89R1083 SRA-F By: Cain H.B. No. 5023 A BILL TO BE ENTITLED AN ACT relating to a periodic comprehensive performance audit of certain operations of hospital districts located in populous counties. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Subchapter C, Chapter 281, Health and Safety Code, is amended by adding Section 281.0495 to read as follows: Sec. 281.0495. PERIODIC COMPREHENSIVE PERFORMANCE AUDIT. (a) The commissioners court shall contract at least once every five years with an independent auditor for a comprehensive performance audit of the district's management, accounting practices, financial controls, recordkeeping, and compliance with applicable law. (b) The audit required under this section must include: (1) an evaluation of the performance of: (A) the district in each area described by Subsection (a); and (B) the district's vendors with respect to each contract between the vendor and the district; and (2) a determination whether the district's management adheres to the best practices and national standards applicable to the administration of hospitals and hospital systems. (c) The auditor shall produce and provide to the district and commissioners court a written audit report that describes any deficiencies identified during the audit and includes the auditor's recommendations to address those deficiencies. (d) If the district maintains a publicly accessible Internet website, the district shall post the report described by Subsection (c) in a conspicuous location on the district's website. (e) The commissioners court shall hold a public hearing on the report described by Subsection (c). SECTION 2. This Act takes effect September 1, 2025.