The constitutional language bears on a hospital district = s liability for
providing care, but it does not address the method by which that liability may
be enforced; that is, whether a hospital district is or is not immune from suit
to establish and secure a judgment for the amount of whatever its liability may
be. We need go no further than the plain language of the Constitution to
conclude it does not provide that suits for damages may be filed against a
hospital district. See Bouillion , 896 S.W.2d at 148 . [2] We hold that article IX, section 4 does
not waive a district = s
governmental immunity from suit.
E. Statutory Provisions
Looking next
to the statutes involved, we note that it is more difficult to determine
legislative consent to suit against an entity when language specifying that
“immunity is waived” is absent from the provisions in question. Taylor , 106 S.W.3d at 697 . We have developed aids to help analyze
statutes for legislative consent to suit: (1) whether the statutory provisions,
even if not a model of clarity, waive immunity without doubt; (2) ambiguity as
to waiver is resolved in favor of retaining immunity; (3) immunity is waived if
the Legislature requires that the entity be joined in a lawsuit even though the
entity would otherwise be immune from suit; and (4) whether the Legislature
provided an objective limitation on the governmental entity = s potential liability.
See id. at 697-98 . We have also considered
whether the statutory provisions would serve any purpose absent a waiver of
immunity. See, e.g. , id. at 700; Tex. Dep = t of Transp . v. City of Sunset Valley , 146 S.W.3d 637, 643 (Tex. 2004); Kerrville State Hosp. v. Fernandez , 28 S.W.3d 1, 6
(Tex.
2000).
Pursuant to
the authority granted by Texas Constitution Article IX, Section 4, section
281.002 of the Health and Safety Code statutorily authorizes creation of
hospital districts in counties with populations over 190,000. Section 281.046
provides that if such a district is created, then “[b] eginning on the date on which taxes are collected for the
district, the district assumes full responsibility for furnishing medical and
hospital care for indigent and needy persons residing in the district.” Section
281.046 = s language
parallels that of the Constitution insofar as mandating that once a district
begins collecting taxes for purposes of providing health care to indigents, then
it has the responsibility to provide such care. Our analysis of the similar
constitutional language applies to section 281.046 which is, for purposes of the
issue before us, the same as the language in article IX, section 4. The
statutory language might impact or even foreclose the question of whether a
hospital district is liable for allowable expenses, an issue not before
us, but the statute is silent as to waiver of a district = s immunity from suits such
as the one THA has brought. And section 281.046 neither requires the district to
be joined in some type of suit nor does it set an objective limitation on the
district = s potential
liability. See Taylor , 106 S.W.3d at
697 -98 . In sum, section 281.046 does not waive HCHD = s immunity from suit.
We next
consider THA = s
argument that HCHD = s
immunity is waived by Section 61.002(6) of the IHCTA. Section 61.002 contains
definitions applicable to that chapter:
(6)
“Governmental entity” includes a county, municipality, or other political
subdivision of the state, but does not include a hospital district or hospital
authority.
(7)
“Hospital district” means a hospital district created under the authority of
Article IX, Sections 4-11, of the Texas Constitution.
THA claims
that because a hospital district is excluded from the definition of
“governmental entity,” immunity does not apply to hospital districts for claims
under the IHCTA because only “governmental entities” are protected by the
doctrine of governmental immunity. A fair and reasonable reading of the statute
yields the conclusion that where the term “governmental entity” is used
in the chapter, a hospital district is not included. If the chapter said that
notwithstanding any provision of the chapter that might be interpreted
otherwise, immunity is retained for governmental entities, then THA’s argument would carry greater weight. But the chapter
nowhere addresses immunity of “governmental entities.” Applying the
interpretation aids of Taylor , we conclude that section
61.002(6)’s definition of “governmental entity” which excludes HCHD, does not
waive HCHD’s immunity. See Taylor , 106 S.W.3d at 697 -98 .
Section
61.0045 is entitled “Information Necessary to Determine Eligibility.” Section
61.0045(a) allows medical service providers to require patients to furnish and
authorize the release of information necessary for determination that the
patient is an eligible resident of the service area so the provider may submit a
claim to the A county , hospital
district, or public hospital that is liable for payment for the service.”
Section 61.0045(b) provides:
A county,
hospital district, or public hospital that receives information obtained under
Subsection (a) shall use the information to determine whether the patient
to whom services were provided is an eligible resident of the service area of
the county, hospital district or public hospital and, if so, shall pay
the claim made by the provider in accordance with this chapter.
