Opinion ID: 1532348
Heading Depth: 2
Heading Rank: 2

Heading: Governmental and Proprietary Activities

Text: Before we can address Petitioner's arguments with respect to the Equal Protection Clause, the Due Process Clause, and Article 19 of the Maryland Declaration of Rights, we must determine whether Montgomery County's provision of health care through the operation of a clinic and subsidization of hospital services is a governmental or proprietary function because this conclusion will determine whether the County may properly assert immunity as a defense in the present action. In Mayor and City Council of Baltimore v. Blueford, 173 Md. 267, 195 A. 571 (1937), and reaffirmed in Austin v. Mayor and City Council of Baltimore, 286 Md. 51, 405 A.2d 255 (1979), we recognized the difficulty in distinguishing between those functions which are governmental and those which are not, [and] established guidelines in [ Blueford ]. E. Eyring & Sons Co. v. City of Baltimore, 253 Md. 380, 382-83, 252 A.2d 824, 825 (1969). We stated, in truth there is no universally accepted or all-inclusive test to determine whether a given act of a municipality is private or governmental in its nature, but the question is usually determined by the public policy recognized in the jurisdiction where it arises. Blueford, 173 Md. at 275-76, 195 A. at 576. Therefore, we crafted the following guidelines: Where the act in question is sanctioned by legislative authority, is solely for the public benefit, with no profit or emolument inuring to the municipality, and tends to benefit the public health and promote the welfare of the whole public, and has in it no element of private interest, it is governmental in its nature. Id. at 276, 195 A. at 576. Moreover, we explained that: [I]t is better that the adequate performance of such an act be secured by public prosecution and punishment of officials who violate the duties imposed upon them in respect to it than to disburse public funds dedicated to the maintenance of such public conveniences as public parks, playgrounds, hospitals, swimming pools, and beaches maintained at the public expense to private persons who have suffered loss through the negligence or default of municipal employees or agents charged with their management. Id. In Gutowski v. Mayor and City Council of Baltimore, 127 Md. 502, 96 A. 630 (1916), we created a temporal means of categorizing local government action as either proprietary or governmental in nature, and we noted that all of the cases imposing liability on municipalities had involved proprietary functions. Id. at 508, 96 A. at 632. Extensive research has revealed no case prior to Gutowski where this Court has determined that a local government's provision of subsidized health care to less affluent residents, or more generally the administration of a hospital by a municipality, created liability on the part of the local government as a proprietary function. In fact, our cases appear to indicate the contrary. In Finan v. Mayor and City Council of Cumberland, 154 Md. 563, 141 A. 269 (1928), we recognized that [f]or many years there has been general statutory authority given to municipal and county authorities in Maryland to provide hospitals or temporary places for the reception of the sick.... And during a large part of the existence of state government, hospitals of various kinds have been maintained here by governmental agencies, and it has generally been regarded and treated as a normal governmental activity. Id. at 564-65, 141 A. at 270; see also Thomas v. Bd. Of County Commissioners of Prince George's County, 200 Md. 554, 559, 92 A.2d 452, 454 (1952) (noting that [p]erhaps it has been assumed by litigants that a municipality is no more liable than a charitable corporation. In at least two cases in this Court, operation of a hospital is mentioned as an illustration of just such a governmental function); Blueford, 173 Md. at 276, 195 A. at 576 (stating, in dicta, that hospitals are considered governmental functions of the municipality). Moreover, it is beyond question that the County's program providing prenatal health care to low-income mothers residing therein is solely for the public benefit and tends to benefit the public health and promote the welfare of the public. The County's program enables mothers who otherwise would not be able to afford prenatal care or to have their child delivered in a hospital to do so in an amount reduced from $5,000.00 to $1,500.00 payable solely to the hospital. [12] As a result, the County's program, Project Delivery, in this circumstance is entitled to absolute governmental immunity under the terms of the LGTCA. Therefore, Petitioner cannot prevail on the claim directly against Montgomery County due to its governmental immunity. Thus, the only issue remaining is the applicability of the 180-day notice requirement with respect to Petitioner's claim against Dr. Footer and Montgomery County's obligation to defend and indemnify Dr. Footer under the LGTCA.