Texas Health and Human Services Commission v. Susana Lopez

Texas Court of Appeals, 8th District (El Paso)·Decided February 2, 2026·No. 08-25-00095-CV·Published

Opinion

COURT OF APPEALS

EIGHTH DISTRICT OF TEXAS

EL PASO, TEXAS

HHSC’s stated reasons were false and a pretext for retaliation, we reverse and render judgment dismissing the underlying lawsuit for lack of jurisdiction.

I. BACKGROUND

A. Lopez’s employment with HHSC

Lopez was employed by HHSC for about seven years. HHSC is the state agency in Texas charged with the responsibility for operating the Medicaid program.1 Texas Health & Hum. Servs. Comm’n v. Est. of Burt, 689 S.W.3d 274, 279–80 (Tex. 2024). Qualifying recipients can receive care at HHSC operated facilities, such as the El Paso State Supported Living Center (the Center), where Lopez worked during her employment with HHSC. Id. HHSC terminated Lopez for two reasons: (1) failure to remain compliant with required training, and (2) the unauthorized use of her personal cell phone. At the time of her termination, Lopez held the title of Direct Support Professional (DSP) III, a supervisory role.

HHSC’s policy2 provides that employees are required “to maintain compliance with assigned minimum training requirements, including core and specialty requirements, and facility- specific information and local training requirements.” Through governing body reports, HHSC facilities must report the percentage of employees in compliance with training requirements and take appropriate action if compliance goals are not met. The policy states that employees are delinquent with training “when they fail to complete or receive credit for all required training within the time frames specific to each required course.” It further provides that employees are responsible for ensuring their compliance with required training and requires that “at least 95% of

1 Medicaid is a federal and state assistance program that provides medical care for qualifying recipients. El Paso Hosp. Dist. v. Texas Health & Hum. Servs. Comm’n, 247 S.W.3d 709, 711 (Tex. 2008); see also 42 U.S.C. §§ 1396–1396w- 8. Federal law establishes Medicaid’s parameters, and states enact legislation to implement the program. See El Paso Hosp. Dist. v. Texas Health and Hum. Servs. Comm’n, 247 S.W.3d 709, 711 (Tex. 2008); 42 U.S.C. § 1396a; 42 C.F.R. § 430.0. 2 “2.0 Minimum Training Requirements for State Supported Living Centers in the Health and Human Services.”

all employees” be in “full (100% compliance) with their core and specialty training requirements at all times.”

Lopez’s direct supervisor was Residential Coordinator Rosa Valerio. Part of Valerio’s responsibilities included ensuring that employees were current on all required training. The training courses were offered both in person and online, with the in-person sessions offered on specific, scheduled dates. Valerio ran monthly reports showing which employees were delinquent on training, and because most trainings were required annually and expired at different times, the Center held monthly “house meetings” where training was discussed. When an employee became delinquent in training, supervisors gave both verbal and written notice, counseled the employee, and provided schedules with upcoming training dates. Employees could take training courses during their workday if enough staff were available to cover their shifts.

Lopez also reported to the Center’s Unit Director, Joana Alferez, who also ensured employees complied with required training. She did so by running training reports monthly and testified that employees were responsible for maintaining their own compliance. She also testified that employees could run their own reports and were responsible for doing so.

During the relevant time, the Center’s training compliance goal requirement was 96%.

Alferez confirmed that when an employee became delinquent in training, they received notice verbally and in writing and could receive disciplinary action if they did not complete required training. She testified that once employees received a first notice, they usually did not remain delinquent. Alferez also explained the termination process required review by Human Resources, the legal department, Director Kevin Ward, and Assistant Director of Programs (ADOP) Teresa Trevino.

B. Lopez’s testimony

Lopez testified she was diagnosed in 2013 with anxiety, depression, and insomnia and had taken medication for her conditions since that time. She was promoted from DSP II to DSP III that same year and described it as a challenging “new experience” that required her to “start over.”

Lopez acknowledged attending monthly meetings where employees were routinely reminded about training requirements. When asked whether she agreed that it was her responsibility to stay current with training, Lopez responded, “I agree and disagree[,]” explaining she relied on her residential coordinator, Valerio, to remind her. Lopez confirmed she could access her own training report at “any time” and when asked whether she regularly ran her reports, Lopez responded, “Not [on a] regular basis, not every day or -- I can’t recall how many times.” After her shifts, Lopez explained she was “mentally [and] physically exhausted. You don’t go to the computer. You just want to go home, so you don’t check.”

She admitted that supervisors reminded employees about training compliance and that she was able to take trainings during her shifts. Lopez claimed she became delinquent because she was on FMLA leave and that when she returned, HHSC gave her opportunities to complete her training.

She was also questioned about her lawsuit and confirmed she was pursuing a retaliation claim against HHSC.3 In addition to termination, she identified three acts of alleged retaliation: being written up after filing complaints, being moved from “cottage to cottage,” and being overly monitored by Alferez.

C. Lopez’s disciplinary action The following timeline summarizes the events pertinent to Lopez’s disciplinary actions:

3 She confirmed during her deposition, and at oral argument, that her only claim against HHSC was retaliation.

• December 29, 2017: This is the earliest documented training delinquency in the record. Lopez was delinquent in four trainings: Abuse/Neglect, CPR, Observing and Reporting, and I-Learn Employee Time and Leave. She was given until December 29, 2018, to complete them.

• May and June 2018: Lopez attended house meetings where supervisors reminded employees to remain current on annual trainings.

• August 2018: A coworker reported that Lopez used her personal cell phone and appeared to take photos of facility documents.

• September 2018: ADOP Trevino referred the August incident for investigation by the Center’s Incident Management Team. Incident Management Coordinator, Michael Reed, and Incident Investigator Juan Lopez, investigated. Reed and Lopez reviewed video footage, interviewed the reporting witness, and interviewed Lopez. Lopez admitted she used her phone “one time”

before to photograph or reference documents while preparing notes but denied any improper use and claimed she used it for translation and spell-check purposes during the incident. The investigation concluded that Lopez used her personal phone to take photos of a facility 24-hour report in violation of HHSC policy.

• September 7, 2018: Lopez was reminded of her delinquent training status and was provided a copy of her training report and a course schedule.

• October 11, 2018: As of this date, Lopez remained delinquent in CPR training. • October 19, 2018: Lopez failed to attend a scheduled CPR training session. Supervisors reminded her of her delinquency. The Center’s training specialist advised Alferez in an email that due to Lopez’s CPR delinquency status, she could not perform CPR procedures or be left alone with residents and had to be accompanied by trained staff at all times until she completed her training.

• October 24, 2018: Valerio and Alferez issued Lopez a six-page “Written Warning-Personal Cell Phone Usage and failure to maintain training,” citing Lopez’s training delinquency and the unauthorized use of her personal phone.

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