Safety

Environmental Protection

Health

Chapter 1
Department of Health

Part 1
General Provisions

68-1-101. Department organized into divisions — Expedited issuance of license.

  1. The department of health shall be organized into the following divisions:
    1. The division of sanitary engineering, the head of which shall be the sanitary engineer;
    2. The division of laboratories, the head of which shall be the bacteriologist;
    3. The division of tuberculosis control, the head of which shall be the commissioner of health;
    4. The division of preventable diseases, the head of which shall be the director of preventable diseases;
    5. The division of children's special services, the head of which shall be the director of crippled children's service;
    6. The division of medical care, the head of which shall be the director of medical care, who shall be appointed by the governor;
    7. The division of rabies control, the head of which shall be the director of rabies control; and
    8. The division of health related boards for all administrative, fiscal, inspectional, clerical and secretarial functions of the following boards, agencies and commissions:
      1. Board of alcohol and drug abuse counselors;
      2. Board of athletic trainers;
      3. Board for professional counselors, marital and family therapists and clinical pastoral therapists;
      4. Board of chiropractic examiners;
      5. Board of communication disorders and sciences;
      6. Board of communication disorders and sciences' council for hearing instrument specialists;
      7. Board of dentistry;
      8. Board of dietitians/nutritionists examiners;
      9. Board of dispensing opticians;
      10. Board of electrolysis examiners;
      11. Board of examiners for nursing home administrators;
      12. Board of examiners in psychology;
      13. Board of medical examiners;
      14. Board of medical examiners' committee for clinical perfusion;
      15. Board of medical examiners' committee on physician assistants;
      16. Board of medical examiners' Tennessee advisory committee for acupuncture;
      17. Board of nursing;
      18. Board of occupational therapy;
      19. Board of optometry;
      20. Board of osteopathic examination;
      21. Board of osteopathic examination's council of certified professional midwifery;
      22. Board of pharmacy;
      23. Board of physical therapy;
      24. Board of podiatric medical examiners;
      25. Reflexology practitioners' registration;
      26. Board of respiratory care;
      27. Board of social worker licensure;
      28. Tennessee massage licensure board;
      29. Tennessee medical laboratory board; and
      30. Board of veterinary medical examiners.
    1. Notwithstanding any other law to the contrary, each health related board and the emergency medical services board shall establish a procedure to expedite the issuance of a license, certification or permit to perform professional services regulated by each such board to a person:
        1. Who is certified or licensed in another state to perform professional services in a state other than Tennessee;
        2. Whose spouse is a member of the armed forces of the United States; and
        3. Whose spouse is the subject of a military transfer to this state; or
        4. [Deleted by 2019 amendment.]
        1. Who, as a member of the armed forces of the United States, carries a current license or certification in another state to perform substantially similar professional services in a state other than Tennessee; and
        2. Who applies for a license in Tennessee within one hundred eighty (180) days of:
          1. Retiring from the armed forces of the United States;
          2. Receiving any discharge other than a dishonorable discharge from the armed forces of the United States; or
          3. Being released from active duty into a reserve component of the armed forces of the United States.
    2. The procedure shall include:
      1. Issuing the person a license, certificate or permit, if, in the opinion of the board, the requirements for certification or licensure of such other state are substantially equivalent to that required in this state; or
      2. Developing a method to authorize the person to perform professional services regulated by the board in this state by issuing the person a temporary permit for a limited period of time in accordance with § 63-1-142.
  2. The commissioner, each health related board and the emergency medical services board shall, upon application for certification or licensure, accept military education, training or experience completed by a person described in subdivisions (b)(1)(B)(ii)(a )-(c ) toward the qualifications to receive the license or certification if such education, training or experience is determined by the commissioner or board to be substantially equivalent to the standards of this state.
    1. Notwithstanding any other law to the contrary, any member of the national guard or a reserve component of the armed forces of the United States called to active duty, and who, at the time of activation, was duly licensed or certified to perform professional services by a health related board of this state or by the emergency services board of this state, shall be kept in good standing by the board during the period of activation.
    2. A license, certification or permit issued by a health related board of this state or by the emergency services board of this state for a person described in subdivision (d)(1) shall be temporarily renewed pursuant to subdivision (d)(3) without:
      1. Payment of dues or fees;
      2. Obtaining continuing education credits when:
        1. Circumstances associated with the person's military duty prevent the obtaining of continuing education credits and a waiver request has been submitted to the appropriate health related board or to the emergency medical services board; or
        2. The person performs the licensed or certified occupation as part of such person's military duties and provides documentation to the appropriate health related board or to the emergency medical services board; or
      3. Performing any other act typically required for the renewal of the license or certification.
    3. The license, certification or permit issued under this subsection (d) shall be continued or renewed while the person described in subdivision (d)(1) is on active duty until no later than six (6) months from the person's release from active duty.

Acts 1923, ch. 7, § 47; Shan. Supp., § 373a108; Code 1932, § 326; Acts 1935, ch. 135, § 1; 1937, ch. 33, § 64; 1939, ch. 77, § 2; 1939, ch. 102, § 1; 1941, ch. 23, § 6; 1947, ch. 16, § 3; mod. C. Supp. 1950, § 326 (Williams, §§ 255.67, 255.68a, 326, 4432.23, 4752, 4916.2, 5827.6); Acts 1953, ch. 252, § 3 (Williams, § 5109.22); impl. am. Acts 1967, ch. 173, § 1; Acts 1971, ch. 81, § 2; impl. am. Acts 1971, ch. 188, § 1; impl. am. Acts 1972, ch. 771, § 1; 1974, ch. 495, § 8; impl. am. Acts 1976, ch. 575, § 1; Acts 1976, ch. 623, § 1; 1976, ch. 650, § 15; impl. am. Acts 1977, ch. 128, § 3; Acts 1978, ch. 906, § 5; 1978, ch. 924, § 2; impl. am. Acts 1979, ch. 378, §§ 2, 19; T.C.A. (orig. ed.), § 53-101; Acts 1984, ch. 921, § 6; 1984, ch. 1003, § 3; 1995, ch. 419, § 1; 2007, ch. 424, § 1; 2008, ch. 1016, § 8; 2011, ch. 230, § 1; 2013, ch. 122, §§ 1, 3, 5; 2019, ch. 195, § 2.

Compiler's Notes. Acts 2013, ch. 122, § 7 provided that each entity subject to the act shall promulgate rules and regulations to effectuate the purposes of the act. All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. Notwithstanding § 4-5-208, each entity subject to the act is authorized to promulgate emergency rules to implement the act.

Acts 2019, ch. 195, § 3  provided that the commissioner of commerce and insurance and the commissioner of health shall promulgate rules to effectuate the purposes of this act. The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2019, ch. 195, § 4  provided that the act, which amended this section, shall apply to all persons who make application for an exemption from licensure under the  act.

Amendments. The 2013 amendment, in (b)(1), inserted “and the emergency medical services board” in the introductory paragraph, redesignated former (A)-(D) as present (A)(i)-(iv), and added present (B); and added (c) and (d).

The 2019 amendment, deleted (b)(1)(A)(iv), which read, “(iv) Who left employment to accompany the person's spouse to this state; or”.

Effective Dates. Acts 2013, ch. 122, § 8. July 1, 2013; provided, that, for the purpose of promulgating rules and regulations, the act shall take effect April 12, 2013.

Acts 2019, ch. 195, § 4.  July 1, 2019.

Cross-References. Advisory committee for children's special services, § 68-12-106.

Board of alcohol and drug abuse counselors, § 68-24-601.

Board of chiropractic examiners, § 63-4-102.

Board of communication disorders and sciences, § 63-17-104.

Board of dentistry, title 63, ch. 5.

Board of dietitian and nutritionist examiners, § 63-25-106.

Board of dispensing opticians, § 63-14-101.

Board of examiners for nursing home administrators, § 63-16-102.

Board of examiners in psychology, title 63, ch. 11, part 1.

Board of medical examiners' committee on physician assistants, § 63-19-103.

Board of medical examiners, title 63, ch. 6, part 1.

Board of nursing, title 63, ch. 7, part 2.

Board of optometry, §§ 63-8-10363-8-112.

Board of osteopathic examination, §§ 63-9-10163-9-103.

Board of podiatric medical examiners, § 63-3-10363-3-106.

Board of respiratory care, § 63-27-103.

Board of social worker licensure, § 63-23-101.

Board of veterinary medical examiners, §§ 63-12-10463-12-110.

Clinical perfusionists, title 63, ch. 28.

Creation of department of health, §§ 4-3-101, 4-3-1801.

Director of division of health related boards, §§ 63-1-13163-1-133.

Disposition of dead bodies, title 68, ch. 4.

Division of health related boards, title 63, ch. 1.

Division of tuberculosis control, creation and maintenance, § 68-9-102.

Hearing instrument specialists, title 63, ch. 17, part 2.

Massage therapists, title 63, ch. 18.

Medical care division, title 68, ch. 1, part 9.

Medical laboratories, title 68, ch. 29.

Midwifery, title 63, ch. 29.

Powers of department of health, in general, § 4-3-1803.

Primary health care centers, title 68, ch. 1, part 7.

Professional counselors, marital and family therapists, and clinical pastoral therapists, title 63, ch. 22.

Rabies, title 68, ch. 8.

Reflexology practitioners, title 63, ch. 30.

Sanitary engineering, title 68, ch. 221.

Speech language pathologists and audiologists, title 63, ch. 17, part 1.

State examining boards, title 4, ch. 19.

Tennessee advisory committee for acupuncture, § 63-6-1003.

Vital records, title 68, ch. 3.

Water quality, oil and gas control board, § 69-3-104.

Comparative Legislation. State department of health:

Ala.  Code § 22-2-1 et seq.

Ark.  Code § 20-7-101 et seq.

Ga. O.C.G.A. § 31-2-1 et seq.

Ky. Rev. Stat. Ann. § 211.005 et seq.

Miss.  Code Ann. § 41-3-1.1 et seq.

Mo. Rev. Stat. §§ 191.400, 191.411; § 205.010 et seq.

N.C. Gen. Stat. § 130A-1 et seq.

Va. Code § 32.1-5 et seq.

Collateral References. 39 Am. Jur. 2d Health § 3 et seq.; 40 Am. Jur. 2d Hospitals and Asylums § 4.

39A C.J.S. Health and Environment § 4 et seq.

41 C.J.S. Hospitals § 6.

Health and Environment 2 et seq.

Hospitals 1 et seq.

68-1-102. Commissioner — Deputies — Chief medical officer.

  1. The department of health shall be under the charge and general supervision of the commissioner of health, who shall be appointed by the governor in the same manner as other commissioners and who shall have the same official status as other commissioners. The commissioner shall hold office at the pleasure of the governor. The compensation of the commissioner shall not exceed that of a Class 1 official, as established in § 8-23-101.
    1. The commissioner may appoint a deputy commissioner, who, in the event of absence or incapacity of the commissioner or in the event of a vacancy in the office of commissioner, may be authorized in accordance with § 4-4-115 to exercise any and all of the powers of the commissioner until such time as the duly appointed commissioner can fulfill the commissioner's responsibilities.
    2. The commissioner is also authorized to delegate any of the powers, duties, responsibilities or authority vested in the commissioner by the laws of the state of Tennessee. This delegation shall be made in writing to any appropriate official of the department.
    1. The commissioner shall appoint a state health officer to be called the chief medical officer for the state who shall, at the direction of the commissioner, be responsible for and advise the commissioner and the department on all matters of health policy in all state services and programs, including, but not limited to, medicaid, public health, and environmental health.
    2. The chief medical officer shall be:
      1. A physician licensed to practice medicine in Tennessee; and
      2. Appointed from a list of nominees containing at least three (3) names for consideration by the commissioner to be submitted by the Tennessee Medical Association board of trustees.
    3. Any of the powers, duties, responsibilities, or authorities vested in the commissioner that require or imply that the commissioner is a licensed physician may be delegated by the commissioner to the chief medical officer. Any such delegation shall be made in writing and shall be filed with the secretary of state. The salary for the chief medical officer shall be paid consistent with the January 1, 1983, physician 959 classification or the highest paid physician in subsequent classification/compensation plans.

Acts 1951, ch. 225, § 1 (Williams, § 328.3); T.C.A. (orig. ed.), § 53-102; Acts 1983, ch. 219, § 1.

Compiler's Notes. For transfer of the bureau of environment in the department of health and its related functions and the administration of the Tennessee environmental statutes (excluding chs. 14, 110 (formerly 28) and 112 (formerly 42) of this title) from the department of health to the department of environment and conservation, see Executive Order No. 42 (February 4, 1991).

Cross-References. Chief executive officers of administrative departments, § 4-3-111.

Creation of the department of health, § 4-3-101, title 4, ch. 3, part 18.

68-1-103. Rules and regulations — Fees and charges.