(Emphasis
added). THA argues that the use of “shall” mandates payment by HCHD, and if the
language is not interpreted as waiving HCHD’s immunity
from suit, then the statute’s use of mandatory language is of no effect. THA
urges that failing to interpret section 61.0045 as waiving immunity would
violate our principles of statutory construction and the Legislature’s mandate
that in interpreting statutes it is presumed the entire statute is intended to
be effective and that a just and reasonable result is intended. See Tex. Gov’t Code § 311.021(2) ,( 3). We disagree with THA. Like our discussion of sections
281.046 and 61.002(6), the analysis for legislative consent to suit applies here
as well: (1) the statutory provisions do not waive the district’s immunity from
suit without doubt; (2) to the extent the statute creates some ambiguity as to
waiver of immunity from suit, we resolve the doubt in favor of retaining
immunity; (3) neither section 61.0045 nor chapter 61 requires a hospital
district to be joined as a party to some type of lawsuit; and (4) neither
section 61.0045 nor chapter 61 places an objective limitation on any potential
liability. See Taylor , 106 S.W.3d at
697 -98 .
Section
61.0045 requires a hospital district to pay claims by a provider for services
rendered to an eligible resident of the district. But as with Article IX,
Section 4 of the Constitution and section 281.046, section 61.0045 is directed
toward the question of whether a hospital district is liable for
allowable expenses; but the statute is silent as to waiver of a district’s
immunity from suit asserting a right to reimbursement by parties such as
THA. Thus, section 61.0045 does not waive HCHD’s
immunity from suit.
Section
61.060 is entitled “Payment for Services.” Section 61.060(b) provides that “[a]
hospital district is liable for health care services as provided by the Texas
Constitution and the statute creating the district.” Section 61.060 also
addresses a hospital district’s liability for payment and not its immunity from
suit. THA’s urging that section 61.060 waives HCHD’s immunity from suit is misplaced for the reasons we
have expressed above as to sections 281.046, 61.002(6), and 61.0045.
F. Additional Considerations
Next we
consider THA’s assertion that the IHCTA is part of a
framework of law that waives HCHD’s immunity from
suit. THA contends that the provisions of the IHCTA, when considered with the
previously discussed language of Article IX, Section 4 of the Constitution and
section 281.046(a) (specifying that a hospital district “assumes full
responsibility for furnishing medical and hospital care for indigent and needy
persons residing in the district”), yield the inescapable conclusion that the
Legislature intended for hospital districts’ immunity from suit to be waived.
Districts could then be required to pay claims for which they are statutorily
liable and for which they have received tax money. THA posits that if the law
were otherwise, hospital districts could collect taxes to pay for indigent care,
yet deny a treating entity’s requests for payment with impunity, thereby
transferring the cost of the care to entities such as THA that do not have
taxing authority. See Tex. Health & Safety Code §§
262.003(e), 281.045(a) (providing that a hospital authority does not have taxing
power). THA warns that if we hold the Legislature has not
waived HCHD’s immunity from suit, then (1) cities will
begin withholding taxes collected for hospital districts and offset those
collections against alleged A debts ” owed by
districts to the cities for indigent care, resulting in numerous suits by
districts to recover the taxes withheld; (2) cities and municipal hospital
authorities will be bankrupted by paying for indigent medical care; and (3)
cities and municipal hospital districts, by expending funds for care of
ineligible indigents will be in violation of Texas Constitution Article III,
Section 52(a). Despite THA’s construct and warnings of
dire results if HCHD prevails here, we disagree with THA that the statutory
framework or predicted negative effects of sustaining HCHD’s claim of immunity to suit justifies our reading clear
and unambiguous waiver language into the statutes. See Seay v. Hall , 677 S.W.2d 19, 25 (Tex. 1984) (“While this
court may properly write in areas traditionally reserved to the judicial branch
of government, it would be a usurpation of our powers to add language to a law
where the legislature has refrained.”); Simmons v. Arnim , 220 S.W. 66, 70 (Tex. 1920) (“[Courts] are not
the law‑making body. They are not responsible for omissions in legislation. They
are responsible for a true and fair interpretation of the written law.”).
Even though a
hospital district assumes responsibility for providing medical and hospital care
as a condition of collecting a tax, none of the statutes referenced by THA
clearly waive a hospital district’s governmental immunity so it can be sued over
how and when the tax receipts are spent. And policy
determinations involving who actually collects taxes, whether collecting
entities are subject to suit if taxes are withheld by the collecting authority,
whether laws will result in bankruptcy of municipal entities, and conforming
statutory mandates for indigent care to constitutional mandates are the very
type of policy decisions the Legislature is expected to make. The
judiciary’s task is not to refine legislative choices about how to most
effectively provide for indigent care and collect and distribute taxes to pay
for it. The judiciary’s task is to interpret legislation as it is written. See McIntyre v. Ramirez , 109 S.W.3d 741, 748 (Tex. 2003) (“Our role . .
