IN THE SUPREME COURT OF
════════════
No. 05-0986
════════════
Harris County Hospital District, Petitioner,
v.
════════════════════════════════════════════════════
On Petition for Review from the
Court of Appeals for the Fourteenth District of
════════════════════════════════════════════════════
Argued December 4, 2007
Justice Johnson delivered the opinion of
the Court, in which Justice Hecht,
Justice Wainwright, Justice
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
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.
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.
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 (
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 (
B. Governmental Immunity
Governmental
immunity protects political subdivisions of the State from lawsuits for
damages. See Reata Constr. Corp. v. City of
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.
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.”
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.
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
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
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 Acounty, 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
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 Adebts” 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 (
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
(
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.
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
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 (
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 (
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
[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.