Amends TCA Title 4; Title 14; Title 58; Title 68, Chapter 2 and Chapter 550 of the Public Acts of 2021.

This bill makes various changes and additions to present law concerning the exercise of governmental powers related to public health. This bill specifies that, during the existence of any declared pandemic, the governor has exclusive jurisdiction to issue executive orders and directives with respect to each county health department in this state. This bill prohibits the commissioner of health and any local health department, board, entity, or official from superseding, vacating, contradicting, or refusing to comply with any such executive order or gubernatorial directive. This bill deletes present law authorization for county health officers to order rules and regulations as are necessary or appropriate to protect the general health and safety of the county. Present law requires the commissioner of health to appoint county health directors. Present law specifies that, if the commissioner appoints a county health director, the appointment must be made in concurrence with the county mayor. This bill clarifies that appointment of a county health director is not optional. This bill also gives county mayors 10 days within which to concur or not concur with a proposed appointee. If a county mayor non-concurs a commissioner's nominee within 10 days in writing, the commissioner will be required to submit a different nominee to the county mayor for approval. If a mayor does not respond to notice of a nomination in writing within 10 days of notification of any commissioner appointee, the appointment is approved by operation of law. Present law makes county health officers responsible for providing medical direction including medical enforcement actions. This bill specifies that such actions require the direction of the commissioner of health or county mayor. Present law authorizes county boards of health to exercise various powers, including, but not limited to: (1) Advising the county mayor on the enforcement of such rules and regulations as may be prescribed by the commissioner of health essential to the control of preventable diseases and the promotion and maintenance of the general health of the county; and (2) Advising the county mayor on the adoption of rules and regulations as may be necessary or appropriate to protect the general health and safety of the citizens of the county. This bill specifies that, under advisement of the county board of health as described in (1) and (2) and except as limited by this bill's conferring of certain powers related to quarantines solely on the commissioner of health, the county mayor has the power to issue orders as are necessary or appropriate to protect the general health and safety of county residents. This bill gives the commissioner of health the sole authority to: (1) Determine quarantine guidelines for a person if the person tests positive for COVID-19. The quarantine of a person must be lifted if the person receives a negative antigen detection test result or a negative molecular diagnostic test result at any time during the quarantine period; and (2) Determine quarantine guidelines for a private business for purposes of closing the private business or restricting the operation of the private business for purposes of COVID-19. The quarantine of a business must be lifted as soon as practicable after the commissioner is satisfied that conditions at the business do not present a serious public health and safety threat with respect to the spread of COVID-19. This bill specifies that the commissioner of health may only determine quarantine guidelines by administrative rules that are promulgated under the Uniform Administrative Procedures Act. Present law authorizes county health officers to order the quarantine of any place or person in order to protect the public health from an epidemic. This bill specifies that such authority will be secondary to the exclusive authority that this bill confers on the governor and the commissioner of health. ON OCTOBER 29, 2021, THE HOUSE ADOPTED AMENDMENT #1, AND PASSED HOUSE BILL 9076, AS AMENDED. AMENDMENT #1 retains the provisions of this bill concerning the commission having the sole authority to determine quarantine guidelines by rule and the commensurate subordination of county health officers' authority to order quarantines, and otherwise rewrites this bill to make various changes and additions to present law concerning the exercise of governmental powers related to public health. Present law authorizes county health officers to order rules and regulations as are necessary or appropriate to protect the general health and safety of the county. This amendment removes such authorization during a declared state of emergency for a COVID-19 pandemic. Present law requires the commissioner of health to appoint county health directors. Present law specifies that, if the commissioner appoints a county health director, the appointment must be made in concurrence with the county mayor. This amendment creates a nomination process for county health officers whereby a county mayor will be required to submit a slate of up to three nominees to the commissioner for consideration within 10 days of a request for nominees by the commissioner. The commissioner will be authorized to appoint a health director from the list of nominees, or request additional nominees, or appoint someone to the position that has not been nominated by the mayor. Prior to appointing someone who is not a mayoral nominee, this amendment requires the commissioner to first consult with the mayor and provide written justification as to why a mayoral nominee was not selected. ON OCTOBER 29, 2021, THE SENATE SUBSTITUTED HOUSE BILL 9076 FOR SENATE BILL 9013, ADOPTED AMENDMENT #1, AND PASSED HOUSE BILL 9076, AS AMENDED. AMENDMENT #1 deletes the provisions of this bill that confer on the commissioner of health the sole authority to determine quarantine guidelines. This amendment removes entirely (instead of only during a COVID-19 pandemic) the authorization for county health officers to order rules and regulations as are necessary or appropriate to protect the general health and safety of the county. This amendment restores the provision of this bill that was removed by House Amendment #1, which authorizes county mayors, under advisement with county boards of health, to issue orders to protect the general health and safety of county residents, subject to the governor's emergency powers. This amendment changes the nomination process for county health officers that was added by House Amendment #1 by removing authorization for the commissioner of health to appoint as county health director a person who was not nominated by the county mayor. This amendment also adds a requirement that the commissioner make appointments of county health directors in writing. ON OCTOBER 29, 2021, THE HOUSE NONCONCURRED IN SENATE AMENDMENT #1. ON OCTOBER 29, 2021, THE SENATE REFUSED TO RECEDE IN ITS ACTION IN ADOPTING SENATE AMENDMENT #1. ON OCTOBER 29, 2021, THE HOUSE REFUSED TO RECEDE IN ITS ACTION IN NONCONCURRING IN SENATE AMENDMENT #1, AND APPOINTED A CONFERENCE COMMITTEE. ON OCTOBER 29, 2021, THE SENATE APPOINTED A CONFERENCE COMMITTEE. ON OCTOBER 30, 2021, THE HOUSE ADOPTED THE CONFERENCE COMMITTEE REPORT AND MADE IT THE ACTION OF THE HOUSE. ON OCTOBER 30, 2021, THE SENATE ADOPTED THE CONFERENCE COMMITTEE REPORT AND MADE IT THE ACTION OF THE SENATE.