the University of Texas Health Science Center at Houston v. Dr. John McNeely ( 2021 )


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  •                              In The
    Court of Appeals
    Sixth Appellate District of Texas at Texarkana
    No. 06-21-00041-CV
    THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON, Appellant
    V.
    DR. JOHN MCNEELY, Appellee
    On Appeal from the 11th District Court
    Harris County, Texas
    Trial Court No. 2020-32037
    Before Morriss, C.J., Burgess and Stevens, JJ.
    Memorandum Opinion by Chief Justice Morriss
    MEMORANDUM OPINION
    John McNeely, a former staff physician and clinical assistant professor of anesthesiology,
    sued his employer, the University of Texas Health Science Center at Houston (UTHSC), in
    Harris County1 for age-related employment discrimination after he was terminated from
    employment at the age of sixty-three and replaced by a physician younger than forty. UTHSC
    filed a plea to the jurisdiction arguing that McNeely failed to establish his age-related
    discrimination claim through direct or circumstantial evidence. After the trial court denied the
    plea to the jurisdiction, UTHSC filed this interlocutory appeal. Because we find that the plea
    should have been granted, we reverse the trial court’s ruling and render judgment dismissing
    McNeely’s claims for lack of jurisdiction.2
    (1)      Legal Framework
    “Sovereign immunity . . . exist[s] to protect the State and its political subdivisions from
    lawsuits and liability for money damages.” Univ. of Tex. MD Anderson Cancer Ctr. v. Simpson,
    No. 01-20-00679-CV, 
    2021 WL 3083104
    , at *4 (Tex. App.—Houston [1st Dist.] July 22, 2021,
    no pet. h.) (mem. op.). “[S]overeign immunity ‘extends to various divisions of state government,
    including agencies, boards, hospitals, and universities.’” 
    Id.
     (quoting Ben Bolt-Palito Blanco
    1
    Originally appealed to the First Court of Appeals, this case was transferred to this Court by the Texas Supreme
    Court pursuant to its docket equalization efforts. See TEX. GOV’T CODE ANN. § 73.001. We follow the precedent of
    the First Court of Appeals in deciding this case. See TEX. R. APP. P. 41.3.
    2
    The trial court also granted McNeely’s motion to compel discovery, which McNeely mischaracterizes as
    jurisdictional discovery. Instead, the record shows that McNeely propounded and sought to compel production of
    documents not limited to the jurisdictional inquiry, including requests to produce trial exhibits, documents showing
    that McNeely’s supervisor was trained on age discrimination, and documents in support of UTHSC’s affirmative
    defenses of statute of limitations, waiver, laches, collateral estoppel, ratification, res judicata, and unclean hands.
    Because nothing in the trial court’s order indicated that its grant of the motion to compel discovery was limited to
    jurisdictional facts, it appears that the trial court denied the plea to the jurisdiction and then granted McNeely’s
    motion to compel general discovery.
    2
    Consol. Indep. Sch. Dist. v. Tex. Pol. Subdivisions Prop./Cas. Joint Self-Ins. Fund, 
    212 S.W.3d 320
    , 323–24 (Tex. 2006)). “We interpret statutory waivers of sovereign immunity narrowly, as
    the Texas Legislature’s intent to waive immunity must be clear and unambiguous.”                    
    Id.
    “Without an express waiver of sovereign immunity or governmental immunity, courts do not
    have subject-matter jurisdiction over suits against the State or its political subdivisions.” 
    Id.
    (citing State v. Shumake, 
    199 S.W.3d 279
    , 283 (Tex. 2006); Tex. Dep’t of Parks & Wildlife v.
    Miranda, 
    133 S.W.3d 217
    , 224–25 (Tex. 2004)).
    It is undisputed that UTHSC is protected by sovereign immunity.                Yet, the Texas
    Commission on Human Rights Act (TCHRA) waives immunity when “[a]n employer commits
    an unlawful employment practice if because of . . . age the employer . . . discharges an individual
    . . . .” TEX. LAB. CODE ANN. § 21.051(1). One of the purposes of the TCHRA is to “provide for
    the execution of the policies of Title VII of the Civil Rights Act of 1964.” TEX. LAB. CODE ANN.
    § 21.001(1).
    UTHSC’s plea to the jurisdiction is based on sovereign immunity. “We review de novo a
    trial court’s ruling on a jurisdictional plea.” Simpson, 
    2021 WL 3083104
    , at *3 (citing Ben Bolt-
    Palito Blanco Consol. Indep. Sch. Dist., 212 S.W.3d at 323; City of Houston v. Vallejo, 
    371 S.W.3d 499
    , 501 (Tex. App.—Houston [1st Dist.] 2012, pet. denied)). “A plea to the jurisdiction
    is a dilatory plea that seeks dismissal of a case for lack of subject-matter jurisdiction.” 
    Id.
     (citing
    Harris Cty. v. Sykes, 
    136 S.W.3d 635
    , 638 (Tex. 2004); Villarreal v. Harris Cty., 
    226 S.W.3d 537
    , 541 (Tex. App.—Houston [1st Dist.] 2006, no pet.)); see Sullivan v. Univ. of Tex. Health
    Sci. Ctr. at Houston Dental Branch, No. 01-08-00327-CV, 
    2008 WL 5179023
    , at *1 (Tex.
    3
    App.—Houston [1st Dist.] Dec. 11, 2008, pet. denied) (mem. op.). “A defendant may use a plea
    to the jurisdiction to challenge whether the plaintiff has met [the] burden of alleging
    jurisdictional facts or to challenge the existence of jurisdictional facts.” Simpson, 
    2021 WL 3083104
    , at *3 (citing Miranda, 133 S.W.3d at 226–27).
    When “the plea challenges the existence of jurisdictional facts, we must move beyond the
    pleadings and consider evidence when necessary to resolve the jurisdictional issues, even if the
    evidence implicates both subject-matter jurisdiction and the merits of a claim.” Alamo Heights
    Indep. Sch. Dist. v. Clark, 
    544 S.W.3d 755
    , 770–71 (Tex. 2018). “In reviewing such a plea, we
    take as true all evidence favorable to the nonmovant, indulging every reasonable inference and
    resolving any doubts in the nonmovant’s favor.” Simpson, 
    2021 WL 3083104
    , at *3 (citing
    Alamo Heights, 544 S.W.3d at 771; Miranda, 133 S.W.3d at 228). “However, we cannot
    disregard evidence necessary to show context or evidence and inferences unfavorable to the
    nonmovant if reasonable jurors could not do so.” Id. (citing Alamo Heights, 544 S.W.3d at 771).