. is not to second‑guess the policy choices that inform our statutes or to weigh
the effectiveness of their results; rather, our task is to interpret those
statutes in a manner that effectuates the Legislature’s intent.”). And as
to THA’s contention that municipal hospital districts’
expenditures for certain indigent health care are a constitutional violation, no
one has charged in this case that THA’s expenditures
are unconstitutional, and whether they are is not an issue properly
presented.
THA also argues
that in light of the constitutional provision, the Legislature must have
intended to waive immunity to suit by so thoroughly addressing hospital
districts’ liability and procedures for determination of eligibility of
indigents for care. [3] THA refers to two statutes that have been
interpreted as waiving sovereign or governmental immunity by language that the
governmental entity “is liable for” certain damages, similar to the statutes
under consideration here. The first is the Tort Claims Act’s provision that “[a]
governmental unit in the state is liable for . . . property damage, personal injury,
and death” under certain circumstances. See Tex. Civ. Prac. & Rem.
Code § 101.021. THA
cites University of Texas Medical Branch v. York , 871 S.W.2d 175, 177-79
(Tex. 1994),
for support. THA’s reliance on the language of the
Tort Claims Act and York is misplaced. First, the Tort Claims Act
specifically waives immunity in section 101.025:
101.025
Waiver of Governmental Immunity; Permission to Sue
(a)
Sovereign immunity to suit is waived and abolished to the extent of liability
created by this chapter.
(b) A
person having a claim under this chapter may sue a governmental unit for damages
allowed by this chapter.
Tex. Civ. Prac. & Rem.
Code § 101.025. And in
York , the question was not whether immunity to suit had been waived by
the Tort Claims Act; the issue was whether the use, misuse, or non-use of
information recorded in a patient’s medical records constituted use of tangible
personal property for which governmental immunity is waived. York , 871 S.W.2d at 175 .
THA also points
to Code of Criminal Procedure article 104.002(a) which states “[e] xcept as otherwise provided by this article, a county is
liable for all expenses incurred in the safekeeping of prisoners . . . kept
under guard by the county.” THA refers us to Harris County v. Hermann
Hospital , 943 S.W.2d 547 (Tex. App.—Eastland 1997, no writ), in which a
suspect who was under guard by Harris
County was taken by Life Flight to
Hermann
Hospital and treated. When
the County refused to pay for the care rendered, Hermann Hospital sued. Id. at
548. The trial court denied Harris County’s motion for summary judgment and granted that
of Hermann
Hospital. Id. The question
of immunity to suit was not urged, but the court of appeals, in addressing
Harris County’s claim that article 104.002 did not authorize a third-party
lawsuit against the County held that “[a] lthough the
statute does not explicitly authorize a suit against a county for the payment of
prisoners’ medical expenses, it is clear that the statute imposes liability for
these expenses on counties.” Id. at
550. The court then stated that the hospital’s only recourse after the
County refused to pay was to bring suit. Id. The court relied on former Texas
Local Government Code section 81.041 [4] (now section 89.004) which provided that
“a person may not sue on a claim against a county unless the person has
presented the claim to the commissioners court and the commissioners court has
neglected or refused to pay all or part of the claim.” The court also cited
Farmers State Bank of New Boston v. Bowie County , 95 S.W.2d 1304, 1306
(Tex. 1936), and Jensen Construction Co. v. Dallas County , 920 S.W.2d
761, 770 (Tex. App.—Dallas 1996, writ denied), which interpreted similar
statutory language to determine whether suit against a county was authorized. We
are not persuaded that the referenced authorities are a firm footing for THA.
First, those cases did not rely only on a statute that provided a governmental
entity was liable. Additionally, after those cases were decided, this Court
rejected the argument that Texas Local Government Code Section 89.004 waived
immunity from suit. Travis
County v. Pelzel & Assocs., Inc. , 77 S.W.3d 246, 249
(Tex.
2002).
Furthermore, as
we have noted, “[T]he > heavy presumption in
favor of immunity’ derives not just from principles related to separation of
powers but from practical concerns: > In a world with
increasingly complex webs of governmental units, the Legislature is better
suited to make the distinctions, exceptions, and limitations that different
situations require.’” Nueces County v. San Patricio County , 246 S.W.3d
651, 653 (Tex. 2008) ( quoting City of
Galveston v. State , 217 S.W.3d 466, 469
(Tex. 2007)).
