### TEXA S C OU R T OF A PPEAL S, THIR D DIST R ICT , AT AU STIN

NO. 03-04-00253- CV

Te xa s St at e Boa r d of P odi at r ic M e dic al E xa m ine r s, App e lla nt
v. Texas Orthopaedic Association, Texas Medical Association

and An drew Kant, Appellees

F ROM THE DISTRICT CO URT OF TRAVIS COUNTY , 345TH JUDICIAL DISTRICT

NO. GN204022 , HO NORAB LE PAUL DAVIS, JUDGE P RESIDING

M E M O R

A N D U M O P I N I O N
The Te x as State Boa

rd of Podiatric Me dical Examiners (the B oard) appea ls the trial
c ourt ’s de nia l of its ple a to the jur isd ic tio n. Th e B oa rd c on te nd s that the Te xas Ort ho paed ic As so c ia tio n, Te xas M e dic a l A sso c ia tio n, and Dr. An dr e w K ant ( c oll e c tiv e ly , th e As so c ia tio ns ) la c ke d s tand ingto c ha lle ng e on e of its ru le s b e c a

us e their pl eadi ng s d id n ot a ff ir ma tiv e ly de mon str a te tha

t any le g a l r ig ht or pr ivi le g e of the ir ind ivi du a l me mbe rs wo uld be int e rf e re d w ith
or imp a ir e d b y

the ru le and

that th e re wa s no thr e a t that th e ru le wo uld be a pp lie d to the ir

me mbe rs . We disag ree with the Boa rd and a ffirm the tria l court’s de nial of the plea to the jurisdiction.
BACK GR OUND Although the underlying dispute in this case cente rs on whether the ankle is pa rt of the foo t , we re v i ew here only the standing of the Assoc iations to challeng e a r ule adopted by

theP o d i a tr y i s t h e t r e a t m e n to f

o r o f f e r t o t r e a t an y d i s e a s e , d i s o r d e r , p h ys i c a l i n j u r y, 1 defor mity , or ailment of the huma n foot by

any sy stem or method. Tex. Occ. Code A nn. § 202.001(a) (4) ( West 2004).

Th e B oa rd de fi ne d f oo t to inc lud e , “ the tib ia

and fi bu la in t he ir art ic ulatio n wi th the ta lus , 2 and a ll b on e s to the toe s, inc lus ive of a ll s of t ti ssu e s ( mus c le s, ne rv e s, va sc ula r s tr uc tur e s, te nd on s, lig a me nts , a

nd any oth e r a natom ic a l stru c tur e s) that in se rt int o th e tib ia

and fi bu la in t he ir articulation with the talus and all bones to the toes.” 22 Te x . Admin. Code § 375.1 (2001).

The Assoc iations sought dec laratory relief unde r th e A d mi n is trative Proce dure A ct (APA) 3 and the Unif

orm Dec laratory

J udg ments Act. See Tex. Gov’t C ode Ann. § 2001.038 (West 2000); Tex. Ci v. Prac. & Rem. Code Ann. § 37.004(a ) (West 1997).

A per son may appea l f

rom an interlocutory order of a district c ourt that g rants or de nies 4 a plea to the jurisdiction by a g overnme ntal unit. Tex . Civ. P rac . & Re m. Code Ann. § 51.014(a) (8) (West Supp. 2004-05). 2 B o ar d
. T h e B o ar d h a s s t a tu t o r y a u t h o r i t y t o r e g u l a t e t h e p r a c t i c e o f p o d i a t r y. See Tex. Occ . Code 1 Ann. § 202.151 (West 2004). The oc cupation code does not de fine “foot.” On J anuar y 17, 2001, the B oa rd a do pte d a ru le de fi nin g the fo ot a s inc lud ing pa rt of the ank le
. Th e As so c ia tio ns fi le d s uit

2 seekinga dec larati o n i n v al i d at ing the Boa rd’s rule and dec laring that the statutory scope of the pr a c tic e of

po diatr y is c on fi ne d to the fo ot as ma tte r o f l aw. I n r e sp on se , th e B oa rd fi le d a ple a to 3 the jurisdiction claiming that the Associations lacke d standing to challeng e its rule bec ause the leg al rig hts or privileg es of the A ssociations’ member s have not be en interf ere d with or impaired by

the rule a nd there was no thre at t h at t h e ru le would be a pplied to their individual members. The tr ial court de nied the plea

to the jurisdiction, and this int erloc utory appea l followed. 4
STA ND AR

D O F RE VI EW Stan d in g is a

p r e r e qu is it e to s u

b je c t- matt e r

ju r is d ic ti o n , an d

s u b je c t- ma tter jurisdiction is essential to a court’s power to hear a ca se. Texas Ass’n of Bus. v. Texas Air Control3