  1. The commissioner of health may adopt rules and regulations subject to this chapter.
  2. The commissioner is empowered to adopt, promulgate and enforce, with the concurrence of the comptroller of the treasury and the commissioner of finance and administration, rules and regulations establishing fees and charges for any public health service, including, but not limited to, licenses, permits, or authorizations rendered pursuant to, or required by, any statute administered by the department of health. Any and all recipients of public health services shall be responsible for payment of same. The commissioner is empowered to promulgate regulations to reduce or eliminate fees for any classification or classifications of services, based upon recipients' condition or ability to pay. All fees received for the performance of services shall be retained by the district, municipal or county health department rendering the service, subject to the prior approval of the commissioner. Any fees received by the state department of health, and any fees not retained by the district, municipal or county health department, shall be deposited with the state treasurer in accordance with the provisions set forth in § 9-2-127. Any fees retained by district, municipal or county public health departments are to be applied toward the cost of providing or expanding the service or evaluating and processing the license, permit or other authorization, and the district, municipal or county department shall provide an accounting to the state of all such fees retained by that department, in such manner as shall be determined by the commissioner. With the approval of the commissioner, district, municipal and county public health departments may establish fees and charges in excess of, or less than, fees and charges set by the commissioner. Any fee for services performed by the municipal, county or district public health departments not included on the fee schedule prepared by the commissioner shall be established by the district, municipal or county public health department. The amount of any fee established by the commissioner or by a district, municipal or county public health department under this section shall not exceed the cost of providing the service.
  3. Rules and regulations establishing fees shall be in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 1877, ch. 98, § 8; Shan., § 3094; impl. am. Acts 1923, ch. 7, § 46; Code 1932, § 5756; Acts 1973, ch. 323, § 1; 1981, ch. 192, §§ 1, 2; T.C.A. (orig. ed.), § 53-103; Acts 1983, ch. 294, § 1.

Compiler's Notes. For transfer of the bureau of environment in the department of health and its related functions and the administration of the Tennessee environmental statutes (excluding chs. 14, 110 (formerly 28) and 112 (formerly 42) of this title) from the department of health to the department of environment and conservation, see Executive Order No. 42 (February 4, 1991).

Cross-References. Establishment of fees for the regulation of health and related facilities, § 68-11-216.

Establishment of fees for emergency services, § 68-140-317.

Powers and duties of the department of health, §  4-3-1803.

Rules and bylaws to control sexually transmitted diseases, § 68-10-109.

Rules and regulations regarding acupuncture, § 63-6-1004.

Rules and regulations regarding advertisement pertaining to board certification and specialty, § 63-1-145.

Rules and regulations regarding area health educations centers, § 68-1-1614.

Rules and regulations regarding certified nurse practitioners, § 63-7-123.

Rules and regulations regarding chiropractors, § 63-4-106.

Rules and regulations regarding enforcement of pharmaceutical laws, § 63-10-304.

Rules and regulations regarding family planning, § 68-34-106.

Rules and regulations regarding funeral directors and embalmers, § 62-5-203.

Rules and regulations regarding hazardous waste, §§ 68-212-312, 68-212-504.

Rules and regulations regarding health related boards, § 63-1-139.

Rules and regulations regarding inspection of hotels, food service establishments and public swimming pools, § 68-14-326.

Rules and regulations regarding licensing of alcohol and drug abuse counselors, § 68-24-603.

Rules and regulations regarding management and regulation of cemeteries, § 46-2-101.

Rules and regulations regarding medical laboratories, § 68-29-105.

Rules and regulations regarding midwifery, § 63-29-116.

Rules and regulations regarding operation of X-ray equipment in physicians' offices, § 63-9-112.

Rules and regulations regarding podiatrists, § 63-3-202.

Rules and regulations regarding primary health care centers, § 68-1-702.

Rules and regulations regarding rabies, § 68-8-112.

Rules and regulations regarding reflexology practitioners, § 63-30-112.

Rules and regulations regarding regulation of health and related facilities, § 68-11-209.

Rules and regulations regarding sanctions for violations of division of health related boards, § 63-1-146.

Rules and regulations regarding social workers, § 63-23-110.

Rules and regulations regarding solid waste disposal, §§ 68-211-107, 68-211-111, 68-211-1006.

Rules and regulations regarding subsurface sewage disposal systems, §§ 68-221-409, 68-221-414.

Rules and regulations regarding the cancer reporting system, § 68-1-1004.

Rules and regulations regarding the prevention of diseases, § 68-5-103.

Rules and regulations regarding the public school nurse program, § 68-1-1204.

Rules and regulations regarding tuberculosis, § 68-9-104.

Rules and regulations regarding veterinarians, § 63-12-105.

Rules and regulations regarding vital records, § 68-3-103.

Rules for beauty shops, § 62-4-125.

Sexually transmitted diseases, making rules and bylaws to control, § 68-10-109.

68-1-104. Duties of commissioner.

The department of health shall have the general supervision of the interests of health and life of the citizens of this state. The commissioner shall:

  1. Especially study the vital statistics of this state, and endeavor to make intelligent and profitable use of the records of sickness and death among the people;
  2. Make sanitary investigations and inquiries respecting the causes of disease, especially epidemics, the causes of death, effects of employment, habits, localities and circumstances, upon the health of the people;
  3. Advise, when the commissioner deems it necessary, in reference to location, water supply, drainage, and ventilation of any public institutions;
  4. From time to time, recommend works upon the subject of hygiene for the use of the schools of this state;
  5. Have the authority to petition the chancery court of Davidson County for judicial review, pursuant to § 4-5-322, of any final order of any board or similar multi-member agency administered by or administratively assigned to the department. This subdivision (5) shall not apply to the boards created by title 59, chapter 8; chapter 201 or chapter 211 of this title; or title 69, chapter 3;
  6. Have the authority to appoint administrative judges from the administrative procedures division of the office of the secretary of state, pursuant to § 4-5-301, to hear contested cases before the department, and contested cases before any board or similar multi-member agency administered by or administratively assigned to the department, upon the request of such board or agency. These boards and agencies are authorized to utilize such administrative judges; and
    1. Develop a grant program for research and development in the area of solid waste disposal technologies to include, but not be limited to, the following options:
      1. Reducing the use of landfills;
      2. Source separation;
      3. Recycling;
      4. Retrieval;
      5. Mass burn;
      6. Private sector involvement; and
      7. Educating the public on the importance of separation; and
    2. Develop standards and guidelines for the submission of proposals for grant applications under the program established by this subdivision (7) and for the manner in which such grant applications will be selected and approved. The amount of the grant shall be as provided in the general appropriations act each fiscal year.

Acts 1877, ch. 98, § 6; Shan., § 3095; impl. am. Acts 1923, ch. 7, § 46; Code 1932, § 5757; T.C.A. (orig. ed.), § 53-104; Acts 1984, ch. 897, §§ 1, 2; 1988, ch. 830, § 1.

Cross-References. Administrative procedures division, § 4-5-321.

Duties of commissioner under Third-Party Prescription Program Act, § 63-10-108.

Powers and duties of the department of health, § 4-3-1803.

Review of fire and life safety codes under law regulating health and related facilities, § 68-11-202.

Sexually transmitted diseases, clinical and laboratory criteria to be set up for guidance of health officers, § 68-10-106.

Solid waste disposal, title 68, ch. 211.

Subsidized receiving homes for children, approval of license application required, § 37-2-306.

Vital records, title 68, ch. 3.

68-1-105. Appropriations for health demonstration work.

  1. The county legislative bodies are empowered to appropriate such sums of money as may be necessary or expedient to be used in cooperating with the department of health in carrying on health demonstration work in the counties.
  2. The state treasurer is authorized and directed to receive and disburse money provided by any agency for the purpose of enabling the department to engage in health demonstration work. When such money is received by the state treasurer, it shall be placed to the credit of the department, and shall be disbursed by the state treasurer as are other funds provided for the department.

Acts 1921, ch. 32, § 1; 1921, ch. 90, § 1; impl. am. Acts 1923, ch. 7, § 46; Shan. Supp., §§ 3100a7, 3100a8; Code 1932, §§ 5766, 5767; modified; impl. am. Acts 1978, ch. 934, §§ 7, 36; T.C.A. (orig. ed.), §§ 53-116, 53-117.

Cross-References. County appropriation and disbursement of funds, title 5, ch. 9.

68-1-106. Acceptance of benefits of acts of congress.

  1. The state of Tennessee does hereby accept the benefits of any acts now passed or hereafter to be passed by the senate and house of representatives of the United States to provide for cooperation with the states in the protection of mothers and infants and promotion of a public health program. The state treasurer is empowered to receive grants of money appropriated under any act of congress and in accordance with any act of congress.
  2. The department of health is required to carry on work in accordance with the terms and conditions of the acts of congress, and shall have necessary authority to cooperate with the federal authorities administering the acts, the department to be deemed the administering agency under the federal acts.

Acts 1923, ch. 65, §§ 1, 2; Shan. Supp., §§ 3100a9, 3100a10; mod. Code 1932, §§ 5768, 5769; modified; T.C.A. (orig. ed.), §§ 53-118, 53-119.

Cross-References. Family planning, title 68, ch. 34.

Programs and services for abused persons, title 71, ch. 6.

Programs and services for children, title 71, ch. 3.

Programs and services for poor persons, title 71, ch. 5.

Treatment of disabled children, title 68, ch. 12.

68-1-107. Indemnity insurance for health officials.

The commissioner of finance and administration, on approval of the fiscal review committee, may procure indemnity insurance, indemnifying the heads of departments of health for the state, counties and cities throughout the state against actions claimed to arise out of acts of omission or commission of such personnel performed in the course of their official duties.

Acts 1971, ch. 417, § 1; T.C.A., § 53-120.

Cross-References. Insurance, title 56.

68-1-108. Reports of claims data by licensed hospitals — Penalties — Waiver — Licensure — Civil liability — Annual report.

  1. Each hospital licensed under this title or title 33, or the hospital's designated entity, shall report all claims data found on the UB-92 form or a successor form on every inpatient and outpatient discharge to the commissioner of health. A hospital shall report the claims data to the commissioner at least quarterly. After receiving the claims data, the commissioner shall promptly make the data available for review and copying by the Tennessee Hospital Association (THA) who shall use the data strictly for its own internal purposes and for internal purposes of its members. No information shall be made available to the public by either the commissioner or the THA that reasonably could be expected to reveal the identity of any patient. The claims data reported to the commissioner under this section are confidential and not available to the public until the commissioner processes and verifies the data. The commissioner shall prescribe conditions under which the processed and verified data are available to the public and shall establish policies for the release of HIPAA compliant limited use data sets.
  2. A licensed hospital shall pay to the commissioner a civil penalty of five cents (5¢) for each day the claims data discharge report is delinquent. A claims data report is delinquent if the commissioner does not receive it before sixty (60) days after the end of the quarter. If the commissioner receives the report in incomplete form, the commissioner shall notify the hospital and provide fifteen (15) additional days to correct the error. The notice shall provide the hospital an additional fifteen (15) days to complete the form and return it to the commissioner prior to the imposition of any civil penalty. The maximum civil penalty for a delinquent report is ten dollars ($10.00) for each discharge record. The commissioner shall issue an assessment of the civil penalty to the hospital. The hospital has a right to an informal conference with the commissioner, if the hospital requests such conference within thirty (30) days of receipt of the assessment. After the informal conference or, if no conference is requested, after the time for requesting the informal conference has expired, the commissioner may proceed to collect the penalty by setting the penalty off against funds owed to the hospital or by instituting litigation.
  3. In its request for an informal conference, the hospital may request the commissioner to waive the penalty. The commissioner may waive the penalty in cases of an act of God or other acts beyond the control of the hospital. Waiver of the penalty is in the sole discretion of the commissioner. None of these proceedings is subject to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  4. A hospital licensed pursuant to chapter 11, part 2 of this title shall, as a condition of licensure, continue to complete and submit annually the report of hospital statistics required by § 68-11-310 and regulations promulgated pursuant to that section.
  5. No person or entity, including the THA, may be held liable in any civil action with respect to any report or disclosure of information made under this section, unless the person or entity has knowledge of any falsity of the information reported or disclosed.
  6. On or before March 1 of each year, the department of health shall submit to the governor, the speaker of the senate, the speaker of the house of representatives, the health and welfare committee of the senate, and the health committee of the house of representatives a report with de-identified aggregate claims data on every inpatient and outpatient discharge that includes coded drug poisonings as reported for the calendar year two (2) years prior to the current year by licensed hospitals to the commissioner of health pursuant to this chapter. The department shall also publish the data submitted under this subsection (f) on the department's Internet web site.

Acts 1985, ch. 480, §§ 1-4; 1994, ch. 889, § 1; 2011, ch. 37, § 1; 2012, ch. 704, § 1; 2012, ch. 916, § 1; 2013, ch. 236, § 49; 2015, ch. 373, § 1; 2018, ch. 618, § 1.

Compiler's Notes. Acts 2012, ch. 916, § 3 provided that the act, which added subsection (f), shall be known and may be cited as the  “The Henry Granju Act.”

Amendments. The 2013 amendment substituted “the health committee of the house of representatives” for “the health and human resources committee of the house of representatives” in the first sentence of (f).

The 2015 amendment rewrote the last sentence of (a), which read “The commissioner shall prescribe conditions under which the processed and verified data are available to the public.”

The 2018 amendment substituted “Each hospital licensed under this title or title 33,” for “Each licensed hospital,” at the beginning of (a).

Effective Dates. Acts 2013, ch. 236, § 94. April 19, 2013.

Acts 2015, ch. 373, §  3. May 4, 2015.

Acts 2018, ch. 618, § 2. July 1, 2018.

Cross-References. Claims data reports from ambulatory surgical treatment centers (ASTCs), § 68-1-119.

Confidentiality of public records, § 10-7-504.

68-1-109. Uncompensated care.