Given the interaction between federal, state, and local entities to provide for
indigent health care, it is the Legislature that is in the better position to
weigh the competing interests, financial burdens, benefits, and allocation of
costs and resources among the participants in the process of providing that
care. If the Legislature intends to waive hospital districts’ immunity from
suit, we have confidence it will do so clearly and unambiguously, not by
implication as THA in effect urges has been done. If we were to hold that waiver
of governmental immunity to suit can occur in the manner contended for by THA—by
repeatedly using language in statutes to the effect that the district “assumes
liability” and “is liable” for expenses—our holding would be at odds with the
Legislature’s plainly expressed intent that statutes not be construed as waiving
immunity unless there is clear and unambiguous waiver language in the statute.
See Tex. Gov’t
Code § 311.034 (“[A] statute shall not be
construed as a waiver of sovereign immunity unless the waiver is effected by
clear and unambiguous language.”); id. § 311.016
(providing that use of the word “shall” in a statute imposes a duty absent another meaning from the context or
specific statutory provision). The language THA references
is not a clear and unambiguous waiver of hospital districts’ immunity
from suit for the type claim it makes. Cf. Tex. Dep’t of
Transp . , 146 S.W.3d at 643-44 (holding that a
statute’s requirement that compensation “shall be made” does not alone waive
immunity). Nor does the whole of the referenced framework of
constitutional and statutory law, when analyzed according to the factors we set
out in Taylor , lead us to the interpretation
THA urges. [5]
IV. Response to the Dissent
The dissent
argues that the case should be remanded based on City of Beaumont v. Bouillion , 896 S.W.2d 143 (Tex. 1995), and City of Elsa v. M.A.L. , 226 S.W.3d
390, 392 (Tex.
2007), which provide that suits for injunctive relief may be maintained against
governmental entities. The dissent claims that by not doing so, we preclude THA
from seeking injunctive relief. But this has always been and remains a suit for
money damages. In the trial court, THA sought judgment for “liquidated actual
damages” for the itemized care it had already provided to specific patients as
well as interest, costs, and attorney’s fees. HCHD filed pleas to the
jurisdiction asserting immunity, and although THA amended its petition twice, it
never requested relief other than monetary damages. Nor did THA ask that we
remand the case so that it may replead and request
such relief. See State v. Brown , 262 S.W.3d 365, 370 (Tex. 2008) (declining to
remand a case when the petitioner did not seek such relief). [6]
V. Conclusion
HCHD’s immunity from suit for damages has not been waived
and the trial court did not have jurisdiction over TRH = s suit. The judgment of the
court of appeals is reversed and the cause is dismissed.
________________________________________
Phil
Johnson
Justice
OPINION DELIVERED: May 1,
2009
[1] Further
references to provisions of the Health and Safety Code will generally be by
section numbers.
[2] Even if we
were to go behind the plain language of the Constitution, the available
legislative history and records of public discussions about the proposed
amendment do not show that any consideration was given to the subject of
immunity from suit.
[3] This argument
is similar to an argument that the statutes at issue would have no purpose
absent waiver of HCHD’s immunity from suit. See
Tex. Dep’t of
Transp . , 146 S.W.3d at
643 . THA does not claim that the statutes have no purpose in the absence
of waiver. To the contrary, at oral argument THA candidly professed that the
statutory construct is well designed in regard to allocation of responsibility
for indigent care.
[4] See Act of May 15, 1987, 70th Leg., R.S., ch . 149, § 1, 1987 Tex. Gen. Laws 707 ,
793.
[5] THA also
references several Attorney General opinions responding
to questions about county hospital districts’ liability for costs of indigent
care. The opinions address liability of the districts, but not immunity
from suit. The referenced Attorney General opinions do not persuade us that
districts’ immunity from suit has been waived for the reasons we have expressed
as to statutory provisions addressing districts’ liability for indigent health
care costs.
[6] In City of
El Paso v. Heinrich , ___ S.W.3d ___ (Tex. 2009), also issued today, the
Court holds that a claim for prospective declaratory and injunctive relief
against government actors in their official capacities but acting ultra
vires is not barred by immunity even if the requested relief compels the
governmental entity to make monetary payments. However, the Court reaffirms the
principle that immunity bars suits against governmental entities for
retrospective monetary relief. Id. at
___.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/3008416. Public record. Not legal advice.