Bd. , 852 S.W .2d 440, 443 (Tex. 1993)
. The absenc e of subject-matter jurisdiction may

be ra ised by a plea to the jurisdiction. Bla nd Indep. Sc h. Dist. v. Blue , 34 S.W .3d 547, 554 (Tex. 2000). To invoke a court’s authority , a plainti ff must alleg e facts t hat affirmatively demonstrate that the court has jurisdiction to hea

r the c ause. Texas Dep’t of Parks &W

ildlif e v. M iranda , 133 S.W .3d 217, 226 (Tex. 2004). W h en a plea to the jurisdiction cha lleng es jurisdictional fac ts, we consider rele vant evidenc e as ne cessa

ry to resolve the issues r aised. Id . at 227. We revie w the denia l of a plea to the jurisdiction de novo
. Id . at 22 8; Texas N atural Res. Conservation Comm’n v . IT-Davy , 74 S.W .3d 8 4 9 , 8 5 5 (T ex . 2 0 0 2 ) ( ci t i n g Ma y he w v . To wn o

f Su nn y v ale , 9 6 4 S. W. 2 d

9 2 2 , 9 2 8 ( T e x. 1 9 8 8 ) )
. We liberally co n strue the plea dings a nd rele vant evidenc e in favor of jurisdiction, looking to the p la in ti f f ’ s in te nt. Mi r a nda , 1 33 S.W. 3d a t 22 6; City

of S an An ge lo v . S

mi th , 69 S.W .3d 303, 306 (Tex. App.—Austin 2002, pet. denied).

Th e g e ne ral te st f

or sta nd ingin T e xas r e qu ir e s th a t th e re be (a ) a re a l c on tr ov e rs y betwee n the parties, which (b) will ac tually be dete rmined by

the judicial dec laration sought. Texas As s’ n o f B us . , 852 S.W .2d at 446. Tex as cour ts apply the Hu nt test when de termining whether an org anization has st anding to sue on behalf of its members. Id . at 447 (a dopting test for associational
s ta n d in g s e t f

o rth in Hunt

v. W ashington Stat e Adv er. Comm’n , 432 U.S. 333, 343 (1977)). A n
or g anizatio n h a s st and ingto s ue on be ha lf of its me mbe rs if

a re vie w o f i ts p le a din g s a nd a ll
e vid e nc e re le va

nt t o ju risd ic tio n a ff

ir ma tiv e ly de mon str a te s th a t ( a ) i ts m e mbe rs wo uld oth e rw ise have sta nding to sue in their own rig ht; (b) the intere sts it s eeks t o protec t are g erma ne to the org anization’s purpose; and ( c) ne ither the c laim asserte d nor the re lief re q uested re quires the participation of individual members in the lawsuit. Id
.To seek de clar atory relief under the APA a plaintiff must alleg e that a r ule or its threatened 5 application interf

ere s with or impairs, or t h re at en s to interfer e with or impair, a leg al rig ht of the plaintiff. Tex. Occ. Code. A nn. § 2001.038(a) (West 2000). I mpair i s d ef

i n ed as, “to make or ca

use to bec ome worse ; dimini sh in ability , value, 6 excellence .” Random House Dictionary of the English Language (Stuart B . Flexner e t al. eds., 2d ed. 1987). In construing a statute we start wi t h t he plain and c ommon meaning of the statute’ s words. Fitzgerald v. Advanc e Spine Fi xa t i o n S ys . , Inc. , 9 9 6 S. W. 2 d

8 6 4 , 8 6 5 ( T e x. 1 9 9 9 ) ; T e x. Gov’t Code Ann. § 312.002( a) ( West 1998). 4 DI SCU SSIO N I n its so le iss ue on a

pp e a l, the B oa

rd argue s that the As so c ia tio ns la c ke d sta nd ingto
se e k a de c larator

y jud g me nt b e c a

us e the y fa ile d to a ff

ir ma tiv e ly de mon str a te ho w the B oa rd ’s ru le int e rf e re d w ithor

imp a ir e d a

ny le g a l r ig ht o r p ri vil e g e of the ir ind ivi du a l me mbe rs . We n owa pp ly 5 the Hu nt test to the fac ts of this case.

The fir st prong of the Hunt te st r e qu ir e s th a t th e As so cia ti on s’ ple a din g s, in conjunction with any

evidenc e in the re cord r eleva nt to jurisdiction, d emonstrate tha t the Associations’ member s have standingto sue in their own behalf
. Id. This require ment should not be int erpr eted to im pose an unr easona ble obstacle to associational standing
. Id .; se e als o Ne w York Sta te Clu b A ss’n v . Ci ty

of N e w York, 487 U.S. 1, 9 (1986) (statingthat purpose of first prong of Hunt test is sim ply

to weed out plaintiffs who try to bring case s that could not otherwise be broug ht by manufa cturing alleg ations of standing that lack a ny rea l f oundation). I t does not appea r that the Associations have manufa cture d this lawsuit, and we conclude that they have demonstrated that the B oa rd ’s ru le imp a ir s a

le g a l r ig ht o r p ri vil e g e po sse sse d b y the ir ind ivi du a l me mbe rs . 6 Phy sicians and or

thopaedists are licensed to pr actice medicine in this st ate a s long a s they comply with the requirements and regulations of t he Te x as Medica l Practice Act (the Act). See5

Tex. Oc c. Code Ann. §§ 151.001-165.160 ( West 2004). The leg islature believe s that the prac tice of me dic ine is a

pr ivi le g e and

e na c te d th e Ac t to re g ulate the g ra nti ngof that pr ivi le g e in o rd e r t o protec t the public’s intere st. Id. § 151 .0 03 (1 ). L ic e ns e d pod ia tr ist s ar e e xemp t f ro m c omp lyingwi th the Act a s long a s they strictly eng ag e in the pra ctice of p odiatry as def ined by law. Id. § 151.052(a) (5).