    “This standard mirrors our summary-judgment standard under Texas Rule of Civil
    Procedure 166a(c) and places the burden on the governmental unit, as the movant, to meet the
    standard of proof to support its contention that the trial court lacks subject-matter jurisdiction.”
    Id. (citing Miranda, 133 S.W.3d at 228; Mission Consol. Indep. Sch. Dist. v. Garcia, 
    372 S.W.3d 629
    , 635 (Tex. 2012)).
    “In assessing whether subject-matter jurisdiction exists, we first focus on whether the
    plaintiff’s petition, construed in the plaintiff’s favor, pleads facts that affirmatively show that
    subject-matter jurisdiction exists.” Univ. of Tex. MD Anderson Cancer Ctr. v. Contreras, 576
    
    4 S.W.3d 439
    , 442–43 (Tex. App.—Houston [1st Dist.] 2019, no pet.) (citing Hearts Bluff Game
    Ranch v. State, 
    381 S.W.3d 468
    , 476 (Tex. 2012)). “Sometimes, however, we also must consider
    evidence as to jurisdictional facts.” 
    Id.
     (citing Hearts Bluff, 381 S.W.3d at 476). “If a fact issue
    exists as to whether subject-matter jurisdiction exists and the issue is inextricably entwined with
    the merits, the resolution of this issue is for the fact-finder.” Id. (citing Miranda, 133 S.W.3d at
    226–28). “But evidence also may undermine the jurisdictional allegations of the plaintiff’s
    petition.” Id. (citing Hearts Bluff, 381 S.W.3d at 476). “If the undisputed evidence negates
    jurisdiction, then the plaintiff’s suit must be dismissed.” Id. (citing Miranda, 133 S.W.3d at
    234).
    “[W]hen analyzing a claim brought under the TCHRA, we look not only to state cases
    but also to analogous federal statutes and the cases interpreting those statutes.” Hartranft v. UT
    Health Sci. Ctr.-Houston, No. 01-16-01014-CV, 
    2018 WL 3117830
    , at *11 (Tex. App.—
    Houston [1st Dist.] June 26, 2018, no pet.) (citing Mission Consol. Indep. Sch. Dist. v. Garcia,
    
    372 S.W.3d 629
    , 634 (Tex. 2012)). “Discrimination and retaliation cases under the TCHRA can
    be established with either direct or circumstantial evidence.” 
    Id.
    “In the absence of direct evidence of discrimination, the employee must make a prima
    facie case of discrimination under the McDonnell-Douglas burden-shifting analysis.”3 Anderson
    v. Houston Cmty. Coll. Sys., 
    458 S.W.3d 633
    , 643 (Tex. App.—Houston [1st Dist.] 2015, no
    pet). “The three-part burden-shifting framework set forth in McDonnell Douglas Corp. v. Green,
    3
    “Direct evidence is evidence that, if believed, ‘proves the fact of discriminatory animus without inference or
    presumption.’” Anderson, 458 S.W.3d at 643 (quoting Jespersen v. Sweetwater Ranch Apartments, 
    390 S.W.3d 644
    , 653 (Tex. App.—Dallas 2012, no pet.). “If an inference is required for the evidence to be probative as to the
    employer’s discriminatory animus, the evidence is circumstantial, not direct.” 
    Id.
     Here, as shown by the discussion
    below, we find no direct evidence of discriminatory animus.
    5
    
    411 U.S. 792
    , 802 (1973)[,] enables an employee to establish discrimination with circumstantial
    evidence.” Hartranft, 
    2018 WL 3117830
    , at *11. “If the employee can establish a prima facie
    case of discrimination, a rebuttable presumption of discrimination arises, which can alone sustain
    a discrimination claim.” 
    Id.
     (citing McDonnell Douglas Corp., 
    411 U.S. at 802
    ). “But the
    employer can defeat this presumption merely by producing evidence of a legitimate,
    nondiscriminatory reason for the disputed employment action.” 
    Id.
     (citing McDonnell Douglas
    Corp., 
    411 U.S. at 802
    ). “Once rebutted, the presumption disappears, and an employee lacking
    direct evidence cannot prove a statutory violation without evidence that the employer’s stated
    reason is false and a pretext for discrimination.” 
    Id.
     (citing McDonnell Douglas Corp., 
    411 U.S. at 802
    ); see Democratic Sch. Rsch., Inc. v. Rock, 
    608 S.W.3d 290
    , 308 (Tex. App.—Houston [1st
    Dist.] 2020, no pet.) (“If the employer rebuts the presumption of discrimination, the burden of
    production shifts back to the employee to show that the employer’s stated reason was a pretext
    for discrimination.”). For that reason, “when jurisdictional evidence negates the prima facie case
    or . . . rebuts the presumption it affords, some evidence raising a fact issue on retaliatory intent is
    required to survive a jurisdictional plea.” Alamo Heights, 544 S.W.3d at 764. “In both direct-
    and circumstantial-evidence cases, the burden of persuasion remains at all times with the
    employee.” Hartranft, 
    2018 WL 3117830
    , at *11 (citing McDonnell Douglas Corp., 
    411 U.S. at 802
    ).
    (2)     Factual and Procedural Background
    After receiving notice of his termination from Holger Eltzschig, who was hired in
    September 2016 to serve as Chairman of UTHSC’s Department of Anesthesiology (Department)
    6
    at the McGovern Medical School, McNeely filed a complaint with the Texas Workforce
    Commission Civil Rights Division for unlawful discharge by UTHSC from his positions as
    assistant professor and staff physician. In the complaint, McNeely said,
    Dr. Eltzschig has made clear that he is terminating Dr. McNeely due to
    Dr. McNeely’s age. On three occasions, Dr. Eltzschig has informed Dr. McNeely
    that the department is under budget pressure and has had to cut costs. On three
    occasions, Dr. Eltzschig brought in three different younger replacements for
    Dr. McNeely who are each around age 40 or younger, including the latest who is
    30 years old, to replace Dr. McNeely, who as an older (age 63) and more
    experienced doctor, is paid more. Dr. McNeely was terminated despite
    outstanding performance reviews and multiple letters of support from other
    doctors he worked with, all to save money by replacing him with a younger
    physician who is being paid less.
