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

Present law requires the county legislative body of each county to establish a board of health, and requires each county to establish a county health department. Present law also provides that private acts relative to county boards of health or county health departments that were in effect at the time these general law requirements were enacted (which was July 1, 1985) remain in effect. This bill deletes the present law provision that continues the validity of pre-July 1, 1985, private acts relating to county boards of health and county health departments, and provides that each county health department in this state, including a county health department created by private or public act prior to July 1, 1985, or by action of a county legislative body, is deemed to be a county health department created under the general laws of this state, and must comply with and is subject to those general laws. Under this bill, with respect to county health departments created, by private or public act prior to July 1, 1985, or by action of a county legislative body, such health departments: (1) Will control the manner in which they are funded and staffed; and (2) Will maintain the manner in which they submit proposed budgets for funding, staffing, facilities, and resources. Present law authorizes the commissioner of health to appoint a county health officer responsible for providing medical direction including medical enforcement actions. This bill rewrites this provision to instead provide that the county mayor may appoint a county health officer, subject to the written concurrence of the commissioner of health (as discussed below). Also, present law provides the following: (1) The county health director is to be appointed by the commissioner of health or by the commissioner's designee; (2) If the commissioner appoints a county health director, the appointment must be made by the commissioner in concurrence with the county mayor of the county for which the appointment is made. This bill rewrites the above provisions to instead provide the following: (1) The county health director will be appointed by the county mayor; (2) The county mayor must appoint the county health director in concurrence with the commissioner of health. The commissioner must concur or not concur with the proposed appointee in writing within 10 days of notification of the appointment by the mayor. If the commissioner does not concur, the county mayor must submit a different nominee to the commissioner for approval. If the commissioner does not respond to the county mayor in writing within 10 days of notification of any county mayor appointee, the appointment is deemed to be approved. For purposes of promulgating rules and orders, and carrying out administrative duties necessary to effectuate the provisions and intent of this bill, this bill will take effect upon becoming law. For all other purposes, this bill will take effect on July 1, 2022.