Each hospital shall apply and use the definitions  in subdivisions (1) and (2) when reporting on the joint annual reports to the department of health, center for health statistics. The center for health statistics and comptroller of the treasury's office shall use and apply the definitions when auditing or compiling statistics based on the reports or for any related reports or statistics:

  1. “Bad debts” means amounts considered to be uncollectible from accounts and notes receivable that are created or acquired in providing services. “Accounts receivable” and “notes receivable” are designations for claims arising from rendering services and are collectible in money in the relatively near future;
    1. A debt must meet these criteria:
      1. The provider must be able to establish that reasonable collection efforts were made;
      2. The debt was actually uncollectible when claimed as worthless;
      3. Sound business judgment established that there was no likelihood of recovery at any time in the future; and
      4. Accounts turned over to a collection agency should be classified as bad debt;
      1. If after reasonable and customary attempts to collect a bill, the debt remains unpaid more than one hundred twenty (120) days from the date the first bill is mailed to the patient, the debt may be deemed uncollectible;
      2. Bankrupt accounts shall be considered bad debts, unless there is documented evidence that the medical bill caused bankruptcy. Such accounts would then be counted as charity; and
  2. “Charity care” means reductions in charges made by the provider of services because of the indigence or medical indigence of the patient.
    1. The provider should apply the following guidelines for making a determination of indigence or medical indigence:
      1. The patient's indigence must be determined by the provider, not by the patient; i.e., a patient's signed declaration of the patient's inability to pay the patient's medical bills cannot be considered proof of indigence;
      2. The provider should take into account a patient's total resources, which include, but are not limited to, an analysis of assets, only those convertible to cash and unnecessary for the patient's daily living, liabilities, and income and expenses. Indigence income is determined by the provider's posted charity care policy as required by § 68-11-268. Medical indigence is a status reached when a person uses or commits all available current and expected resources to pay for medical bills and is not limited to a defined percent of the federal poverty guidelines. In making this analysis, the provider should take into account any extenuating circumstances that would affect the determination of the patient's indigence;
      3. The provider shall determine that no source other than the patient is legally responsible for the patient's medical bill; e.g., Title XIX, local welfare agency or guardian; and
      4. The patient's file should contain documentation of the method by which indigence was determined, in addition to all backup information to substantiate the determination.
    2. If indigence is determined and the provider concludes that there had been no improvement in the beneficiary's financial condition, then the hospital may deem uncollectible the debt, or the portion of the debt, determined to be charity care without having to apply the bad debt collection criteria.

Acts 1987, ch. 319, § 1; 2007, ch. 281, § 1; 2020, ch. 619, §§ 1, 2.

Compiler's Notes. Title XIX, referred to in this section, is a reference to Title XIX of the federal Social Security Act, compiled in 42 U.S.C. § 1396 et seq.

Amendments. The 2020 amendment rewrote the second sentence of (2)(A)(ii) which read: “Indigence income means an amount not to exceed one hundred percent (100%) of the federal poverty guidelines.”; and in (2)(B), substituted “If” for “Once” and substituted “then the hospital may deem uncollectable the debt, or the portion of the debt, determined to be charity care without having to apply” for “the debt may be deemed uncollectible without applying.”

Effective Dates. Acts 2020, ch. 619, § 3. March 25, 2020.

Cross-References. Annual report, mental health and developmental disabilities, § 33-4-208.

Collection services, title 62, ch. 20.

Independent review and verification of information for joint annual report for commissioners of health, mental health and substance abuse services, and intellectual and developmental disabilities, § 68-11-1615.

Remedies and special proceedings, title 29.

Report of hospital statistics, § 68-11-310.

68-1-110. Annual list of medicaid and temporary assistance for needy families (TANF) options.

The departments of health and human services shall jointly provide to the health and welfare committee of the senate and the health committee of the house of representatives, on or before December 31 each year, a written list of the options available to the state, and the extent of federal financial participation for each option, under medicaid and temporary assistance for needy families (TANF).

Acts 1988, ch. 713, § 1; 2013, ch. 236, § 87.

Code Commission Notes.

References to “aid to families with dependent children (AFDC)” were deleted as obsolete by authority of the code commission and were changed to “temporary assistance for needy families (TANF),” compiled in 42 U.S.C. § 601 et seq.

Amendments. The 2013 amendment substituted “the health and welfare committee of the senate and the health committee of the house of representatives” for “the general welfare committee of each house, the senate and the house of representatives”.

Effective Dates. Acts 2013, ch. 236, § 94. April 19, 2013.

68-1-111. Record retention requirement.

Notwithstanding any rule, regulation or law to the contrary, home health care agencies shall keep records dating back five (5) years from the date information is obtained by the agency.

Acts 1988, ch. 733, § 1.

68-1-112. Unauthorized revealing of information.

  1. It is prohibited conduct for any department of health employee to knowingly reveal, or cause to be revealed, any information to a person not authorized by the authority of the commissioner to receive or have knowledge of the information that can reasonably be expected to provide the person with advance notification of the date, time or place that an inspection to be conducted by the department will occur.
  2. If the commissioner finds that any department employee has revealed information in violation of subsection (a), then the commissioner has the authority to terminate the employee from state employment, in accordance with the same procedures, safeguards and rights of appeal as are generally provided by law or regulation for the discipline or termination of state employees.
  3. The commissioner shall publish a memorandum to employees explaining subsections (a) and (b) and shall post appropriate notices of this law.

Acts 1988, ch. 956, § 1; 1989, ch. 370, § 1; 1992, ch. 693, § 2.

Compiler's Notes. For transfer of the administration of the Tennessee environmental statutes from the department of health to the department of environment and conservation, see Executive Order No. 42 (February 4, 1991).

Cross-References. Public officers and employees, civil service, title 8, ch. 30.

68-1-113. Office on civil rights compliance — Sanctions.

    1. There is established, as an extension of the office of Title VI compliance within the department of health, an office on civil rights compliance by health care facilities.
    2. The office shall monitor, and upon receiving a complaint shall investigate, health care facilities licensed by the state, to determine whether any facility is denying any individual the full and equal enjoyment of the services, privileges, advantages and accommodations offered within the facility on the grounds of race, color or national origin.
    3. Following an investigation, if a determination is made by the office that any such discriminatory practice has occurred or is occurring, the office shall inform the health care facility of its findings and shall work with the facility to take affirmative action to ensure compliance with this section, and to ensure the health care facility shall cease and desist from the discriminatory practice.
    4. The office on civil rights compliance shall report and document any such discriminatory practice to the commissioner, the Tennessee human rights commission, and the board for licensing health care facilities.
  1. If complaints of discriminatory practices continue to be received by the office during the time the office is monitoring previously investigated complaints or during follow-up investigations, and if the office determines that the facility has continued to engage in the discriminatory practices, the office shall forward its findings to the board for licensing health care facilities for appropriate disciplinary action. The board shall have the authority to impose sanctions as provided in subsection (c) for violations of this section.
  2. The board for licensing health care facilities may deny, suspend or revoke the license issued to the health care facility for a violation of this section.
  3. In addition to the action pursuant to subsection (c) by the board, the commissioner may impose a civil penalty in an amount not to exceed five thousand dollars ($5,000) for violation of this section.
  4. Any sanction imposed upon a health care facility by the board or the commissioner pursuant to this section shall be imposed in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  5. Implementation of this section shall be subject to funding being provided in the general appropriations act.

Acts 1988, ch. 977, §§ 1, 2.

Compiler's Notes. For an Order establishing the Tennessee Title VI Compliance Commission, see Executive Order No. 34 (August 9, 2002).

Title VI, referred to in this section, is a reference to title VI of the Civil Rights Act of 1964, compiled in 42 U.S.C. § 2000d et seq.

Cross-References. Board for licensing health care facilities, § 68-11-203.

Human rights, title 4, ch. 21.

68-1-114. Release of disciplinary reports.

  1. The division of health related boards shall issue monthly a press release containing a disciplinary report, which shall list all disciplinary actions taken by each board during the prior month. The report shall list, by board, the following:
    1. Name and professional address of any person disciplined the prior month;
    2. Disciplinary action taken; and
    3. Any civil penalty imposed.
  2. The disciplinary report for the prior month shall be made available to newspapers of general circulation in each of the state's metropolitan areas, Nashville, Memphis, Knoxville, Chattanooga and the tri-cities area composed of Bristol, Johnson City and Kingsport, by the fifteenth of each following month.

Acts 1989, ch. 389, § 4.

68-1-115. Regulations — Tennessee family insurance assistance program.

The commissioner of health shall promulgate regulations regarding the issuance of information concerning the availability of financial assistance through the state medical assistance program for beneficiaries of group health plans, pursuant to the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), compiled in 29 U.S.C. §§ 1161 — 1168 and 42 U.S.C. §§ 300bb-1 — 300bb-8, § 56-7-2312 and related laws and regulations.

Acts 1991, ch. 420, § 1.

68-1-116. Licenses and renewals for registered professional environmentalists.

  1. Notwithstanding any provision of this chapter to the contrary, all persons who wish to obtain a license as a registered professional environmentalist must, by August 31, 1994, submit an application to the board, accompanied by a nonrefundable fee as set by the state board of examiners for registered professional environmentalists. In addition, an applicant shall successfully pass an examination approved by the board by September 30, 1994.
  2. After August 31, 1994, all persons who wish to renew a license as a registered professional environmentalist shall submit an application for renewal to the department of health. The department may set fees for the renewal of licenses pursuant to this section.

Acts 1994, ch. 916, § 3.

68-1-117. Program for health care professional development for underserved and disadvantaged populations in Tennessee.

  1. There is established a program for health care professional development for underserved and disadvantaged populations in Tennessee at Meharry Medical College School of Medicine. The program shall develop resources for recruiting, training and deploying physicians for service in areas of Tennessee with disadvantaged and medically underserved populations.
  2. The program shall:
    1. Develop programs in undergraduate medical education with positions for qualified Tennessee residents, especially for residents from disadvantaged and medically underserved areas (MUAs);
    2. Expand specialty training in family medicine, preventive medicine, and enhance generalist physician training in the disciplines of internal medicine, pediatrics, and obstetrics/gynecology;
    3. Increase recruitment of students from disadvantaged communities and health resource shortage areas (HRSAs) of the state;
    4. Deploy physicians into disadvantaged communities in service to local health departments and counties demonstrating need; and
    5. Expand academic and student support services as required for enrolled Meharry students from disadvantaged communities and HRSAs of the state.

Acts 1998, ch. 1000, § 1.

68-1-118. Specific authorization required for release of information.

The department of health or any employee of the department of health shall not release information that is not specifically authorized by state or federal law to any insurance company, agency, company or firm, pertaining to the health of any person without the patient's consent, or, if a minor, the consent of the minor's parent, guardian or legal custodian, or pursuant to an appropriate court order.

Acts 2001, ch. 427, § 2.

Cross-References. Dissemination of social security numbers, § 4-4-125.

68-1-119. Claims data discharge reports by ambulatory surgical treatment centers (ASTCs) — Penalties — Waiver — Civil liability — Exceptions.

  1. Each licensed ambulatory surgical treatment center (ASTC) and each licensed outpatient diagnostic center (ODC) shall report all claims data found on the appropriate form on every discharge to the commissioner of health. ASTCs and ODCs shall file joint annual reports as required by the department of health. ASTCs and ODCs shall submit the data through third party entities approved by the department of health for the purpose of editing the data according to rules and regulations established by the commissioner. The ASTCs and ODCs shall be responsible for the costs associated with processing of the data by the approved vendors. An ASTC and an ODC shall report the claims data at least quarterly to the commissioner. No information shall be made available to the public by the commissioner that reasonably could be expected to reveal the identity of any patient. The claims data reported to the commissioner under this section are confidential and not available to the public until the commissioner processes and verifies the data. The commissioner shall prescribe conditions under which the processed and verified data are available to the public and shall establish policies for the release of HIPAA compliant limited use data sets.
  2. A licensed ASTC and ODC shall pay to the commissioner a civil penalty of five cents (5¢) for each day the claims data discharge report is delinquent. A claims data report is delinquent if the commissioner does not receive it before sixty (60) days after the end of the quarter. If the commissioner receives the report in incomplete form, the commissioner shall notify the ASTC and ODC and provide fifteen (15) additional days to correct the error. The notice shall provide the ASTC and ODC an additional fifteen (15) days to complete the form and return it to the commissioner prior to the imposition of any civil penalty. The maximum civil penalty for a delinquent report is ten dollars ($10.00) for each discharge record. The commissioner shall issue an assessment of the civil penalty to the ASTC and ODC. The ASTC and ODC has a right to an informal conference with the commissioner, if the ASTC and ODC requests the conference within thirty (30) days of receipt of the assessment. After the informal conference or, if no conference is requested, after the time for requesting the informal conference has expired, the commissioner may proceed to collect the penalty by setting the penalty off against funds owed to the ASTC and ODC or by instituting litigation.
  3. In its request for an informal conference, the ASTC and ODC may request the commissioner to waive the penalty. The commissioner may waive the penalty in cases of an act of God or other acts beyond the control of the ASTC and ODC. Waiver of the penalty is in the sole discretion of the commissioner. None of these proceedings are subject to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  4. No person or entity may be held liable in any civil action with respect to any report or disclosure of information made under this section, unless the person or entity has knowledge of any falsity of the information reported or disclosed.
  5. This section shall not affect or replace any other reporting responsibility placed upon ASTCs. The report filed pursuant to this section shall not be required for discharges reported by ASTCs under § 68-3-505.
  6. The claims data required to be reported by this section shall be collected and reported only to the extent it is collected and reported in the normal billing process, unless other claims data is deemed by the commissioner to be essential to the development or use of the ASTC claims data reporting system, in which case the identified data that is outside the normal billing process must be collected and reported; provided, however, that other claims data that may be required to be collected and reported shall be consistent with data required to be collected and reported by other healthcare providers. Any data that is submitted to the commissioner pursuant to this section shall be made available to the public no more frequently and no sooner after the data is submitted than the data collected and reported by licensed hospitals pursuant to § 68-1-108.