    McNeely obtained a right-to-sue letter. In this lawsuit, McNeely alleged that he was replaced by
    Dallas Clendeninn,4 a thirty-year-old, part-time, non-benefits-eligible staff physician who was
    hired by UTHSC in 2017 while Clendeninn was completing his fellowship.
    In response to McNeely’s claims, UTHSC filed a plea to the jurisdiction and argued that
    the decision not to renew McNeely’s contract “was due to a reduction-in-force . . . as a result of
    budget concerns.”      According to UTHSC, the Department was forced to cut payroll and
    eliminate three benefit-eligible positions, and McNeely was selected for non-renewal of his
    employment contract “because he was the only benefits eligible Staff Physician that did not have
    a salaried faculty appointment.” UTHSC also argued that McNeely, who also served as the
    medical director of anesthesiology for the Ambulatory Services Center of Memorial Hermann
    4
    This physician’s surname has been spelled various ways in the record. We have chosen to use the spelling
    “Clendeninn” throughout.
    7
    Hospital-Houston Medical Center (ASC), improperly relied on evidence that ASC sought to
    replace him as medical director.
    UTHSC’s plea to the jurisdiction was supported by Eltzschig’s declaration. Eltzschig
    described McNeely’s position, the relationship between UTHSC and the ASC, and the decisions
    related to McNeely’s termination. Eltzschig said that UTHSC had both faculty and non-faculty
    positions and that non-faculty positions, including staff physicians, are categorized as
    administrative and professional employees who may or may not be benefit eligible, do not serve
    fixed terms, and are appointed at the pleasure of the president and with the approval of the
    executive vice chancellor for health affairs. According to Eltzschig, McNeely was hired to work
    in a faculty position in 2005, but voluntarily stepped down from that position in 2011 to become
    a non-benefit-eligible, non-faculty, staff physician.
    To support UTHSC’s claim that McNeely was terminated “because he was the only
    benefits eligible Staff Physician that did not have a salaried faculty appointment,” Eltzschig said
    that McNeely had a voluntary faculty position as assistant professor without pay. Even so,
    McNeely said that his assistant professorship was not without pay and disputed UTHSC’s
    evidence by introducing UTHSC’s memorandum of appointment showing that he was
    compensated for both of his positions at UTHSC. McNeely’s memorandum of appointment
    from UTHSC also showed that, as staff physician, he was required to spend eighty percent of his
    time at the ASC.5
    5
    Eltzschig said that McNeely remained in this position until he was “non-reappointed” on August 31, 2018.
    8
    As for UTHSC’s relationship with the ASC, Eltzschig, as UTHSC’s chairman of the
    department, was responsible for assigning anesthesiologists to work at the ASC. Eltzschig said
    that McNeely, who had served as the medical director at the ASC since November 1, 2007,
    reported directly to the UTHSC department’s vice-chair of clinical affairs, Sam Gumbert, and
    Vice-Chair of Finance Carlos Artime, who were also responsible for the day-to-day scheduling
    of staffing and assignments for the ASC. Gumbert filed a declaration confirming that, in his
    position with UTHSC, he was responsible for the operations of all clinical affairs for the
    Department, which included, in part, financial and staffing coverage at the ASC. Despite this
    connection between UTHSC and the ASC, Eltzschig claimed that the day-to-day operations of
    ASC were managed by United Surgical Partners International (USPI) and that UTHSC did not
    control the operations of ASC. Eltzschig also said that the ASC’s board members, not UTHSC,
    appointed ASC’s medical director, although UTHSC could recommend a candidate for the
    position.
    After Eltzschig was hired in 2016, he noted that McNeely did not have qualifications that
    Eltzschig believed important to enhance the success of the ASC, including regional anesthesia
    fellowships, business training, active teaching, and academic research activities. According to
    Gumbert, the ASC “saw a shift towards a more specialized surgical practice with increased
    diversity that often required anesthesiologists with unique, specialized regional fellowship
    anesthesia training.” Gumbert said that Donita Fleming, regional vice president of USPI, told
    him and Eltzschig that the ASC stakeholders “wanted to focus on cultivating leadership partners
    with strong regional fellowship academic backgrounds” and said that McNeely “was unable to
    9
    perform the Medical Directorship position alone in part because of his limited regional
    proficiency.”
    In his 2017 evaluation as medical director, McNeely met all expectations. Even so,
    Eltzschig promoted UTHSC’s Jennifer Wu, a doctor under forty who had an MBA, to the
    position of associate professor in September 2017 and recommended that the ASC hire her as co-
    medical director. On November 13, 2017, Theresa Le, the director of management operations
    for UTHSC’s department, emailed Eltzschig and USPI employees that “Eltzschig ha[d] already
    communicated to Dr. McNeely about sharing the responsibility as well as the supplement [paid
    by UTHSC] with Dr. Wu,” who was to be co-medical director, and that McNeely was “on board
    with it.” Wu began working as a co-medical director with McNeely in January 2018 but left in
    March 2018.           According to Gumbert, UTHSC leadership began considering candidates to
    transition into the co-director position to replace Wu. UTHSC’s Sumreen Vaid-Pinyard, a doctor
    under forty, and Sudipta Sen, a younger doctor,6 were “brought in on a trial basis for the role of
    Chief of Anesthesia [at UTHSC] and co-ASC Medical Director to replace Dr. Wu” “[s]ometime
    between January 4, 2018[,] to April 30, 2018.” After Vaid-Pinyard’s and Sen’s unfruitful trials,
    Eltzschig turned his attention to Clendeninn, who was working on an MBA in April 2018.
    Clendeninn’s resume showed that he graduated from medical school in 2013, was an
    intern and resident at UTHSC from 2013 to 2017, and was working to complete his fellowship in
    regional anesthesia, acute pain medicine, and perioperative ultrasound at the time Eltzschig was
    considering him. He “worked as a part-time, hourly non-benefit eligible (casual) Staff Physician
    6
    The record does not reveal Sen’s age.
