Tennessee Code Title 68. Health, Safety and Environmental Protection § 68-2-603
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(a)(1) Each county shall establish a county health department which shall be headed by, and under the immediate direction of, a county health director.
(2) The county health director shall be appointed by the commissioner of health or by the commissioner's designee, act as the administrative officer of the county health department, take actions and make determinations necessary to properly execute the state department of health's programs, and adequately enforce the rules and regulations established by the commissioner and the county board of health.
(3) The county health director shall be a health professional who possesses the necessary education and experience in public health administration as determined by the state department of health and approved by the department of human resources.
(4) The county health director shall have compensation paid, all or in part, by the state department of health.
(5) If the county health director is a qualified physician, such county health director may also serve as a county health officer.
(6) If the commissioner appoints a county health director pursuant to this subsection (a), the appointment shall be made by the commissioner in concurrence with the county mayor of the county for which the appointment is made.
(b) It is the county health director's duty to enforce the regulations of the county board of health and the state department of health in counties which fail to establish a board of health.
(c) The commissioner may appoint a county health officer responsible for providing medical direction including medical enforcement actions. The county health officer shall be a graduate doctor of medicine or osteopathy, schooled and experienced in public health work and licensed to practice in the state of Tennessee. The county health officer shall have compensation paid, all or in part, by the state department of health.
(d) Any person who undertakes to hold the position of county health officer without being qualified as provided in this section commits a Class C misdemeanor.
(e) In the absence of a duly-appointed county health officer, the commissioner or the commissioner's designee shall appoint a physician who shall provide medical direction, including the authority outlined in § 68-2-609 .
(f) In the absence of an epidemic or immediate threat of an epidemic, any person who shall file with the county board of health a signed, written statement that a specific regulation pertaining to personal medical treatment conflicts with the person's religious tenets and practices, affirmed under penalty of perjury, shall be exempted from the regulation.
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