Acts 2002, ch. 513, § 1; 2004, ch. 917, §§ 6, 7; 2006, ch. 625, §§ 1-3; 2015, ch. 373, § 2.

Compiler's Notes. Acts 2002, ch. 513, § 2 provided that no ambulatory surgical treatment center (ASTC) shall be liable for penalties set forth in § 68-1-119(b) for any reports due on or before January 1, 2004.

Amendments. The 2015 amendment rewrote the last sentence of (a), which read:  “The commissioner shall prescribe conditions under which the processed and verified data are available to the public.”

Effective Dates. Acts 2015, ch. 373, § 3. May 4, 2015.

Cross-References. Claims reports from licensed hospitals, § 68-1-108.

Confidentiality of public records, § 10-7-504.

68-1-120. Report on nursing home inspection and enforcement activities.

The commissioner shall submit a report by not later than February 1 of each year to the governor and to each house of the general assembly regarding the department's nursing home inspection and enforcement activities during the previous year. The report shall analyze trends in compliance with nursing home standards and residents' rights by nursing homes in the state, and shall be limited to identifying those trends through aggregate and quantitative data only. In preparing the report, the commissioner may utilize quantitative data compiled by nursing homes pursuant to federal or state regulations. The commissioner shall ensure that the report is promptly made available to the public by dissemination via the Internet and that the report is available for members of the public to copy.

Acts 2003, ch. 169, § 2.

Compiler's Notes. Acts 2003, ch. 169, § 1 provided that the act shall be known and may be cited as the “Nursing Home Compassion, Accountability, Respect and Enforcement Reform Act.”

68-1-121. Waiver of foreign residence requirement.

  1. The commissioner of health is empowered to promulgate emergency rules and regulations pursuant to a waiver of the foreign residence requirement with respect to an alien who agrees to practice medicine in a federally-designated underserved area of the state of Tennessee, in accordance with the requirements of the Immigration and Nationality Technical Corrections Act of 1994, P.L. 103-416.
    1. Primary care physicians, including primary care physicians who have subspecialty training, shall be placed in health care practice sites that are located in counties containing federally designated health professional shortage areas (HPSAs) or medically underserved areas (MUAs), or both, either of which must also be located within the top thirty (30) state designated health resource shortage areas (HRSAs) for TennCare, primary care, obstetrics or pediatrics.
      1. No more than thirty percent (30%) of the slots permitted by federal law shall be allocated to physician specialists between October 1 and June 30 of each federal fiscal year. To be considered, physician specialists shall be affiliated with a hospital that meets one (1) of the following criteria:
        1. Within the twenty (20) nonpsychiatric hospitals with the highest percentage of total adjusted patient days for TennCare patients;
        2. A rural referral center hospital;
        3. A sole community hospital;
        4. A Medicare dependent hospital; or
        5. A rural hospital meeting the guidelines for placement of a primary care physician.
      2. Applications for a physician specialist will be accepted from critical access hospitals after March 31. Physician specialists shall agree to practice their specialty with the affiliated hospital for a minimum of forty (40) hours per week and for a minimum of three (3) years. Physician specialists delineated in rules and regulations, as well as general surgeons, may be placed at any eligible hospital.
  2. Additionally, no more than one-third (1/3) of the specialty physicians granted slots between October 1 and June 30 of each year may serve in urban HPSAs. A hospital that has received a physician specialist slot between October 1 and March 31 may only have its application for a second specialist accepted if additional slots permitted by federal law are available and the thirty percent (30%) of specialty slots have not been committed by April 1. If the full complement of slots permitted by federal law has not been committed by June 30, the percentage limitations on the number of slots allocated to specialty physicians and on the placement of specialty physicians, as set forth in this subsection (c), shall no longer be applicable. After June 30, specialist slots shall be opened to all eligible hospitals, urban and rural, for the final quarter of the year. During the final quarter, priority for the specialist slots is given to specialists but primary care provider applications will be accepted if specialist slots are available and no other specialist provider application has been received and deemed eligible.

Acts 2003, ch. 117, § 1; 2004, ch. 572, § 1; 2009, ch. 566, § 12.

Compiler's Notes. The Immigration and Nationality Technical Corrections Act, referred to in this section, is compiled primarily in 8 U.S.C. § 1101 et seq.

Acts 2009, ch. 566, § 12 provided that the Tennessee code commission is directed to change all references to public necessity rules, wherever such references appear in this code, to emergency rules, as sections are amended and volumes are replaced.

68-1-122. Memorandum of understanding regarding annual health professional shortage area designation process.

  1. The department of health shall enter into a memorandum of understanding (MOU) with the Tennessee Primary Care Association, the Tennessee Hospital Association, and the Tennessee Rural Health Recruitment and Retention Center to work cooperatively with respect to the annual health professional shortage area (HPSA) designation process.
  2. The MOU shall include, but not be limited to, the following:
    1. A communication plan including each of the parties during the annual HPSA designation process;
    2. A plan to ensure that the information and methodology utilized to determine the HPSA designation is adequate and accurate; and
    3. A period for comment to the department by the other three (3) MOU parties prior to the submission of the recommendations to the federal government for approval.

Acts 2006, ch. 571, § 1.

68-1-123. Report on access to care and safety net adequacy.

On or before January 15 of each year, the commissioner of health, in consultation with the department of finance and administration and any other state agency involved in the administration of the safety net program, shall report to the general assembly on data relating to access to care and safety net adequacy related issues. The data shall address adequacy of access and the array of services to which access is available. The report shall also seek to address the allocation of scarce health care resources in the safety net, with attention to developing a rational health care system that does not duplicate services. The report shall specifically assess access to care in rural and underserved areas across the state. The comptroller of the treasury shall also comment on the report. The commissioner shall present the findings of the report to the health and welfare committee of the senate and the health committee of the house of representatives.

Acts 2006, ch. 571, § 2; 2013, ch. 236, § 63.

Amendments. The 2013 amendment substituted “the health and welfare committee of the senate and the health committee of the house of representatives” for “the general welfare, health and human resources committee of the senate and the health and human services committee of the house of representatives” at the end.

Effective Dates. Acts 2013, ch. 236, § 94. April 19, 2013.

68-1-124. Coordination of programs to prevent and treat diabetes — Central data repository.

The commissioner is authorized to appoint an individual within the department to coordinate with other state government departments and agencies to ensure that all programs that impact the prevention and treatment of diabetes are coordinated, that duplication of efforts are minimized, and that the impact of the programs is maximized in an attempt to reduce the health consequences and complications of diabetes in this state. The department of health shall serve as the central repository for this state for data related to the prevention and treatment of diabetes.

Acts 2008, ch. 896, § 1.

68-1-125. Funds for in-home visitation programs — Emphasis on evidence-based programs — Report on findings.

  1. As used in this section, unless the context otherwise requires:
    1. “Evidence-based” means a program or practice that meets the following requirements:
      1. The program or practice is governed by a program manual or protocol that specifies the nature, quality, and amount of service that constitutes the program; and
      2. Scientific research using methods that meet high scientific standards, evaluated using either randomized controlled research designs, or quasi-experimental research designs with equivalent comparison groups. The effects of such programs must have demonstrated using two (2) or more separate client samples that the program improves client outcomes central to the purpose of the program;
    2. “In-home visitation” means a service delivery strategy that is carried out in the homes of families of children from conception to school age that provides culturally sensitive face-to-face visits by nurses, other professionals, or trained and supervised lay workers to promote positive parenting practices, enhance the socioemotional and cognitive development of children, improve the health of the family, and empower families to be self-sufficient. “In-home visitation” does not include any medicaid funded disease management or case management services or programs which may include home visits;
    3. “Pilot program” means a temporary research-based or theory-based program or project that is eligible for funding from any source to determine whether or not evidence supports its continuation beyond the fixed evaluation period. A pilot program must provide for and include:
      1. Development of a program manual or protocol that specifies the nature, quality, and amount of service that constitutes the program; and
      2. Scientific research using methods that meet high scientific standards for evaluating the effects of such programs must demonstrate on at least an annual basis whether or not the program improves client outcomes central to the purpose of the program;
    4. “Research-based” means a program or practice that has some research demonstrating effectiveness, but that does not yet meet the standard of evidence-based; and
    5. “Theory-based” means a program or practice that has general support among treatment providers and experts, based on experience or professional literature, may have anecdotal or case-study support, and has potential for becoming a research-based program or practice.
    1. With the long-term emphasis on procuring services whose methods have been measured, tested, and demonstrated to improve client outcomes, the department of health, and any other state agency that administers funds related to in-home visitation programs shall ensure that fifty percent (50%) of state-appropriated funds expended for in-home visitation services are used for evidence-based models during fiscal year 2012-2013 and that seventy-five percent (75%) of such funds are used for evidence-based programs during fiscal year 2013-2014 and each subsequent fiscal year thereafter.
    2. With the goal of identifying and expanding the number and type of available evidence-based programs, the department shall continue the ongoing research and evaluation of sound, theory-based and research-based programs and to that end the department may engage in and fund pilot programs as defined in this section.
  2. The department shall include in any contract with a provider of services related to in-home visitation programs a provision requiring that the provider shall set forth a means to measure the outcome of the services. The measures must include, but not be limited to, the number of people served, the type of services provided, and the estimated rate of success of the population served.
  3. The department of health, in conjunction with a representative of the Tennessee commission on children and youth, and with ongoing consultation of appropriate experts and representatives of relevant providers who are appointed by the commissioner of health to provide such consultation, shall determine which of its current programs are evidence-based, research-based and theory-based, and shall provide a report of those findings, including an explanation of the support of those findings, to the governor, the health and welfare committee of the senate, the judiciary committee of the house of representatives and the judiciary committee of the senate by no later than January 1 of each year. The department of health shall also provide in its report the measurements of the individual programs, as set forth in subsection (c).

Acts 2008, ch. 1029, §§ 1, 2; 2011, ch. 410, § 3(ee); 2012, ch. 873, §§ 1-3; 2013, ch. 236, § 24; 2019, ch. 345, § 130.

Compiler's Notes. Acts 2008, ch. 1029, § 3 provided that the commissioner of health is authorized to promulgate rules and regulations to effectuate the purposes of this act. All rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

For the Preamble to the act concerning the prohibition against establishment of a special committee if there is a standing committee on the same subject, please refer to Acts 2011, ch. 410.

Acts 2012, ch. 873, § 4 provided that the commissioner of health is authorized to promulgate rules and regulations for the administration of the act, which amended the definitions of “evidence-based” and “in-home visitation” and amended subdivision (b)(1). All such rules and regulations shall be promulgated in accordance with the provisions of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Amendments. The 2013 amendment substituted “the health and welfare committee of the senate, the civil justice committee of the house of representatives” for “the general welfare, health and human resources committee of the senate, the children and family affairs committee of the house of representatives” in the first sentence of (d).

The 2019 amendment substituted “the judiciary committee of the house of representatives” for “the civil justice committee of the house of representatives” in the first sentence of (d).

Effective Dates. Acts 2013, ch. 236, § 94. April 19, 2013.

Acts 2019, ch. 345, § 148. May 10, 2019.

68-1-126. Plan to establish demonstration sites.

Notwithstanding any law to the contrary, the department of health shall assist the council on children's mental health care in developing a plan that will establish demonstration sites in certain geographic areas where children's mental health care is child-centered, family-driven, and culturally and linguistically competent and that provides a coordinated system of care for children's mental health needs in this state.

Acts 2008, ch. 1062, § 14.

Compiler's Notes. For the Preamble to the act regarding to the mental health needs of Tennessee's children and youth, please refer to Acts 2008, ch. 1062.

68-1-127. Health advisory for MRSA infections.

  1. No later than July 15 of each year, the department of health shall issue an advisory to the department of education which shall be distributed to schools serving students in grades kindergarten through twelve (K-12) and in early childhood programs explaining the risks of community-associated methicillin resistant staphylococcus aureus (MRSA) infections and providing guidance on the most current methods on recognizing and preventing these infections.
  2. The departments of health and education shall also prominently display on their web sites links to this information.

Acts 2010, ch. 828, § 3.

Compiler's Notes. Acts 2010, ch. 828, § 1 provided that the act, which enacted § 68-1-127, shall be known and may be cited as the “Kristen K. Hunter Infection Control Act.”

Acts 2010, ch. 828, § 2 provided that the general assembly recognizes that community-associated methicillin resistant staphylococcus aureus (MRSA) infections present a risk to all Tennesseans and are responsible for preventable deaths among Tennesseans.

68-1-128. High volume prescribers of controlled substances — High-risk prescribers based on clinical outcomes.