    10
    from 7/1/2017 – 7/31/2018.” Eltzschig admitted that he had shared at a staff meeting that he
    would recommend Clendeninn to the ASC board as a candidate for medical director on May 10,
    2018, while McNeely was still serving in that position and that Clendeninn “continued to work at
    the ASC on a trial basis for the position of co-ASC Medical Director” from May to November
    2018.7 Although Eltzschig and Gumbert said that Clendeninn was to replace Wu, McNeely said
    that Eltzschig stated his intention to replace McNeely as medical director of the ASC at the
    meeting with others in attendance, including Clendeninn, Gumbert, Artime, and several CRNAs.
    Emails from several CRNAs that attended that meeting were attached to McNeely’s declaration
    and confirmed his version of events, including that Eltzschig said he was replacing McNeely, not
    Wu. McNeely said that, because Clendeninn was still in his fellowship, it was necessary for him
    to sign off on Clendeninn’s patient care and that Eltzschig expected him to train Clendeninn in
    the role of medical director.
    7
    Eltzschig said,
    I recommended Dr. Clendeninn for this position because he had several important qualifications
    that would make him a strong leader and benefit the ASC. Dr. Clendeninn completed his regional
    anesthesia fellowship training in July 2018 and was therefore highly competent with all the
    required skills needed for regional anesthesia services at the ASC. . . . In contrast, Dr. McNeely
    was not fellowship trained in regional anesthesia, and was struggling to provide some of the
    regional anesthesia approaches that were requested by specific surgeons. . . . In addition,
    Dr. Clendeninn had qualifications in the use of ultrasound, a technique which helps to make
    regional anesthesia safer for our patients and provides better outcomes. His training in the use of
    ultrasound included the “Basic Focus Assessed Transthoracic Echocardiography Certification,”
    and the “Basic Perioperative Transesophageal Echocardiography Certification and Testatmur
    Status.” Both of these qualifications are important assets for patient safety, outcomes, and patient
    satisfaction. Dr. Clendeninn . . . also had MBA training that would prove useful for the financial
    issues at ASC. . . . Dr. Clendeninn was academically highly active, including participation at
    National Meetings and moderation of research sessions for regional anesthesia . . . .
    Dr. Clendeninn had experience in academic presentations, publications, and lectures, which made
    him an outstanding teacher and scholar, again, which was in line with the Vision and Mission of
    the Department of Anesthesiology . . . . Dr. McNeely had none of these described qualifications.
    11
    After that announcement, a May 29, 2018, email related to the budget asked participants
    to the meeting, including Eltzschig, to be prepared to discuss “faculty changes for year-end
    incentive requests and any growth for FY 2018.” According to Eltzschig, the president of
    UTHSC told him on May 30, 2018, to reduce the Department budget for the upcoming fiscal
    year by $1,000,000.00 due to decreased funding. Eltzschig said that the only option was for him
    to reduce the faculty or benefit-eligible staff physician positions, an approach that was endorsed
    by the president and Dean Barbara Stoll at the May 30 budget meeting. Eltzschig decided to
    eliminate three benefit-eligible positions as a reduction in force and to spread the cuts across the
    general, cardiovascular and pediatric anesthesiology divisions. The pediatric anesthesiology
    assistant professor resigned “due to family reasons,” the cardiovascular assistant professor was
    non-reappointed to his faculty position, and McNeely was terminated as a staff physician.
    Eltzschig swore that he selected McNeely for non-renewal because “he was the only employee in
    that division who was working as a benefits eligible Staff Position and did not have a paid
    faculty appointment.”
    Eltzschig met with McNeely on June 4, 2018, to inform him that his position as staff
    physician would not be renewed due to a reduction in force and, after receiving approval from
    the president and dean, informed McNeely of the non-renewal. Eltzschig wrote a letter to the
    president and dean on June 5, which stated:
    In light of the recent call for budget reduction, I would like to obtain your
    approval for the Department of Anesthesiology to eliminate one (1) benefit-
    eligible staff physician at the [ASC]. The physician affected by this position
    elimination will be Dr. John McNeely who is currently the sole physician that
    holds this type of position, at the location mentioned above . . . . This action is
    12
    necessary due to our budget constraint. Your consideration of this request is
    greatly appreciated.
    The letter contained signature approvals from the president and dean. A letter to McNeely from
    Eltzschig dated June 5, 2018, simply said, “Per our conversation on June 4, 2018, this is to notify
    you that your Staff Physician position will not be renewed on September 1, 2018.”
    On July 2, 2018, an email from Le to Eltzschig said that the president wanted “to see
    proof documentation of the 3 eliminated positions [they] intended.” Also on July 2, after
    receiving an email asking whether McNeely had “stepped down already” as medical director or
    whether the [ASC] needed “to send him a termination letter,” Fleming said that McNeely would
    be “stepping down” effective September 1. The email stated that the ASC would require written
    notice from McNeely if he was resigning, but no written notice of resignation was included in
    the record. On July 10, Le emailed Melissa Pifko at UTHSC and wrote that ASC was remaking
    the medical directorship agreement “in place of their previous agreement with doctor John
    McNeely in the past” and that “all financial support [would] have to be routed through
    UT/Department.” The record contained a new directorship agreement executed between the
    ASC and UTHSC showing that the ASC “desired to contract with [UTHSC] to provide [a]
    Physician” “to serve as Medical Director and to preside over the [ASC’s] Medical Staff.”
    After Eltzschig’s termination notice, but before its effective date, Clendeninn completed
    his fellowship on July 31, 2018. Evidence attached to Eltzschig’s declaration showed that
    Clendeninn accepted UTHSC’s job offer for the position of assistant professor of anesthesiology
    on July 27, before completing the fellowship. Yet, Eltzschig’s declaration said that Clendeninn
    (1) “transitioned to a non-tenured faculty position as an Assistant Professor” on August 1, 2018,
    13
    after completing his fellowship and (2) received a letter from Eltzschig on November 8
    informing him that ASC had appointed him as medical director.                            According to McNeely,
    Clendeninn was offered benefits in December 2018, after McNeely was terminated.
