Unlike the board of health, the county health department is a required agency.  It is to be headed by the county health director, who is appointed by the commissioner of health and is compensated, at least in part, by the state.  The commissioner also appoints a county health officer who must be a physician.  If the county health director is a physician, he or she may also serve as the county health officer.  T.C.A. § 68-2-603.

The county legislative body must provide necessary office facilities and funds for the functioning of the county health department.  T.C.A. § 68-2-604.  All private acts relative to county boards of health or county health departments remain in effect after the passage of T.C.A. §§ 68-2-601 et seq., 68-2-606.