  1. No later than July 31, 2013, and at least annually thereafter but more often at the discretion of the commissioner, the department of health shall:
      1. Identify the top fifty (50) prescribers who have unique DEA numbers of controlled substances, other than buprenorphine formulations that have not received approval for pain applications from the federal food and drug administration, in the previous calendar year, or if implemented more frequently for the relevant time period as determined by the department, from the data available in the controlled substances database established pursuant to title 53, chapter 10, part 3;
      2. Identify the top twenty (20) prescribers who have unique DEA numbers of buprenorphine products or equivalent products in the previous calendar year, or if implemented more frequently for the relevant time period as determined by the department, from the data available in the controlled substances database established pursuant to title 53, chapter 10, part 3. The department may organize the list of prescribers required by this subdivision (a)(1)(B) in any manner as may be appropriate to reflect levels of service, training, or other relevant factors by a healthcare provider. These factors may include, but not be limited to, whether the provider is board-certified;
    1. Send a letter through registered mail to each prescriber identified in subdivision (a)(1), and to the collaborating physician as found on the provider's profile established in title 63, chapter 32 of each advanced practice registered nurse and each physician assistant identified in subdivision (a)(1) that notifies the prescribers and, where appropriate, the collaborating physician that the prescriber has been identified pursuant to subdivision (a)(1) and includes the following information:
      1. The significant controlled substances prescribed by the prescriber;
      2. The number of patients prescribed these controlled substances by the prescriber;
      3. The total milligrams in morphine equivalents of controlled substances prescribed during the relevant period of time; and
      4. Any other relevant information sought by the department; and
    2. If there is an active investigation against the prescriber or, where appropriate the collaborating physician on the lists of prescribers identified in subdivision (a)(1), the department is authorized to withhold any communication required under this section until such time as charges are brought or the investigation is closed.
      1. At the discretion of the department, each prescriber and each collaborating physician of an advanced practice registered nurse and physician assistant who appear on the lists of the top twenty (20) prescribers of buprenorphine products, the top fifty (50) prescribers of controlled substances in the state, and the top ten (10) prescribers of controlled substances in all of the counties combined having a population of less than fifty thousand (50,000), according to the 2010 federal census or any subsequent federal census in the relevant period of time shall submit to the department within fifteen (15) business days through registered mail or electronic mail an explanation justifying the amounts of controlled substances prescribed in the relevant period of time by the prescriber demonstrating that these amounts were medically necessary for the patients treated and that, for advanced practice registered nurses and physician assistants, the collaborating physician had reviewed and approved the prescribing amounts. The department shall consider the prescriber's specialty and the patients' ages to make a determination as to whether the explanation of the prescriber and, where appropriate the collaborating physician for the prescribing habits of the prescriber of controlled substances is justifiable.
      2. The department is authorized to develop a model form to assist the prescriber and where appropriate the collaborating physician in completing the explanation required by this subsection (b).
      3. The department is authorized to contract with an expert reviewer to determine if the explanation is acceptable. Should charges ultimately be filed against the prescriber or, where appropriate the collaborating physician  any report of the expert reviewer shall be discoverable by the licensee.
    1. If the department is not satisfied with any explanation by the prescriber or where appropriate a collaborating physician it shall communicate via registered mail such concerns to the prescriber and, if appropriate, the collaborating physician. The prescriber and, if appropriate, the collaborating physician shall have fifteen (15) business days to attempt to rectify the department's stated concerns.
    2. If the department remains unsatisfied after receiving a justification pursuant to subdivision (b)(2), the department may submit its concerns to the member of the controlled substance database committee who represents the board which has licensed the individual. This member shall have access to all of the documents pertaining to the concerns of the department and the expert reviewer. If that member also believes that the explanations which have been provided are not sufficient to justify the prescribing pattern of the prescriber, the concerns may be forwarded to the department's office of investigations. Investigations are conducted by the entity responsible for licensure of that prescriber.
    1. In addition to identifying prescribers pursuant to subsections (a) and (b), beginning July 1, 2017, and annually thereafter, the department shall identify high-risk prescribers based on clinical outcomes, including patient overdoses. The determination of which providers are high-risk prescribers, including the criteria to make such determination, shall be made by the department. Providers determined to be high-risk prescribers pursuant to this subdivision (c)(1) shall be subject to selected chart review and investigation by the department.
    2. If a prescriber is identified as a high-risk prescriber pursuant to subdivision (c)(1), the department shall submit the high-risk prescriber's information to the board that issued the prescriber's license for appropriate action.
    3. Upon receiving information pursuant to subdivision (c)(2), the licensing board shall notify the prescriber and, if applicable, the prescriber's collaborating physician of the prescriber's identification as a high-risk prescriber and, as applicable, require the prescriber to:
      1. Participate in continuing education that is designed to inform providers about the risks, complications, and consequences of opioid addiction. The specific continuing education courses and number of hours to be completed by the prescriber shall be determined by the licensing board;
      2. Make available, in the prescriber's waiting room and clinic areas where the prescriber's patient can view, educational literature that warns persons of risks, complications, and consequences of opioid addiction. The specific literature to be made available pursuant to this subdivision (c)(3)(B) shall be determined by the department and made available on the department's website;
      3. Obtain written consent on a form that explains the risks of, complications of, medical and physical alternatives to, and consequences of opioid therapy and addiction to any patient who will receive opioid therapy for more than three (3) weeks with daily dosages of sixty (60) morphine milligram equivalents (MME) or higher. The consent shall include a certification from the patient that the patient understands the information. In order to continue to treat the patient, the provider must assure that the consent is signed by the patient and made part of the patient's health record; and
      4. Renew the consent described in subdivision (c)(3)(C) at four-week intervals for patients who continue to receive opioid therapy. In order to continue to treat the patient, the provider must assure that the consent is signed by the patient and made part of the patient's health record.
    4. An identified high-risk prescriber must comply with the requirements set out in subdivision (c)(3) for a period of one (1) year from the time the provider was notified of the provider's identification as a high-risk prescriber of opioids. Failure of a prescriber to comply with the requirements set out in subdivision (c)(3) shall be treated as an act constituting unprofessional conduct for which disciplinary action may be instituted under the authority of the board that issued the prescriber's license.
    5. All costs associated with this subsection (c) shall be paid by the identified provider.
    6. If the provider disputes the identification of the provider as a high-risk prescriber of opioids, the provider may request the department conduct an internal review of the identification, which shall be done by the commissioner or the commissioner's designee. Any such internal review is not subject to the provisions of title 4, chapter 5, part 3.
  2. All data, reports and correspondence under this section shall be confidential and shall not be considered to be a public record for purposes of title 10, chapter 7.
  3. All correspondence and reports can be used by the department's office of investigations and/or the respective entity responsible for licensure to develop a disciplinary case against the prescriber and, where appropriate, the collaborating physician of an advanced practice registered nurse or physician assistant.
  4. The failure of a prescriber or, where appropriate, a collaborating physician to respond to the department's request for information in a timely fashion may be a cause for disciplinary action by the prescriber's, or where appropriate the collaborating physician's licensing board, and may include a penalty of up to one thousand dollars ($1,000) per day for failure to respond or failure to respond in a timely manner.
  5. All correspondence shall be maintained for five (5) years and kept organized by prescriber so that information on a prescriber who appears on multiple lists compiled pursuant to subsection (a) may be aggregated.
    1. After the completion of the study provided for in subdivision (i)(1), and no later than July 31 of each subsequent year, in consultation with the controlled substance database, the department of health shall identify licensed prescribers whose prescribing patterns of controlled substances represent statistical outliers in addition to top prescribers and high-risk prescribers identified pursuant to this section.
    2. The department of health shall inquire of the appropriate licensing board concerning any action taken against a prescriber identified by the department pursuant to subdivision (h)(1). Each board shall respond within thirty (30) days concerning the status of any action or lack of action against an identified prescriber.
    3. Each board shall also report on the total numbers of prescribers disciplined each year and the general categories of discipline imposed on the prescribers, including consent agreements, as well as reasons for declining to exercise discipline.
    4. The commissioner of health shall report a summary of the data concerning prescribers identified under this subsection (h), including a summary of any disciplinary action taken or pending by a licensing board against a prescriber, to the chairs of the health and welfare committee of the senate and the health committee of the house of representatives.
    1. On or before January 1, 2020, the comptroller of the treasury shall complete a study of the incidence of significantly statistically abnormal prescribing patterns by prescribers licensed under title 63 and the disciplinary response of the licensing boards to those prescribers. The comptroller shall report findings and recommendations of the study to the chairs of the health and welfare committee of the senate and the health committee of the house of representatives.
    2. Notwithstanding any other state law, the department of health, the controlled substance database, and a licensing board of any prescriber of opioids shall disclose to the comptroller of the treasury any relevant information in order for the comptroller to complete this study from July 1, 2018, through June 30, 2020. Any record that personally identifies a patient or a healthcare practitioner that is disclosed to the comptroller shall be confidential and shall not be disclosed as a public record at any time and shall not be subject to a subpoena.

Acts 2013, ch. 396, § 3; 2015, ch. 476, § 1; 2016, ch. 980, § 23; 2017, ch. 334, §§ 12-14; 2017, ch. 483, § 1; 2018, ch. 610, §§ 37-40; 2018, ch. 978, §§ 8-12.

Code Commission Notes.

Acts 2013, ch. 396, § 3 provided that title 63 be amended by adding a new section. The new section was added to title 68, chapter 1, part 1 by authority of the code commission.

Compiler's Notes. For the Preamble to the act relative to the relationship between physicians and advanced practice registered nurses, please refer to Acts 2017, ch. 334.

Amendments. The 2015 amendment added “in the state and the top ten (10) prescribers of controlled substances in all of the counties combined having a population of less than fifty thousand (50,000) according to the 2010 federal census or any subsequent federal census” following “the top fifty (50) prescribers of controlled substances” in (b)(1)(A).

The 2016 amendment substituted “advanced practice registered nurse” for “advanced practice nurse” in the introductory language of (a)(2), in the first sentence of (b)(1)(A) and in (d); and substituted “advanced practice registered nurses” for “advanced practice nurses” in the first sentence of (b)(1)(A).

The 2017 amendment by ch. 334 substituted “collaborating physician or supervising physician, as appropriate”  for “supervising physician” throughout; substituted “collaborating physician or physician supervisor, as appropriate,” for “physician supervisor” in the introductory language of (a)(2); and substituted “collaborating physician’s or supervising physician’s licensing board, as appropriate,” for “supervising physician's, licensing board” in (e).

The 2017 amendment by ch. 483 added present (c) and redesignated the remaining subsections accordingly.

The 2018 amendment by ch. 610 in (a), deleted “or supervising physician, as appropriate” preceding “as found on the provider's profile” in (2) and preceding “on the list of prescribers “ in (3); deleted “or physician supervisor, as appropriate” preceding “as found on the provider's” in (2); deleted “or supervising physician, as appropriate,” preceding “of an advanced practice”  in (e); substituted “licensing board,” for “or supervising physician’s licensing board, as appropriate” in (f).

The 2018 amendment by ch. 978 added (a)(1)(B); in (a)(3), substituted “lists” for “list” preceding “of prescribers”; in (b)(1)(A), substituted “on the lists of the top twenty (20) prescribers of buprenorphine products, the top fifty (50) prescribers of controlled substances in the state, and the top ten (10) prescribers” for “on the top fifty (50) prescribers of controlled substances in the state and the top ten (10) prescribers” following “who appear”; and added (h) and (i).

Effective Dates. Acts 2013, ch. 396, § 5. July 1, 2013.

Acts 2015, ch. 476, §  3. May 18, 2015.

Acts 2016, ch. 980, § 25. July 1, 2016.

Acts 2017, ch. 334, § 15. July 1, 2017.

Acts 2017, ch. 483, § 4. June 6, 2017.

Acts 2018, ch. 610, § 42. July 1, 2018.

Acts 2018, ch. 978, § 15. July 1, 2018; provided that for rulemaking purposes, the act took effect on May 21, 2018.

Cross-References. Certified mail in lieu of registered mail, § 1-3-111.

Confidentiality of public records, § 10-7-504.

Law Reviews.

Defining the Opioid Crisis and the Limited Role of the Criminal Justice System Resolving It, 48 U. Mem. L. Rev. 1206 (Summer 2018).

68-1-129. Optical examination waiver form for Alzheimer's and dementia patients.

  1. The department shall develop an optical examination waiver form to permit any patient diagnosed with Alzheimer's disease, Alzheimer's related dementia, or vascular dementia, to obtain lenses, spectacles, eye glasses, or optical devices using an expired prescription when such patient's disease or dementia would preclude the patient from undergoing an optical examination. The department shall make such forms available on its web site.
  2. Such optical examination waiver form shall be signed by a licensed physician who has determined:
    1. The patient has Alzheimer's disease, Alzheimer's related dementia, or vascular dementia;
    2. The symptoms of the disease or dementia significantly affect the patient's ability to sit for an optical examination to obtain a new optical prescription;
    3. The patient's lenses, spectacles, eye glasses, or optical devices are lost, broken, or damaged to a degree that renders them unusable; and
    4. The patient would derive significant benefit from replacement.
  3. It is lawful for any optician, optometrist, or ophthalmologist licensed in this state to fill the most recent expired prescription for any lenses, spectacles, eye glasses, or optical devices for a patient; provided, that the prescription is filled once pursuant to an optical examination waiver form described in subsection (b).

Acts 2014, ch. 683, § 1.

Code Commission Notes.

Acts 2014, ch. 881, § 2 purported to enact §§ 68-1-129 and 68-1-130. Section 68-1-129 was previously enacted by Acts 2014, ch. 683, § 1; therefore, the enactments by Acts 2014, ch. 881, § 2 were designated as §§ 68-1-130 and 68-1-131 by the code commission.

Effective Dates. Acts 2014, ch. 683, § 2. July 1, 2014.

68-1-130. Development of plan to create apprentice program for use by licensing boards and commissions.

  1. The boards and commissions created in title 63, in consultation with the division of health related boards, shall develop a plan to create an apprentice program for use by such boards and commissions.
  2. The plan developed pursuant to subsection (a) shall include, but not be limited to, the subjects of:
    1. Apprenticeship training;
    2. Supervisory standards;
    3. Occupational instruction;
    4. Wages and benefits;
    5. Licensure; and
    6. The role of the division of health related boards in implementing and maintaining the program.
  3. The apprentice plan shall be submitted to the speaker of the senate, the speaker of the house of representatives, the government operations committees of the senate and house of representatives, the commissioner of commerce and insurance, the commissioner of health, and the commissioner of labor and workforce development on or before December 31, 2014.

Acts 2014, ch. 881, § 2.

Code Commission Notes.