    UTHSC’s plea focused on the budgetary reasons for McNeely’s termination and claimed
    that he was not replaced since his position as a benefits-eligible staff physician was eliminated.
    UTHSC argued that Clendeninn “moonlighted” as a casual employee on an as-needed basis
    while he completed his fellowship and that McNeely’s benefit-eligible position was eliminated
    as opposed to the non-benefits-eligible, casual staff physician position held by Clendeninn.
    UTHSC also argued that McNeely had resigned from ASC’s medical directorship, that UTHSC
    did not make employment decisions for ASC, and that McNeely failed to provide either direct or
    circumstantial evidence of any alleged discrimination by UTHSC.8 As a result, UTHSC argued
    that sovereign immunity was not waived and that the trial court erred by denying its plea to the
    jurisdiction after relying on evidence McNeely submitted pertaining to ASC.
    In response to the plea to the jurisdiction, McNeely argued that he had made a prima
    facie case of age discrimination at UTHSC, that evidence of discrimination at the ASC was
    relevant and that the proffered reason that he was terminated due to a reduction in force was
    pretext for age discrimination. McNeely presented evidence of his seasoned credentials, said
    8
    UTHSC also argued that McNeely failed to file an administrative complaint against the ASC and that any
    complaint regarding termination from the ASC was barred for failure to exhaust administrative remedies.
    “[E]xhaustion of administrative remedies is a mandatory prerequisite to filing a civil action alleging violations of the
    [T]CHRA.” Salman v. KIPP, Inc., No. 01-19-00886-CV, 
    2021 WL 2931360
    , at *5 (Tex. App.—Houston [1st Dist.]
    July 13, 2021, no pet. h.) (mem. op.) (quoting Hoffmann-La Roche Inc. v. Zeltwanger, 
    144 S.W.3d 438
    , 446 (Tex.
    2004). “An employee must file a charge with the TWC, allege an unlawful employment practice, state the facts on
    which the complaint is based, and identify the respondent.” 
    Id.
     (citing TEX. LAB. CODE ANN. § 21.201(c); Waffle
    House, Inc. v. Williams, 
    313 S.W.3d 796
    , 804 (Tex. 2010). ASC is not a party to this case, and McNeely did not
    argue in his TWC complaints that he was terminated by ASC from his position as medical director. As a result, we
    limit our review to evidence of UTHSC’s alleged discrimination.
    14
    that he was an assistant professor at UTHSC until his termination, and remained active as an
    instructor teaching medical students at the surgery center. UTHSC’s website for the department
    of anesthesiology included McNeely as a faculty member. McNeely said that, in 2017, he
    “participated in a program called Doctoring Two and Doctoring Three which called for him to
    teach medical students on a weekly basis in a medical setting” and received extremely positive
    feedback from the students, which was proven by letters from students attached to his affidavit.
    His declaration asserted that Eltzschig brought in younger, less experienced, and less well-paid
    doctors as replacements for him on three different occasions.
    McNeely argued that discriminatory intent was shown when Eltzschig announced at the
    May 10, 2018, meeting that he intended to replace him with Clendeninn as the ASC’s medical
    director. McNeely said that UTHSC dictated who worked at the ASC on a daily basis and that it
    was impossible to continue as medical director at the ASC without being an employee of
    UTHSC. Even though Eltzschig claimed that McNeely resigned the position of medical director,
    McNeely swore that he never resigned from the ASC. McNeely pointed out that UTHSC had a
    financial interest in the operations of the ASC, that UTHSC was compensated for the doctors
    placed there, and that Eltzschig’s letter to the president and dean sought permission to terminate
    McNeely’s staff physician position “at the [ASC].”
    McNeely said that, even though a reduction in force was cited as the reason for his
    termination, none of the evidence from UTHSC mentioned an actual reduction in force except
    for Eltzschig’s declaration, which McNeely believed was a conclusory statement. Because the
    evidence showed that UTHSC’s department of anesthesiology had seventy-three physicians in
    15
    2016, eighty-six physicians in 2018, and ninety-six physicians in 2020, McNeely argued that
    there was no reduction in force and that the Department had steadily grown. He also noted that
    the term “reduction in force” was legally defined in the University of Texas system’s policies to
    mean that a position (not a person) was eliminated and argued that no position was eliminated
    since Clendeninn was a staff physician at the time of his termination, Clendeninn had been
    offered a paid assistant professorship, and none of the requirements of the policies were
    followed.
    The University of Texas system’s policy statement (Policy) on reductions in force stated
    that it could “occasionally be required to eliminate positions due to . . . budgetary needs.” The
    Policy required a department head to describe the exact position recommended for elimination
    when eliminating positions through a reduction in force and then to submit the “Reduction in
    Force Report to the Office of Human Resources and Office of General Counsel for review.” The
    Policy required notification in writing of the terminated position “preferably at least 50 days
    before termination,” provision of re-employment support assistance “for any employees affected
    by elimination of their position,” and preferential procedures for rehire for a period of six months
    after termination.9
    McNeely said that he never heard about any reduction in force during his tenure at
    UTHSC, was never offered re-employment support, and was not provided preferential rehiring
    treatment even though he was willing to retain the same position at a lower compensation rate or
    accept a different position. McNeely’s declaration stated that he offered to take a reduction in
    9
    While UTHSC argued that it had its own policies and procedures and that the University of Texas system’s policies
    related to reductions in force were inapplicable, a separate policy was never produced.
    16
    compensation when Eltzschig informed him by telephone on June 3 that his contract would not
    be renewed due to financial issues, but that Eltzschig declined his offer. After his termination,
    McNeely obtained four letters of support from colleagues at UTHSC praising his attitude,
    experience, and technical skill.
    (3)    The Plea to the Jurisdiction Should Have Been Granted
    Under the first part of the McDonnell Douglas framework, we first ask whether McNeely
    established a prima facie case of age discrimination. “The causation standard for the McDonnell
    Douglas prima-facie-case element is not onerous and can be satisfied merely by proving close
    timing between the protected activity and the adverse action.” Alamo Heights, 544 S.W.3d at
    782.    “The requirements for establishing a prima facie case ‘vary depending on the
    circumstances.’” Tex. Tech Univ. Health Scis. Ctr.-El Paso v. Flores, 
    612 S.W.3d 299
    , 305
    (Tex. 2020) (quoting Exxon Mobil Corp. v. Rincones, 
    520 S.W.3d 572
    , 583 (Tex. 2017)). In this
    age-discrimination case, a prima facie case will be made by evidence that McNeely (1) was forty
    years of age or older, (2) was qualified for the position at issue, (3) was terminated, and (4) “was
    either (a) replaced by someone significantly younger or (b) otherwise treated less favorably than
    others who were similarly situated but outside the protected class.” 
