Tennessee Code Title 68. Health, Safety and Environmental Protection § 68-2-703

(a) District health departments shall be headed by, and under the immediate direction of, a district health director, who shall be appointed by the commissioner of health.

(b) The district health director shall act as the administrative officer of the district health department and shall 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 district board of health.

(c) The commissioner may also appoint a district health officer responsible for providing medical direction including medical enforcement actions.