Acts 2014, ch. 881 § 2 purported to enact §§ 68-1-129 and 68-1-130. Section 68-1-129 was previously enacted by Acts 2014, ch. 683 § 1; therefore, the enactments by Acts 2014, ch. 881 § 2 were designated as §§ 68-1-130 and 68-1-131 by the code commission.

Effective Dates. Acts 2014, ch. 881, § 3. May 1, 2014.

68-1-131. Reports on existing apprenticeship programs of boards and commissions.

Each of the boards and commissions created in title 63 that have statutorily created apprenticeship programs in effect as of July 1, 2014, or that previously had such programs in effect, shall submit a report to the persons and entities listed in § 68-1-130(c) on or before December 31, 2014, that includes:

    1. The reason the apprentice program was created; and
    2. The reason the apprentice program is no longer in effect, if applicable;
  1. Historical data on the apprentice program since its creation, including:
    1. The number of persons participating in the program each year; and
    2. Program outcomes, including the percentage of program participants who have continued in their chosen fields;
  2. A description of the apprentice program and its objectives; and
    1. The number of persons licensed in each profession regulated by such boards and commissions from July 1, 2009, to July 1, 2014; and
    2. The number of persons employed in each profession regulated by such boards and commissions from July 1, 2009, to July 1, 2014.

Acts 2014, ch. 881, § 2.

Code Commission Notes.

Acts 2014, ch. 881 § 2 purported to enact §§ 68-1-129 and 68-1-130. Section 68-1-129 was previously enacted by Acts 2014, ch. 683 § 1; therefore, the enactments by Acts 2014, ch. 881 § 2 were designated as §§ 68-1-130 and 68-1-131 by the code commission.

Effective Dates. Acts 2014, ch. 881, § 2. May 1, 2014.

Cross-References. Reporting requirement satisfied by notice to general assembly members of publication of report, § 3-1-114.

68-1-132. Development of tobacco prevention programs.

Using a science and experience-based approach, the department of health shall develop and implement comprehensive tobacco prevention programs for this state. These programs shall include, when available, peer-reviewed and science-based educational materials on tobacco harm reduction and the comparative risks of alternative nicotine products, vapor products, smokeless tobacco products, cigarettes, and other combustible tobacco products.

Acts 2015, ch. 353, § 15.

Effective Dates. Acts 2015, ch. 353, § 16. July 1, 2015.

68-1-133. Department of health website — Links to asthma prevention protocols.

  1. The commissioner of health shall encourage public health organizations, the medical community, the department of education, the department of labor and workforce development, the department of general services, and other relevant stakeholders to examine the asthma prevention protocols posted on the web site of the National Heart, Lung and Blood Institute of the National Institutes of Health (NIH) and related information to assist the medical profession, schools, public venues, workplaces, and other relevant stakeholders, in making appropriate responses to assist in:
    1. Diagnosing environmentally associated exacerbation of asthma in people with asthma;
    2. Avoiding new asthma cases;
    3. Better identifying and avoiding potential triggers so as to protect persons with these conditions; and
    4. Reducing medical costs and lost work or school time.
  2. On or before December 31, 2016, the commissioner shall include on the department of health web site the Internet links to the protocols identified in subsection (a), as existing asthma prevention protocols are helpful tools to better assist people affected by environmental illnesses and multiple chemical sensitivities.

Acts 2016, ch. 886, § 1.

Effective Dates. Acts 2016, ch. 886, § 2. April 27, 2016.

68-1-134. Calculation of income for members of uniformed services for purposes of determining eligibility for supplemental food program.

To the extent permitted by federal law, in calculating income for the purpose of determining eligibility for the special supplemental food program for women, infants, and children, the department of health shall not include as income the basic allowance for subsistence (BAS) for applicants who are members of a uniformed service.

Acts 2016, ch. 950, § 1.

Effective Dates. Acts 2016, ch. 950, § 2. July 1, 2016.

68-1-135. Performance of health maintenance tasks by paid personal aide.

  1. For purposes of this section:
    1. “Caregiver” means a person who is:
      1. Directly and personally involved in providing care for a minor child or incompetent adult; and
      2. The parent, foster parent, family member, friend, or legal guardian of such minor child or incompetent adult;
    2. “Competent adult” means a person eighteen (18) years of age or older who has the capability and capacity to evaluate knowledgeably the options available and the risks attendant upon each and to make an informed decision, acting in accordance with the person's own preferences and values. A person is presumed competent unless a determination to the contrary is made;
    3. “Health maintenance task” means a healthcare task that:
      1. A person without a functional disability or a caregiver would customarily and personally perform without the assistance of a licensed healthcare provider;
      2. The person is unable to perform for the person's own self due to a functional or cognitive limitation;
      3. The licensed healthcare provider determines can be safely performed in the home for the person by a paid personal aide acting under the direction of a competent adult with a functional disability or caregiver;
      4. Enables the person to maintain independence, personal hygiene, and safety in the person's own home; and
      5. Includes, but is not limited to, as determined by rule, administration of glucometer tests, administration of eye or ear drops, nebulizer treatment, and ostomy care, including skin care and changing appliance;
    4. “Home” means the dwelling in which the person resides, whether the person owns, leases, or rents such residence or whether the person resides in a dwelling owned, leased, or rented by someone else;
    5. “Licensed healthcare provider” means the treating physician licensed under title 63, chapter 6 or 9, or a registered nurse; and
    6. “Paid personal aide” is any person providing paid home care services, such as personal care or homemaker services, that enable the person receiving care to remain at home whether a paid personal aide is employed by the person receiving care, a caregiver, or by a contracted provider agency that has been authorized to provide home care services to that person.
  2. Notwithstanding any law or rule to the contrary, a competent adult with a functional disability living in the adult's own home or a caregiver acting on behalf of a minor child or incompetent adult living in the minor child's or the incompetent adult's own home may choose to direct and supervise a paid personal aide in the performance of a health maintenance task subject to the aide having been taught as required by subsection (d).
  3. A paid personal aide may perform health maintenance tasks required by an individual receiving long-term supports and services and be paid to provide those tasks while performing services constituting home and community based long-term care, as defined in § 71-2-103, or under a private pay arrangement. Self-direction of healthcare tasks by an individual receiving medicaid-reimbursed home and community based long-term care services shall be provided pursuant to the Long-Term Care Community Choices Act of 2008, compiled in title 71, chapter 5, part 14.
  4. If a licensed healthcare provider, after completing an assessment of an individual's healthcare needs, determines health maintenance tasks can be performed by paid personal aides, the licensed healthcare provider shall evaluate the ability of the paid personal aide to perform the health maintenance task, teach the health maintenance task to the paid personal aide, ensure supervision of the paid personal aide, and re-evaluate the health maintenance task performed by the paid personal aide at regular intervals. The requirements for documentation of the training required by this subsection (d) are to be determined by rule.
  5. A licensed healthcare provider acting with ordinary and reasonable care under the circumstances and within the protocols of the provider's authority who has ordered treatment to be provided by a paid personal aide, shall not be individually liable for the negligence or intentional acts of such paid personal aide when such negligence or intentional acts are outside the scope of the health maintenance tasks to be performed.

Acts 2017, ch. 349, § 1.

Compiler's Notes. Acts 2017, ch. 349, § 2 provided that the Tennessee commission on aging and disability shall, after consultation with the bureau of TennCare, the department of mental health and substance abuse services, the department of intellectual and developmental disabilities, AARP Tennessee, the Tennessee Disability Coalition, and the Tennessee Association of Home Care, promulgate rules implementing this act. These rules shall be promulgated in accordance with the Uniform Administrative Procedures  Act, compiled in Tennessee Code Annotated, title 4, chapter 5.

Effective Dates. Acts 2017, ch. 349, § 3. January 1, 2018; provided, that for purpose of rule promulgation, the act took effect May 11, 2017.

68-1-136. Needle and hypodermic syringe exchange program.

  1. If approved by the department of health, a county or district health department pursuant to subsection (i) or any nongovernmental organization, including an organization that promotes scientifically proven ways of mitigating health risks associated with drug use and other high-risk behaviors, may establish and operate a needle and hypodermic syringe exchange program. The objectives of the program shall be to do all of the following:
    1. Reduce the spread of human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), viral hepatitis, and other bloodborne diseases in this state;
    2. Reduce needle stick injuries to law enforcement officers and other emergency personnel; and
    3. Encourage individuals who inject drugs to enroll in evidence-based treatment.
  2. Programs established pursuant to this section shall offer all of the following:
    1. Disposal of used needles and hypodermic syringes;
    2. Needles, hypodermic syringes, and other injection supplies at no cost and in quantities sufficient to ensure that needles, hypodermic syringes, and other injection supplies are not shared or reused. A program shall strive for one-to-one syringe exchanges. No public funds may be used by a nongovernmental organization to purchase needles, hypodermic syringes, or other injection supplies;
    3. Reasonable and adequate security of program sites, equipment, and personnel. Written plans for security shall be provided to the law enforcement offices with jurisdiction in the program location and shall be updated annually;
    4. Educational materials on all of the following:
      1. Overdose prevention;
      2. The prevention of HIV, AIDS, and viral hepatitis transmission;
      3. Drug abuse prevention;
      4. Treatment for mental illness, including treatment referrals; and
      5. Treatment for substance abuse, including referrals for medication assisted treatment;
    5. Access to naloxone for the treatment of a drug overdose, or referrals to programs that provide access to naloxone for the treatment of a drug overdose; and
    6. Personal consultations from a program employee or volunteer concerning mental health or addiction treatment as appropriate for each individual requesting services.
    1. It is an exception to the application of title 39, chapter 17, part 4, if an employee, volunteer, or participant of a program established pursuant to this section possesses any of the following:
      1. Needles, hypodermic syringes, or other injection supplies obtained from or returned to a program established pursuant to this section; or
      2. Residual amounts of a controlled substance contained in a used needle, used hypodermic syringe, or used injection supplies obtained from or returned to a program established pursuant to this section.
      1. The exception provided in this subsection (c) shall apply only if the person claiming the exception provides written verification that a needle, syringe, or other injection supplies were obtained from a needle and hypodermic syringe exchange program established pursuant to this section. For a participant in the program, this exception shall only apply to possession when the participant is engaged in the exchange or in transit to or from the exchange.
      2. In addition to any other applicable immunity or limitation on civil liability, a law enforcement officer who, acting on good faith, arrests or charges a person who is thereafter determined to be entitled to immunity from prosecution under this section shall not be subject to civil liability for the arrest or filing of charges.
    2. In addition to any other applicable immunity or limitation on civil liability, a nongovernmental organization and an employee or volunteer of that organization are not subject to civil liability for establishing, operating, or participating in a program established pursuant to this section in the absence of gross negligence or willful, intentional, or malicious conduct.
  3. Prior to commencing operations of a program established pursuant to this section and obtaining approval from the department of health as required by subsection (a), the county or district health department pursuant to subsection (i) or the nongovernmental organization shall report to the department of health all of the following information:
    1. The legal name of the organization or agency operating the program;
    2. The areas and populations to be served by the program; and
    3. The methods by which the program will meet the requirements of subsection (b).
  4. Not later than one (1) year after commencing operations of a program established pursuant to this section, and every twelve (12) months thereafter, each county or district health department pursuant to subsection (i) or organization operating such a program shall report the following information to the department of health:
    1. The number of individuals served by the program;
    2. The number of needles, hypodermic syringes, and needle injection supplies dispensed by the program and returned to the program;
    3. The number of naloxone kits distributed by the program; and
    4. The number and type of treatment referrals provided to individuals served by the program, including a separate report of the number of individuals referred to programs that provide access to naloxone that is approved by the federal food and drug administration for the treatment of a drug overdose.
  5. The department of health shall annually compile a report containing the information submitted to the department pursuant to subsection (e) and submit the report to the members of the general assembly.
    1. Except as otherwise provided in subdivision (g)(2), a program established pursuant to this section shall not conduct an exchange within two thousand feet (2,000') of any school or public park.
    2. A program established pursuant to this section shall not conduct an exchange within one thousand feet (1,000') of any school or public park. This subdivision (g)(2) applies only to a:
      1. County having a metropolitan form of government with a population of more than five hundred thousand (500,000), according to the 2010 federal census or any subsequent federal census; and
      2. Municipality with a population in excess of one hundred sixty-five thousand (165,000), according to the 2010 federal census or any subsequent federal census.
  6. The commissioner of health is authorized to promulgate rules to effectuate the purposes of this section. The rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  7. On a petition to a county health department under chapter 2, part 6 of this title, or a district health department under chapter 2, part 7 of this title, by a county legislative body for the establishing and operating of a needle and hypodermic syringe exchange program in the petitioning county, the county or district health department may subsequently seek approval of the department of health under subsection (a) to establish and operate a needle and hypodermic syringe exchange program in the petitioning county.
  8. Needle and hypodermic syringe exchange programs established under subsection (i) shall be funded entirely by the county legislative body making petition to the county or district health department.

Acts 2017, ch. 413, § 1; 2018, ch. 649, § 1; 2018, ch. 945, §§ 1-6.

Compiler's Notes. Acts 2017, ch. 413, § 2 provided that notwithstanding the act, which enacted this section, or the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, any rule promulgated to implement the provisions of this act shall be provided to the chairs of the health committee of the house of representatives and the health and welfare committee of the senate by the secretary of state, after approval by the attorney general and reporter, at the same time the text of the rule is made available to the government operations committees of the senate and the house of representatives for purposes of conducting the review required by § 4-5-226 in order for the health committee of the house of representatives and the health and welfare committee of the senate to be afforded the opportunity to comment on the rule.