    Id.
     (citing Mission Consol.,
    372 S.W.3d at 632; AutoZone v. Reyes, 
    272 S.W.3d 588
    , 592 (Tex. 2008) (per curiam)). UTHSC
    does not dispute that McNeely met the first three elements but challenges the evidence on the
    fourth element.
    UTHSC argues that it did not replace McNeely with someone younger because no one
    was hired to fill a benefits-eligible staff physician position and Clendeninn’s appointment as
    17
    medical director of the ASC was not attributable to UTHSC. “But . . . the determination of
    whether one employee replaced another cannot depend solely on the employees’ job titles and
    salaries.”   Flores, 612 S.W.3d at 306.       “Such a rule would enable employers to simply
    manipulate titles and salaries to prevent terminated or demoted employees from ever establishing
    a prima facie case.” Id. “Instead, we must look not merely to the employees’ titles and salaries,
    but also to their actual duties, comparing the duties of the plaintiff’s prior position with those of
    the employee []he alleges replaced h[im].” Id. (citing Baker v. Gregg Cty., 
    33 S.W.3d 72
    , 81
    (Tex. App.—Texarkana 2000, no pet.) (“A determination of whether an employee was actually
    replaced by another requires an inquiry into the job position and duties performed by the
    terminated employee, and an inquiry into the work performed by the person who is alleged to
    have replaced that employee.”)).
    McNeely was terminated from his assistant professorship. Although UTHSC claimed
    that this was a voluntary position, McNeely’s memorandum of employment provided some
    evidence that this was a paid faculty position. After McNeely was terminated from this role,
    Clendeninn was given the role of assistant professor in the same Department. McNeely also
    showed that he was terminated from his position as a staff physician effective September 1 and
    that Clendeninn, who occupied the same position, albeit without benefits, was retained.
    McNeely also argued and introduced some evidence that, although Clendeninn transitioned into
    the role of assistant professor and was no longer a staff physician after August 1, the ASC
    contracted with UTHSC to provide a medical director to the ASC and that, as a result,
    Clendeninn also performed the same functions and job duties because of his employment with
    18
    UTHSC that McNeely had performed in his position as a staff physician. Clendeninn also soon
    began receiving benefits.     Because we take as true all evidence favorable to McNeely in
    reviewing the plea to the jurisdiction, we find that McNeely made a prime facie case for
    purposes of this analysis, creating a rebuttable presumption of age discrimination. See Flores,
    612 S.W.3d at 307–08 (If “the plaintiff was removed from h[is] position, that position was not
    filled, an existing employee was given a new and different position, and the existing employee
    was assigned some but not all of the plaintiff’s former duties . . . the evidence is sufficient to
    create a fact issue over whether the existing employee truly replaced the plaintiff if the existing
    employee’s duties in her new position are so similar to the plaintiff’s former duties that a
    reasonable juror could conclude that the existing employee actually took or was placed in the
    plaintiff’s former job or position.”).
    UTHSC sought to rebut this presumption by producing evidence of a legitimate,
    nondiscriminatory reason for the disputed employment action. See McDonnell Douglas Corp.,
    
    411 U.S. at 802
    . It cited several reasons for McNeely’s termination, including (1) a reduction in
    force because of budget concerns and (2) McNeely’s “lack in regional anesthesia techniques,
    organizational inefficiency, continuous medical leave, and inability to manage the organizational
    and financial performance of the ASC.” UTHSC’s evidence, including Eltzschig’s declaration,
    emails regarding the budget meeting, and Eltzschig’s letter to the president and dean requesting
    approval for McNeely’s termination due to budget constraints, constituted evidence of a non-
    discriminatory reason for McNeely’s termination, as did Eltzschig’s and Gumbert’s declarations
    about McNeely’s performance as medical director of the ASC. See M.D. Anderson Hosp. &
    19
    Tumor Inst. v. Willrich, 
    28 S.W.3d 22
    , 24–25 (Tex. 2000) (finding that a reduction in force is a
    legitimate nondiscriminatory reason for a disputed employment action); Donaldson v. Tex. Dep’t
    of Aging & Disability Servs., 
    495 S.W.3d 421
    , 438 (Tex. App.—Houston [1st Dist.] 2016, pet.
    denied) (an employer’s perception of subpar performance is a legitimate nondiscriminatory
    reason); see also White v. Schlumberger Ltd., No. 01-05-00685-CV, 
    2006 WL 948074
    , at *4
    (Tex. App.—Houston [1st Dist.] Apr. 13, 2006, no pet.) (mem. op.); Russo v. Smith Int’l, Inc., 
    93 S.W.3d 428
    , 438 (Tex. App.—Houston [14th Dist.] 2002, pet. denied).
    “Once an employer produces sufficient evidence to support a non-discriminatory
    explanation for its decision, a plaintiff must be afforded the opportunity to show ‘that the
    legitimate reasons offered by the defendant were not its true reasons, but were a pretext for
    discrimination.’” White, 
    2006 WL 948074
    , at *4 (quoting Reeves v. Sanderson Plumbing Prod.,
    Inc., 
    530 U.S. 133
    , 143 (2000)). “That is, a plaintiff may attempt to prove that he was the victim
    of intentional discrimination ‘by showing that the [defendant’s] proffered explanation is
    unworthy of credence.’” 
    Id.
     (quoting Reeves, 
    530 U.S. at 143
    ).
    Regarding the reduction in force, McNeely argued that he presented evidence that
    UTHSC sought to replace him as medical director of the ASC before any notice about budget
    cuts. Emails from CRNAs who attended a meeting before notice of any reduction in force
    showed that Eltzschig said he would be replacing McNeely with Clendeninn as medical director.
