Tennessee Department of Health outlines services, staffing and rural partnerships to House Health Committee

Tennessee Department of Health Commissioner Ralph Alvarado told the House Health Committee on Feb. 1, 2025, that the department employs roughly 2,900 people and manages a budget of about $1.5 billion while operating primary-care clinics, dental sites and local public-health programs across all 95 counties.

Alvarado said the department’s mission is “to protect, promote, and improve the health and the well-being of all people in Tennessee” and emphasized partnerships with metro health departments and other state agencies to reach rural and underserved communities. “The department is 1 of the largest, government, struct or departments in state government and touches almost everybody in the the state,” he said.

The presentation to the House Health Committee was an overview of department programs and services and came during an informational, meet-and-greet committee session. Committee members and department leaders discussed staffing, vaccination trends, maternal and population health initiatives and coordination with metro health departments.

Among program details provided to the committee: the department operates 56 clinic locations and 16 federally qualified health centers; about 870,000 visits are made each year to local health departments; the department runs 57 primary-care clinics that see roughly 560,000 visits annually and 33 dental clinics (about 20,000 visits last year), with 12 additional dental clinic sites ready to open as dentists are hired. Commissioner Alvarado said the department’s total staff is “about over 2,900 positions,” of which “about 2,700 of those are full time” and “214 are part time.” He gave the department’s approximate budget as “a little bit over $1,500,000,000.”

Speakers framed several priorities: infectious-disease control (including syphilis and sexually transmitted infections), environmental health and restaurant inspections, opioid-overdose prevention and a public-health laboratory expansion. Dr. Tim Jones, the department’s chief medical officer, said the department receives roughly 250,000 individual communicable-disease reports annually and that about 75,000 of those are sexually transmitted infections; he noted efforts to expand testing in pregnant women to prevent congenital syphilis. He also described the department’s lab capacity and a new laboratory facility scheduled to open in about 18 months.

Deputy Commissioner J.W. Randolph described locally led County Health Councils that conduct county health assessments and community health improvement plans; he said such local planning was a top recommendation of the state’s rural health task force. Randolph also outlined the Healthcare Resiliency Program and said prior COVID-relief investments supported more than $240 million for 90-plus rural projects; he noted a new state-funded round backed by $50 million in TennCare shared-savings dollars and that the application window had recently closed.

Department officials highlighted maternal and infant initiatives—programs such as WIC, Count the Kicks, evidence-based home visiting (Healthy Families America, Nurse-Family Partnership, Parents as Teachers), safe-sleep distribution and perinatal quality efforts carried out in partnership with hospitals. A population-health speaker described programs to identify and address social drivers of health, walkability planning, safety-net clinics supported by the department and a youth tobacco-prevention effort called TN Strong (Tennessee Stop Tobacco and Revolutionize Our New Generation).

Committee members asked about recent declines in vaccination coverage, the potential return of vaccine-preventable diseases and strategies for improving county-level health rankings. Commissioner Alvarado said Tennessee has moved from a top-10 state for pediatric vaccination to a bottom-10 standing on some metrics and cited a need for engagement and public discussion. He also recommended focus areas—tobacco and cancer screening—to move state health rankings.

Alvarado and staff invited the committee to schedule a longer budget discussion; the department noted it will return later in the year for budget hearings and to provide more detailed proposals. The department also described workforce and recruitment efforts, including public-awareness campaigns and internship expansions to address high vacancy rates in dental and clinical positions.

The committee did not take formal action on any bills or motions during this informational presentation.