For tables of population of Tennessee municipalities, and for U.S. decennial populations of Tennessee counties, see Volume 13 and its supplement.

Amendments. The 2018 amendment by ch. 649 added (g)(2); and added “Except as otherwise provided in subdivision (g)(2),” at the beginning of present (g)(1).

The 2018 amendment by ch. 945 inserted “a county or district health department pursuant to subsection (i) or” in the first sentence of the introductory paragraph in  (a); inserted “by a nongovernmental organization” in (b)(2); inserted “the county or district health department pursuant to subsection (i) or” in the introductory language in (d); inserted “county or district health department pursuant to subsection (i) or” in (e); and added (i) and (j).

Effective Dates. Acts 2017, ch. 413, § 3. May 18, 2017.

Acts 2018, ch. 649 § 2. April 9, 2018.

Acts 2018, ch. 945, § 7. July 1, 2018.

68-1-137. Program established to provide access to voluntary reversible long-acting contraception.

  1. As used in this section:
    1. “Family planning centers” means health clinics that receive funding under the Title X program overseen by the United States department of health and human services, Pub. L. 91-572, as well as other health clinics that the commissioner of health finds are qualified and willing to perform comprehensive family planning services; and
    2. “Voluntary reversible long-acting contraception” or “VRLACs,” also known as “long-acting reversible contraceptives” or “LARCs,” means highly effective methods of contraception that last for several years and are easy to use. VRLACs include, but are not limited to, intrauterine contraceptives and birth control implants.
    1. The department of health shall administer a program to improve access to VRLACs for women.
    2. The program shall include:
      1. Training for family planning centers regarding contraceptive methods, including VRLACs, client-centered and non-coercive counseling strategies, and managing side effects;
      2. Training for all public health facilities to ensure that they are qualified and able to provide forms of contraception, including VRLACs;
      3. Assistance to family planning centers regarding administrative or technical issues such as coding, billing, pharmacy rules, and clinic management related to the provision of forms of contraception, including VRLACs and other methods;
      4. General financial support to expand the capacity of family planning centers to provide VRLACs, to train and staff providers, and to keep supplies in stock and available for same-day access by patients;
      5. Education and outreach to the public about the availability, effectiveness, and safety of contraception including VRLAC;
      6. Education and outreach to the public to inform women about alternatives to abortion, including adoption services, and the numerous public and private agencies and services that are available to assist women during pregnancy and after the birth of the child;
      7. Compiling a list of the contraceptive methods available for both over-the-counter and directly through pharmacies, as California and Oregon have done; and
      8. Other services the commissioner of health deems necessary to improve access to comprehensive family planning options.
  2. Implementation and the continuation of the program established in this section is subject to the availability of federal funds made available to the state for that purpose.

Acts 2018, ch. 686, § 2.

Compiler's Notes. For Preamble to act concerning long-acting reversible contraceptives, please refer to Acts 2018, ch. 686.

Acts 2018, ch. 686, § 1 provided that the act, which enacted this section, shall be known and maybe cited as the “Long-Acting Birth Control lnformation Act.”

Acts 2018, ch. 686, § 3 provided that the commissioner of health is authorized to promulgate rules to effectuate the purposes of this act. The rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Effective Dates. Acts 2018, ch. 686, § 4. April 9, 2018.

68-1-138. Prohibited offer or payment, or offer or solicitation, of commission for referral of patient or patronage with respect to alcohol or drug services.

  1. A healthcare facility or provider licensed under this title, with respect to alcohol and drug services, as defined in § 33-2-402, shall not knowingly:
    1. Offer or pay a commission, benefit, rebate, kickback, or bribe, directly or indirectly, in cash or in kind, or engage in any split-fee arrangement, in any form whatsoever, to induce the referral of a patient or patronage to or from a licensee or facility licensed under title 33, chapter 2, part 4;
    2. Solicit or receive a commission, benefit, rebate, kickback, or bribe, directly or indirectly, in cash or in kind, or engage in any split-fee arrangement, in any form whatsoever, in return for referring a patient or patronage to or from a licensee or facility licensed under title 33, chapter 2, part 4;
    3. Solicit or receive a commission, benefit, rebate, kickback, or bribe, directly or indirectly, in cash or in kind, or engage in any split-fee arrangement, in any form whatsoever, in return for the acceptance or acknowledgment of treatment from a licensee or facility licensed under title 33, chapter 2, part 4; or
    4. Aid, abet, advise, or otherwise participate in the conduct prohibited under subdivision (a)(1), (a)(2), or (a)(3).
  2. Any healthcare facility or provider licensed under this title, with respect to alcohol and drug services, that violates this section is subject to suspension or revocation of the healthcare facility's or provider's license by the appropriate licensing board and the imposition of civil penalties as authorized under this title.

Acts 2018, ch. 855, § 3.

Effective Dates. Acts 2018, ch. 855, § 4. July 1, 2018.

68-1-139. Training program for certified nurse practitioners in treating and processing minor who is victim of sexual offense.

  1. As used in this section, “minor” means any person who has not attained eighteen (18) years of age.
  2. The department of health may seek a federal grant from the federal department of health and human services' health resources and services administration, or any other applicable entity, for the purpose of developing a training program for certified nurse practitioners in treating and processing a minor who is a victim of an offense described in § 39-13-504, § 39-13-505, § 39-13-506, § 39-13-509, § 39-13-518, § 39-13-522, § 39-13-527, § 39-13-531, or § 39-13-532. Participation in the training program must be free of charge for the certified nurse practitioner participants.

Acts 2019, ch. 275, § 1.

Compiler's Notes. Acts 2019, ch. 275, § 2  provided that the commissioner of health is authorized to promulgate rules to effectuate the purposes of the act. The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Effective Dates. Acts 2019, ch. 275, § 3. April 30, 2019.

68-1-140. Inclusion of data related to complications of induced abortions in annual report of selected induced termination of pregnancy data.

The department of health shall include data related to complications of induced abortions, including the number of complications and the types of complications, in its annual report of selected induced termination of pregnancy data. The department shall not release any data pursuant to this section in a manner that could identify individual patients.

Acts 2019, ch. 307, § 1.

Effective Dates. Acts 2019, ch. 307, § 2. July 7, 2019; provided that for purposes of promulgating rules the act took effect May 8, 2019.

Part 2
Quarantine

68-1-201. Power to quarantine.

  1. The commissioner has the power to:
    1. Declare quarantine whenever, in the commissioner's judgment, the welfare of the public requires it; and
    2. Prescribe such rules and regulations as may be deemed proper for the prevention of the introduction of yellow fever, cholera and other epidemic diseases into the state.
    1. Whenever yellow fever, cholera, smallpox or other epidemic diseases appear in any locality within the state, and information thereof is brought to the knowledge of the department, the commissioner shall prepare and carry into effect such rules and regulations as, in the commissioner's judgment, will, with the least inconvenience to commerce and travel, prevent the spread of the disease.
    2. Whenever the commissioner determines that an influenza outbreak may pose a threat of an epidemic, the commissioner shall prepare and carry into effect rules and regulations that, in the commissioner's judgment, will, with the least inconvenience to commerce and travel, prevent the spread of the disease.

Acts 1879, ch. 151, § 2; Shan., § 3096; impl. am. Acts 1923, ch. 7, § 46; Code 1932, § 5758; T.C.A. (orig. ed.), § 53-105; Acts 2006, ch. 588, § 2.

Cross-References. Isolation and quarantine of dogs suspected of being rabid, § 68-8-109.

Isolation and quarantine of tubercular infected persons, title 68, ch. 9, part 2.

Isolation or quarantine of persons infected with sexually transmitted diseases, establishment and termination, § 68-10-106.

Penalty for escaping from quarantine, § 68-5-104.

Quarantine of HIV, § 39-13-108.

Quarantine of person with communicable or contagious disease, § 68-5-104.

Collateral References.

Demurrage as affected by quarantine. 44 A.L.R. 841.

General delegation of power to guard against spread of contagious disease as including power to quarantine. 8 A.L.R. 837.

Typhoid carrier, quarantine of. 22 A.L.R. 845.

Venereal diseases, constitutionality, construction and application of statutes or ordinances concerning quarantine for. 127 A.L.R. 424.

68-1-202. Quarantine stations.

  1. The commissioner shall select suitable localities for establishing quarantine stations, and may erect necessary temporary buildings for the disinfection of passengers, baggage, cargo and other matter believed to convey the contagious principle of cholera, yellow fever, smallpox and other epidemic diseases, and may enforce the transshipment of passengers as the commissioner may deem necessary.
  2. The commissioner shall assign to the charge of each station a competent physician and necessary assistants, who shall receive such compensation as the commissioner may deem reasonable and just.

Acts 1879, ch. 151, § 2; Shan., §§ 3097, 3098; impl. am. Acts 1923, ch. 7, § 46; Code 1932, §§ 5759, 5760; T.C.A. (orig. ed.), §§ 53-106, 53-107.

Collateral References.

Personal liability of health officer. 24 A.L.R. 798.

68-1-203. Violating quarantine a misdemeanor.

Any person who willfully disregards or evades quarantine, or violates any rule or regulation made in attempting to prevent the spread of any epidemic disease, commits a Class B misdemeanor.

Acts 1879, ch. 151, § 3; Shan., § 3099; mod. Code 1932, § 5761; T.C.A. (orig. ed.), § 53-108; Acts 1989, ch. 591, § 112.

Cross-References. Penalty for Class B misdemeanor, § 40-35-111.

68-1-204. Recommendations by commissioner to governor on allocation of health care resources in affected areas.

In the event that an emergency or disaster as defined in § 58-2-101 occurs, that involves outbreaks of disease that present a danger of an epidemic, the commissioner shall make appropriate recommendations to the governor for actions under this title and title 58, chapter 2, to allocate all available heath care resources in the affected areas for immediate and long-term health care needs of the affected populations.

Acts 2006, ch. 588, § 3.

Part 3
Dental Hygiene

68-1-301. Special care of mouth and teeth — Development of statewide strategy — Report.

The commissioner of health has general supervision of the interests of health and life of the citizens of this state, with special reference to the care and preservation of the mouth and teeth. With an understanding of the need to address the lack of resources available for the treatment of adult emergency dental situations, the commissioner will, in conjunction with professional organizations comprised of dental and related health care providers, organizations representing dental health recipients and other key stakeholders, develop a statewide strategy for the provision of adult emergency oral health care, utilizing public and private sector resources. The commissioner will report to the legislature on the progress of this strategy no later than January 15, 2009.

Acts 1919, ch. 172, § 4; impl. am. Acts 1923, ch. 7, § 46; Shan. Supp., § 3100a3; Code 1932, § 5762; T.C.A. (orig. ed.), § 53-109; Acts 2008, ch. 998, § 1.

68-1-302. Instruction as to the care of the teeth — Appointment of director — Assistance of teachers.

The commissioner shall appoint a director to instruct the pupils of the public schools and inmates of the charitable institutions in the importance of the care and preservation of the teeth, and to lecture to the teachers of the schools and institutions with the purpose of securing their assistance in having the pupils of the schools carry out the director's instructions.

Acts 1919, ch. 172, § 4; impl. am. Acts 1923, ch. 7, § 46; Shan. Supp., § 3100a4; mod. Code 1932, § 5763; T.C.A. (orig. ed.), § 53-110.

68-1-303. Supervision over dentists and dental equipment — Distribution of literature — Annual reports.

  1. The commissioner has general supervision over dentists and dental equipment in the various state institutions.
  2. The commissioner shall distribute such literature throughout the state as will inform the people in the proper way to care for the teeth, and shall submit an annual report to the governor and Tennessee State Dental Association on the work done by and under the commissioner.

Acts 1919, ch. 172, § 4; impl. am. Acts 1923, ch. 7, § 46; Shan. Supp., § 3100a5; Code 1932, § 5764; T.C.A. (orig. ed.), § 53-111.

Cross-References. Appointment of dentists for state institutions, § 4-6-110.

68-1-304. County mouth hygienists.

  1. To assist the commissioner in carrying out the duties of the commissioner's office, the commissioner is authorized to appoint a reputable dentist in each county seat, who shall serve without compensation and shall be known as county mouth hygienist.
  2. County health departments, both rural and metro, with existing dental staff and facilities receiving state or federal funds, shall, as a high priority to the extent possible within budgetary limitations, provide indigent children with comprehensive dental services and indigent adults with emergency dental services for the relief of pain and infections. The language “to the extent possible within budget limitations” as used in this section does not relieve metropolitan health departments with dental staffs and clinical facilities from occasionally providing emergency services to adult patients who present for relief of pain and infection. Subject to and within current or existing budget limitations, metropolitan health departments are to see adult emergency patients during cancelled or open appointments in their schedule. Nothing in this section precludes the health departments from charging a fee for those services. The commissioner has authority to monitor compliance and may request corrective actions if necessary.

Acts 1919, ch. 172, § 5; Shan. Supp., § 3100a6; Code 1932, § 5765; T.C.A. (orig. ed.), § 53-112; Acts 2008, ch. 998, § 2; 2010, ch. 766, § 1.

68-1-305. Comprehensive state oral health plan.