    While this could be construed as evidence that UTHSC wanted to oust McNeely from the
    20
    medical directorship,10 there was no evidence that UTHSC wanted to terminate McNeely from
    his position as assistant professor and staff physician before the budget cuts. Even so, McNeely
    argued that there was no reduction in force after citing to evidence that the Department hired
    more employees following his departure. Given the standard of review, we will assume that
    McNeely created a fact issue on the question of whether UTHSC’s proffered reason of
    terminating McNeely due to budget concerns was false.
    Moving to questions about McNeely’s job performance, UTHSC said that concerns about
    McNeely’s performance in his role as medical director, including a lack in regional anesthesia
    techniques, organizational inefficiency, and inability to manage the organizational and financial
    performance of the ASC, contributed to his termination. Gumbert said McNeely “was limited in
    his ability to perform advanced regional anesthesia procedures requested by surgical
    stakeholders” at the ASC. In response, McNeely introduced letters from students, which spoke
    to his skill as a teacher, and colleagues addressing his positions at UTHSC and the ASC. The
    letters from colleagues praised McNeely’s attitude and general skill and stated that his
    contributions to the ASC contributed to its growth. McNeely also introduced a positive, June
    2017 evaluation from the ASC.11 In any case, UTHSC’s claimed deficiencies in performance
    related only to McNeely’s role as medical director, but UTHSC did not employ McNeely in that
    capacity. The evidence shows that McNeely could have continued to serve as a staff physician
    and assistant professor even if he was not the ASC’s medical director, and UTHSC’s proffered
    10
    ASC—not UTHSC—employed McNeely in this position and, no TWC complaint was filed against ASC for the
    termination of McNeely’s position as Medical Director.
    11
    Neither the evaluation form nor the letters of support from colleges discussed whether McNeely was proficient in
    regional anesthesia techniques, and there was also no performance review for 2018.
    21
    reason for termination due to job performance did not specifically address any deficiency
    McNeely had as staff physician or assistant professor. Thus, at this stage, we will assume that
    McNeely presented enough evidence to create a fact issue on whether the proffered reason for
    his termination at UTHSC—job performance at the ASC—was false.
    However, something more was required. “[I]f the employer provides evidence of a
    legitimate reason for the adverse action, under the federal standard, the employee must prove the
    adverse action would not have occurred ‘but for’ the protected activity.” Alamo Heights, 544
    S.W.3d at 782. “The but-for causation standard is significantly more difficult to prove than
    prima facie causation.” Id. The Houston First Court of Appeals has applied this “but-for”
    standard of causation. City of Houston v. Trimmer-Davis, No. 01-19-00088-CV, 
    2020 WL 4983253
    , at *4 (Tex. App.—Houston [1st Dist.] Aug. 25, 2020, no pet.). (mem. op.). As a result,
    because UTHSC produced evidence of a nondiscriminatory reason for McNeely’s termination,
    “the burden of production shift[ed] back to [McNeely] to show that the [UTHSC]’s stated reason
    was a pretext for discrimination.” Democratic Sch. Rsch., Inc., 608 S.W.3d at 308. Although
    there was a fact issue on whether UTHSC’s proffered nondiscriminatory reason for termination
    of employment was false, “an employee lacking direct evidence cannot prove a statutory
    violation without evidence that the employer’s stated reason is false and a pretext for
    discrimination.” Alamo Heights, 544 S.W.3d at 782 (emphasis added).            In Baker Hughes
    Oilfield Operations, Inc. v. Williams, the Houston First Court of Appeals wrote:
    In Reeves, the United States Supreme Court explained that “[p]roof that the
    defendant’s explanation is unworthy of credence is simply one form of
    circumstantial evidence that is probative of intentional discrimination,” which
    “may be quite persuasive” and, “[i]n appropriate circumstances, the trier of fact
    22
    can reasonably infer from the falsity of the explanation that the employer is
    dissembling to cover up a discriminatory purpose.” [Reeves, 530 U.S.] at 147[]
    (emphasis added). Thus, “a plaintiff’s prima facie case, combined with sufficient
    evidence to find that the employer’s asserted justification is false, may permit the
    trier of fact to conclude that the employer unlawfully discriminated.” Id. at 148 []
    (emphasis added). However, the Supreme Court cited with approval its prior
    holdings that “[i]t is not enough . . . to disbelieve the employer; the fact-finder
    must believe the plaintiff’s explanation of intentional discrimination.” Id. at 147
    . . . (citing St. Mary’s Honor Ctr. v. Hicks, 
    509 U.S. 502
    , 519[] (1993)).
    Moreover, the Supreme Court rejected the suggestion that a showing of falsity by
    the plaintiff would “always be adequate to sustain a jury’s finding of liability,”
    and it recognized that “[c]ertainly there will be instances where, although the
    plaintiff has established a prima facie case and set forth sufficient evidence to
    reject the defendant’s explanation, no rational fact-finder could conclude that the
    action was discriminatory.” 
    Id. at 148
    []. For example, “an employer would be
    entitled to judgment as a matter of law . . . if the plaintiff created only a weak
    issue of fact as to whether the employer’s reason was untrue and there was
    abundant and uncontroverted independent evidence that no discrimination had
    occurred.” Id.; see also Little v. Tex. Dep’t of Criminal Justice, 
    177 S.W.3d 624
    ,
    632 (Tex. App.—Houston [1st Dist.] 2005, no pet.) (reviewing Reeves and stating
    that Supreme Court “has made it clear that it is not sufficient merely to show that
    the employer’s reasons are false or not credible; the plaintiff must prove that the
    employer discriminated intentionally”). Accordingly, “[w]hether judgment as a
    matter of law is appropriate in any particular case will depend on a number of
    factors,” including “the strength of the plaintiff’s prima facie case, the probative
    value of the proof that the employer’s explanation is false, and any other evidence
    that supports the employer’s case and that properly may be considered on a
    motion for judgment as a matter of law.” Reeves, 
    530 U.S. at 148
    –149[].
    Baker Hughes Oilfield Operations, Inc. v. Williams, 
    360 S.W.3d 15
    , 22–23 (Tex. App.—
    Houston [1st Dist.] 2011, pet. denied). “Citing to Reeves, the Texas Supreme Court has made
    clear that a plaintiff seeking to recover under the Act for illegal discrimination in a case
    involving an allegation of pretext must show both that the reason proffered by the employer is
    “false, and that discrimination was the real reason.” 
