Tennessee Department of Health provides overview of services, staffing and priorities to House Health Committee

The Tennessee Department of Health outlined its scope of services, staffing and current priorities to the House Health Committee during an informational meeting on Jan. 1, 2025. Commissioner Ralph Alvarado and senior agency officials summarized clinic operations, disease control work, prevention programs and workforce needs.

Why it matters: Committee members heard that the department touches a large share of Tennesseans through local health departments and statewide programs, and that improved public-health investments and partnerships will be needed to move Tennessee out of the bottom tier on many health metrics.

Alvarado said the department operates a statewide network of local health departments and provides primary-care services in health department clinics. “We are the only state in the Union to provide primary care services in our health departments,” he said. He described a department with roughly 2,900 positions and a budget this year of about $1.5 billion, noting federal relief funding has temporarily inflated recent totals. He also identified heart disease, cancer and tobacco use — including vaping — as the biggest drivers of poor outcomes in Tennessee and urged legislative partnerships to address them.

Deputy commissioners and program leads described specific operations that committee members might not see day to day. Chief Medical Officer Tim Jones said county health staff handle roughly 870,000 visits a year, including about 560,000 visits to 57 primary-care clinics and about 20,000 dental visits at 33 dental clinics. Jones also emphasized communicable-disease work: the department receives about 250,000 individual disease reports annually and follows up on interviews, contact tracing and outbreak investigations, and has distributed naloxone widely through local health departments.

A presentation on population and community health programs highlighted vital records, the WIC (Women, Infants and Children) nutrition program, injury-prevention initiatives and evidence-based home visiting. The department said its vital records office handles large volumes of certificates and that demand rose recently, in part because of Real ID and federal documentation changes.

Officials highlighted several programs by name: Count the Kicks (an app-based fetal movement reporting tool rolled out last summer), TN STRONG (a youth-led tobacco-prevention movement), and a navigation/coordination program referred to in the presentation as CHANT (spelling was inconsistent in the briefing). Staff described CHANT as a centralized referral pathway offering multiple social-support connections, from bereavement help to finding dental care.

Environmental health and lab operations were also described in detail. Jones said the state runs approximately 80,000 restaurant inspections annually, regulates pools, tattoo parlors and correctional facilities, and processes about 1.8 million infectious-disease tests in its public-health laboratory. He noted a new state laboratory is under construction and expected to open in about 18 months to expand capacity.

Deputy Commissioner J.W. Randolph reviewed local governance and community-led planning, including county health councils that set local priorities through assessments and improvement plans. Randolph also described the department’s Healthcare Resiliency Program and other rural health investments supported by federal relief and state reinvestment.

Committee questions focused on how to improve statewide outcomes. Representative Brock Martin asked what the legislature could do to move the needle; Alvarado highlighted tobacco and vaping policy, expanded cancer screening and community-level interventions such as Blue Zones-style planning. Representative John Ray Clemens and others pressed on pediatric vaccine rates; Alvarado and staff said Tennessee has fallen from the top 10 nationally to the bottom 10 on pediatric vaccination coverage and described recent measles and polio cases as reminders of the risks when coverage drops.

Members also raised workforce concerns for safety-net clinics and local health departments; staff acknowledged vacancies in dental and clinic positions and described recruitment campaigns and workforce initiatives the department and its partners are pursuing.

The committee did not take formal action on any bills during the session; the department was invited to return later in the year for budget hearings and deeper follow-up on priorities and workforce strategies.

Less-critical details: staff present at the briefing included Deputy Commissioners John Webb and J.W. Randolph, Chief Medical Officer Tim Jones, Deputy Commissioner and General Counsel Mary Kathryn Bratton, and additional program leads and clerks. The meeting also included an operational note that a planned practice vote was postponed because of a new voting system glitch.