I n their orig inal petition the Associations urg e that the B oard’ s expanded definition of foot extends the prac tice of podiatry bey ond its statutory

limit s and into the prac tice of me dicine reg u late d b y th e A c t. T h e A s s o c iati o n s c o n te n d in th e ir p e ti ti o n th a t in d iv id u a l p h y s ic ia ns have standing to seek a

deter mination of t h e ex tent to which podiatrists may eng ag e in the pra ctice of medicine in lig ht of the B oard’ s rule. Al t h o u gh the Associations do not expli citly state that the Boa rd’s de finition im pairs a leg al right or privil eg e of individual Tex as phy sicians, it is clear f rom their orig inal petition and the attac hed af fidavit o f Dr
. Da v i d Teusche r that they believe that po diatr ist s h a ve no statut or y ri g ht to e ng a g e in the pr a c tic e of me dic ine and

that a llo wi ngpo diatr ist s to do so undermines the purpose of the Ac t. Essentially , t h ey asser t in their pleading that if the Boa rd gra nts p o d iatr is ts th e r ig h t t o p e r f o r m p r o c e d u r e s th a t w o u ld

o th e r w is e b e c o n s id e r e d

the prac tice of me dicine, the pr ivilege of pra cticing medicine is diminished beca use podiatris t s are neither lice nsed nor tra ined to prac tice medicine
.

The Associations have suf ficiently demonstrated that the Boa rd’s rule may

impair a pr ivi le g e po sse sse d b y

the ir ind ivi du a l memb e rs . Th e re fo re , the ir me mbe rs wo uld have sta nd ingto sue in their own r ight. The Associations have satisfied the fir st prong of the Hunt te st.6 The second prongof the Hunt test require s that the Associations’ pleading s and any evidenc e in the re co rd re levant to this jurisdictional question demonstrate that the intere sts the Associations seek to pr otect ar e g erma ne to their org anizational purpose. Te x as As s’ n o

f B us . , 852 S.W. 2d a t 44 7. Do nn a

Park e r, Exe c uti ve Di re c tor of the Te xas O rt

ho pa e dic As so c ia tio n, state d in her a ffidavit that the Orthopa edic Assoc iation’s mission of promoting hig h quality musculoskeletal healthca re f or Texans requir es that it be intere sted in leg islation or rulemaking impact i n g or regulating the provision of m usculoskeletal he althcar e in Texas. Simi larly , L ouis Goodman, Vice President of the Texas Medica l Association, asserted i n his aff idavit that the M edica l Association achie ves its mission of

improving the health of a ll Tex ans by being an advoc ate f

or patients and the profe ssion of medicine. In this declaratory action, the Assoc iations are seeking to protec t the value of their membe rs’ rig ht to practice medicine. The question of who has t he rig ht to practice medicine is directly related to the quality

of the c are provided. The ref ore, we hold that the Associations have met the sec ond prong of the Hunt te st. The fi n al prongof the Hunt test require s that the Associations’ plea dings a nd any
e vid e nc e in t

he re c or d r e le va

nt t o th is j ur isdi cti on a l qu e sti on de mon str a te that ne ith e r t he c la im
asser ted nor the r elief r equeste d neces s i tated the pa rticipation of the individual member s in the lawsuit. Id
. The Associations claim that the B oard’ s rule def ining f oot is invalid. The Associations seek a decla ration invalidating the rule a nd decla ring that the pra ctice of

podiatry is confined to the foot as a matter of law . The As s o ci at i o n s ’ claim is a question of law that does not re quire the pa rt ic ipatio n o f ind ivi du a l memb e rs ; the re lie f sou g ht i s a de c larator

y ru lin g that w ou ld b e un if

or mly7

applied to phy sicians and podiatr ists. We hold that the Associations have satisfied the final prong of Hunt
. The Associations’ pleading s in conjunction wit h all rele vant j urisdictional evidenc e aff irmatively

demonstrate that they

have sta nding to c halleng e t h e Bo ar d ’s rule. There fore , we
ov e rr ule the B oa

rd ’s on ly iss ue on a pp e a l.
CO NC LU SION We hold that the trial court cor rec tly denied the plea to the jurisdiction and a ffirm the t ri al co u rt ’s ru l i n g.

__________________________________________ Be a Ann Smith, J ustice Be fore Chief J ustice L aw, Justi ces B . A. Smith and Pemberton Affir med Filed: Nove mber 12, 2004