    Id. at 23
     (quoting Wal-Mart Stores, Inc. v.
    Canchola, 
    121 S.W.3d 735
    , 740 (Tex. 2003) (quoting St. Mary’s Honor Ctr., 
    509 U.S. at 515
    );
    23
    see Hudgens v. Univ. of Tex. MD Anderson Cancer Ctr., 
    615 S.W.3d 634
    , 646 (Tex. App.—
    Houston [14th Dist.] 2020, no pet.).
    As a result, “[t]he relevant inquiry is not whether the complaints made against [the
    employee] were a pretext, but what they were a pretext for.” Canchola, 121 S.W.3d at 740.
    There must be evidence that the employer “was motivated to terminate [the employee] because
    of [discrimination].”     Id.   This is because, “in a discrimination case brought under the
    TCHRA . . . the employee still bears ‘the ultimate burden’ to prove that the employer
    discriminated against him because of a prohibited consideration.” Hudgens, 615 S.W.3d at 645
    (“[A] disagreement with the employer’s determination of inadequate work performance
    generally is not sufficient to raise a fact issue on pretext . . . . The issue at the pretext stage is not
    whether the employer made an erroneous decision; it is whether the decision, even if incorrect,
    was the real reason for the employment determination.”).
    Because “[s]ubjective beliefs are insufficient,” McNeely’s “subjective belief that he was
    terminated based on [age] . . . is insufficient to create a fact issue about whether [UTHSC’s]
    legitimate nondiscriminatory reason for terminating [him] was pretextual.” Willrich, 28 S.W.3d
    at 25. To avoid the plea to the jurisdiction, McNeely “had to provide more than a scintilla of
    evidence that the true reason that [UTHSC] terminated his employment was [age]
    discrimination.” White, 
    2006 WL 948074
    , at *4–5.
    Here, McNeely argues that he has shown that UTHSC intended to replace him with
    younger employees because it brought in Wu and Vaid-Pinyard. The evidence showed that Wu
    24
    and Vaid-Pinyard were not brought in to replace McNeely’s positions at UTHSC.12 As a result,
    the only evidence cited by McNeely to support his claim of age discrimination is Eltzschig’s
    decision on Clendeninn’s appointment as medical director at the ASC, but this did not serve as
    notice that Eltzschig sought to replace McNeely in the role of staff physician or assistant
    professor at UTHSC. Moreover, even had there been evidence that UTHSC sought to replace
    McNeely with Clendeninn as staff physician and assistant professor, “[i]n the absence of other
    evidence of an unlawful employment practice, evidence of the employment of one person in
    place of another is not sufficient to establish an unlawful employment practice.” TEX. LABOR
    CODE ANN. § 21.061. After scouring the record for other evidence of age discrimination, we
    have found none.13 See Hudgens, 615 S.W.3d at 645 (discussing cases where there was other
    evidence of unlawful employment practice including age-related remarks before termination,
    severance packages prepared for fourteen employees over fifty years old to “thin the ranks,” and
    statistical evidence that older employees had a higher rate of turnover than younger
    counterparts).
    “All elements of a TCHRA circumstantial-evidence claim are, perforce, jurisdictional.”
    Alamo Heights, 544 S.W.3d at 783. If “jurisdictional evidence rebuts the prima facie case, the
    entire McDonnell Douglas framework is fully implicated, and sufficient evidence of pretext and
    causation must exist to survive the jurisdictional plea.” Id. (“[T]he burden-shifting scheme in
    12
    Instead, they were being considered for the position of co-medical director at ACS. Although Sen was also
    considered in this capacity, nothing showed that she was a doctor under forty. Also, although Eltzschig said he was
    replacing McNeely with Clendeninn, nothing showed that it was because of McNeely’s age or Clendeninn’s youth.
    13
    We also note that there is no evidence of the age of the other two doctors who were selected for non-reappointment
    by UTHSC.
    25
    toto defines the jurisdictional facts.”). “The absence of a presumption triggers the plaintiff’s
    duty to create a fact question on the ultimate issue—whether [age discrimination] caused the
    adverse employment action—to survive a jurisdictional challenge.” Id. at 784.
    Although McNeely “was an older employee whom the Texas Commission on Human
    Rights Act protects against age discrimination, he has failed to present evidence from which a
    reasonable juror could conclude that [his] age was a motivating factor behind” his termination.
    Flores, 612 S.W.3d at 314. McNeely “had to provide more than a scintilla of evidence that the
    true reason that [UTHSC] terminated his employment was [age] discrimination.” White, 
    2006 WL 948074
    , at *5. Because we conclude that he did not, the TCHRA did not waive UTHSC’s
    “sovereign immunity from this suit, and the trial court therefore erred by not granting its plea to
    the jurisdiction.” Id.; see Suarez v. City of Tex. City, 
    465 S.W.3d 623
    , 631–32 (Tex. 2015)
    (Absent a valid waiver of immunity, the court lacked subject-matter jurisdiction).
    26
    We reverse the trial court’s order denying the plea to the jurisdiction and render judgment
    dismissing McNeely’s claims for lack of jurisdiction.14
    Josh R. Morriss, III
    Chief Justice
    Date Submitted:            August 11, 2021
    Date Decided:              October 26, 2021
    14
    McNeely argues that, “[a]t a minimum, even if no direct or circumstantial evidence existed raising fact issues . . .
    [he] should be allowed targeted discovery regarding the evidentiary claims made by UTHealth in its plea to the
    jurisdiction.” It is true that “trial courts considering a plea to the jurisdiction have broad discretion to allow
    ‘reasonable opportunity for targeted discovery’ and to grant parties more time to gather evidence and prepare for
    such hearings.” Mission Consol. Indep. Sch. Dist. v. Garcia, 
    372 S.W.3d 629
    , 642–43 (Tex. 2012) (quoting
    Miranda, 133 S.W.3d at 233). Yet, this provision contemplates “alter[ing] hearing deadlines to allow parties the
    opportunity to respond with evidence.” Alamo Heights, 544 S.W.3d at 786. Here, the trial court did not alter
    hearing deadlines, but denied the plea to the jurisdiction.
    27