  1. The commissioner of health is authorized to develop a comprehensive state oral health plan. The plan may be used to direct skilled personnel and funding decisions in order to reduce the prevalence of oral disease. The plan may enable the state to compete more effectively for funding resources and opportunities.
  2. The commissioner may develop the plan in consultation with public and private agencies, partners, and stakeholders, including the state oral health coalition and members of the public health, dental, and medical communities.
  3. The plan may:
    1. Include state-specific data;
    2. Be maintained in a current and relevant form with updates every five (5) years;
    3. Be distributed broadly to public partners and policymakers; and
    4. Provide specific, measurable, achievable, relevant, and time-framed (S.M.A.R.T.) objectives.
  4. The plan may also include:
    1. A logic model;
    2. A strong infrastructure;
    3. Accessibility to current resources;
    4. Identified knowledge gaps in resources and recommendations for eliminating those gaps;
    5. Healthy People 2020 oral health objectives;
    6. Identified priority populations and the burdens of oral disease;
    7. Identified partners with the ability to leverage resources;
    8. A communication plan for addressing new or emerging oral health knowledge specifically for:
      1. Dental caries;
      2. Water fluoridation; and
      3. School-based or school-linked dental sealant programs;
    9. Programs to address oral cancer and periodontal diseases;
    10. Efforts to address infection control in dental settings;
    11. Evaluation activities at the initiation of the planning process that involve recommendations for types of evaluation and plans for monitoring outcomes related to plan implementation;
    12. Identified best practices for replication of program implementation; and
    13. A proposal that identifies the process for updating the plan as required by this section.

Acts 2016, ch. 968, § 1.

Effective Dates.  Acts 2016, ch. 968, § 2. April 27, 2016.

Part 4
Vaccines

68-1-401. Production and distribution by department — Charge — Regulations.

  1. It is the duty of the department of health to manufacture and distribute throughout the state of Tennessee such vaccines and other biological products as the division of laboratories is equipped to produce.
  2. The commissioner of health, with the approval of the governor, shall adopt rules and regulations governing the manufacture and distribution of vaccines and biological products.
  3. Subject to the rules and regulations prescribed by subsection (b), health officers and health departments of this state and the heads of state institutions may from time to time make requisitions for vaccines and other products, which requisitions shall, if deemed reasonable and necessary, be honored in the order in which the requisitions are presented to the commissioner.
  4. A reasonable charge may be made to cover the cost of manufacture, distribution and essential overhead expenses, funds as received to be deposited with the state treasurer and disbursed in the same manner as are any state appropriations for the department.
  5. All receipts from the sale of the products provided for in this section shall continue as a manufacturing account of the department for the continuance of the service by the division of laboratories and shall not revert to the general fund.

Acts 1933, ch. 157, § 1; C. Supp. 1950, § 5757.1; T.C.A. (orig. ed.), § 53-113.

68-1-402. Hepatitis vaccinations.

  1. When hepatitis A outbreaks in communities are of such a nature and proportion that the centers for disease control or the commissioner of health deems it appropriate to do targeted or widespread vaccination for hepatitis A, then vaccine shall be made available to that community through state funds, if no federal vaccine program covers the cost of any or all of the vaccine necessary to carry out the vaccination program.
  2. For the purpose of funding the cost of the vaccine required by this section during outbreaks, it is the legislative intent to provide a sum-sufficient appropriation in each fiscal year's annual appropriation bill, which will be subject to approval of the commissioner of finance and administration.

Acts 1996, ch. 1041, §§ 1, 2.

Compiler's Notes. Acts 1996, ch. 1041, which enacted this section, is known as the “Hepatitis A Protection and Control Act.”

Part 5
Control and Prevention of Diabetes

68-1-501. Identification of goals and benchmarks and development of agency plans.

The bureau of TennCare, the department of health, and the department of finance and administration shall collaborate to identify goals and benchmarks while also developing individual agency plans to reduce the incidence of diabetes in this state, improve diabetes care, and control complications associated with diabetes.

Acts 2015, ch. 404, §  1.

Compiler's Notes. Former part 5, §§ 68-1-501, 68-1-502 (Acts 1935, ch. 2, §§ 2, 3, 5; impl. am. Acts 1937, ch. 33, § 63; mod. C. Supp. 1950, §§ 255.60, 255.61 (Williams, §§ 255.66, 282.2, 282.4, 328.1); impl. am. Acts 1959, ch. 9, § 3; impl. am. Acts 1961, ch. 97, § 3; Acts 1967, ch. 192, § 1; 1969, ch. 131, §§ 1-5; 1970, ch. 448, § 1; T.C.A. (orig. ed.), § 53-114; Acts 1976, ch. 806, § 1(85); T.C.A. (orig. ed.), § 53-115; Acts 1988, ch. 1013, § 60), concerning the public health council, was repealed by Acts 2008, ch. 951, § 2, effective July 1, 2008.

Effective Dates. Acts 2015, ch. 404, § 2. July 1, 2015.

68-1-502. Reports.

The bureau of TennCare and the department of health shall jointly submit a report to the health committee of the house of representatives and the health and welfare committee of the senate by February 1 of each odd-numbered year on the following:

  1. The financial impact and reach diabetes of all types is having on the agency, the state, and localities. Items included in this assessment shall include the number of lives with diabetes impacted or covered by the entity, the number of lives with diabetes and family members impacted by prevention and diabetes control programs implemented by the entity, the financial toll or impact diabetes and its complications places on the program, and the financial toll or impact diabetes and its complications places on the program in comparison to other chronic diseases and conditions;
  2. An assessment of the benefits of implemented programs and activities aimed at controlling diabetes and preventing the disease. This assessment shall also document the amount and source for any funding directed to such agency from the general assembly for programs and activities aimed at reaching those with diabetes;
  3. A description of the level of coordination existing between the agencies on activities, programmatic activities, and messaging on managing, treating, or preventing all forms of diabetes and its complications; and
  4. The development or revision of detailed action plans for battling diabetes with a range of actionable items for consideration by the general assembly. The plans shall identify proposed action steps to reduce the impact of diabetes, prediabetes, and related diabetes complications. The plan shall also identify expected outcomes of the action steps proposed in the following biennium while also establishing benchmarks for controlling and preventing relevant forms of diabetes. The role of the department of health in developing these plans shall be limited to primary prevention.

Acts 2015, ch. 404, §  1.

Compiler's Notes. Former part 5, §§ 68-1-501, 68-1-502 (Acts 1935, ch. 2, §§ 2, 3, 5; impl. am. Acts 1937, ch. 33, § 63; mod. C. Supp. 1950, §§ 255.60, 255.61 (Williams, §§ 255.66, 282.2, 282.4, 328.1); impl. am. Acts 1959, ch. 9, § 3; impl. am. Acts 1961, ch. 97, § 3; Acts 1967, ch. 192, § 1; 1969, ch. 131, §§ 1-5; 1970, ch. 448, § 1; T.C.A. (orig. ed.), § 53-114; Acts 1976, ch. 806, § 1(85); T.C.A. (orig. ed.), § 53-115; Acts 1988, ch. 1013, § 60), concerning the public health council, was repealed by Acts 2008, ch. 951, § 2, effective July 1, 2008.

Effective Dates. Acts 2015, ch. 404, § 2. July 1, 2015.

68-1-503. Applicability of requirements of part.

The requirements of this part shall be limited to the diabetes information, data, initiatives, and programs within each agency prior to July 1, 2015, unless there is unobligated funding for diabetes in each agency that may be used for new research, data collection, reporting, or other requirements of this part.

Acts 2015, ch. 404, § 1.

Effective Dates. Acts 2015, ch. 404, § 2. July 1, 2015.

Part 6
Stroke best practices and treatment guidelines task force [Effective until June 30, 2021.]

68-1-601. Establishment of task force — Membership. [Effective until June 30, 2021.]

  1. There is hereby established under the department of health a stroke best practices and treatment guidelines task force.
  2. The membership of the task force shall be appointed by the commissioner of health on or before July 1, 2016. The membership shall include, but not be limited to:
    1. A designated member from each comprehensive stroke center in the state;
    2. A designated member from a primary stroke center;
    3. A designated member from an acute stroke ready hospital; provided, that the designated hospital may be appointed as soon as an appropriate hospital has been certified;
    4. Three (3) emergency medical service (EMS) representatives:
      1. An emergency medical services provider actively working within a county EMS system from an urban area;
      2. An emergency medical services provider actively working within a county EMS system from a rural area; and
      3. An emergency medical services operations representative from the Tennessee ambulance service association;
    5. A representative of an emergency communications district board;
    6. Appropriate staff from the department of health;
    7. A healthcare provider representative, who may be appointed from lists of qualified persons submitted by interested medical organizations including, but not limited to, the Tennessee Medical Association. The commissioner shall consult with the interested medical organizations to determine a qualified person to serve on the task force; and
    8. A representative of a nationally recognized stroke association with a stroke data collection platform system.

Acts 2016, ch. 678, § 1.

Code Commission Notes.

Acts 2016, ch. 678, § 1 enacted a new part 26, §§ 68-1-260168-1-2604,  but the part has been redesignated as part 6, §§ 68-1-60168-1-604 by authority of the Code Commission.

Compiler's Notes. Former part 6, §§ 68-1-60168-1-603, concerning the director of the division of health related boards, was transferred to §§ 63-1-13163-1-133 in 1987.

Former part 6 of this chapter, §§ 68-1-60168-1-606, the Comprehensive Alcohol, Tobacco and Other Drug Prevention Program Act, was transferred to title 33, ch. 10, part 5 by Acts 2009, ch. 186, §§ 40-45, effective May 7, 2009.

Effective Dates. Acts 2016, ch. 678, § 2. March 29, 2016.

Cross-References. Repealer, § 68-1-604.

68-1-602. Volunteer members. [Effective until June 30, 2021.]

Members of the stroke best practices and treatment guidelines task force shall be volunteers. The members shall meet without compensation. The members shall not be eligible for compensation for travel expenses in accordance with the comprehensive travel regulation promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.

Acts 2016, ch. 678, § 1.

Code Commission Notes.

Acts 2016, ch. 678, § 1 enacted a new part 26, §§ 68-1-260168-1-2604,  but the part has been redesignated as part 6, §§ 68-1-60168-1-604 by authority of the Code Commission.

Compiler's Notes. Former part 6, §§ 68-1-60168-1-603, concerning the director of the division of health related boards, was transferred to §§ 63-1-13163-1-133 in 1987.

Former part 6 of this chapter, §§ 68-1-60168-1-606, the Comprehensive Alcohol, Tobacco and Other Drug Prevention Program Act, was transferred to title 33, ch. 10, part 5 by Acts 2009, ch. 186, §§ 40-45, effective May 7, 2009.

Effective Dates. Acts 2016, ch. 678, § 2. March 29, 2016.

Cross-References. Repealer, § 68-1-604.

68-1-603. Meetings — Audio access. [Effective until June 30, 2021.]

Meetings of the stroke best practices and treatment guidelines task force shall provide audio access for participants on the task force and shall be available by audio for monitoring by the public.

Acts 2016, ch. 678, § 1.

Code Commission Notes.

Acts 2016, ch. 678, § 1 enacted a new part 26, §§ 68-1-260168-1-2604,  but the part has been redesignated as part 6, §§ 68-1-60168-1-604 by authority of the Code Commission.

Compiler's Notes. Former part 6, §§ 68-1-60168-1-603, concerning the director of the division of health related boards, was transferred to §§ 63-1-13163-1-133 in 1987.

Former part 6 of this chapter, §§ 68-1-60168-1-606, the Comprehensive Alcohol, Tobacco and Other Drug Prevention Program Act, was transferred to title 33, ch. 10, part 5 by Acts 2009, ch. 186, §§ 40-45, effective May 7, 2009.

Effective Dates. Acts 2016, ch. 678, § 2. March 29, 2016.

Cross-References. Repealer, § 68-1-604.

68-1-604. Progress report and preliminary recommendations — Requirements — Expiration of task force. [Effective until June 30, 2021.]

  1. With assistance from the department of health and college of public health of East Tennessee State University, the stroke best practices and treatment guidelines task force shall provide a progress report and preliminary recommendations to the chair of the health and welfare committee of the senate and the chair of the health committee of the house of representatives by January 1, 2017.
  2. The task force shall report to the chair of the health and welfare committee of the senate and the chair of the health committee of the house of representatives by July 1 of each year with recommendations regarding:
    1. The establishment of a mandatory statewide data collection registry specific to stroke patients;
    2. The potential need for state funding in order to offset the costs of the data collection for some or all hospitals and other healthcare providers;
    3. The need for state-sanctioned designations for hospitals denoting their readiness to treat stroke patients on an emergency basis; and
    4. The need and advisability of destination guidelines or standards for emergency medical services personnel.
  3. The task force shall cease to exist on June 30, 2021.

Acts 2016, ch. 678, § 1.

Code Commission Notes.

Acts 2016, ch. 678, § 1 enacted a new part 26, §§ 68-1-260168-1-2604,  but the part has been redesignated as part 6, §§ 68-1-60168-1-604 by authority of the Code Commission.

Compiler's Notes. Former part 6, §§ 68-1-60168-1-603, concerning the director of the division of health related boards, was transferred to §§ 63-1-13163-1-133 in 1987.

Former part 6 of this chapter, §§ 68-1-60168-1-606, the Comprehensive Alcohol, Tobacco and Other Drug Prevention Program Act, was transferred to title 33, ch. 10, part 5 by Acts 2009, ch. 186, §§ 40-45, effective May 7, 2009.

Effective Dates. Acts 2016, ch. 678, § 2. March 29, 2016.

Part 7
Primary Health Care Centers

68-1-701. Establishment of centers.

  1. The department of health is authorized to establish one (1) or more primary health care centers in Tennessee.
  2. It is the intent of the general assembly that the establishment of these centers will demonstrate new and more effective ways of providing health care in communities of the state, and will assist in achieving a better distribution of health care personnel into areas of Tennessee where a shortage of such personnel currently exists, and that these centers will provide primary health care services to patients and will enhance the delivery of health care in communities.

Acts 1973, ch. 165, § 1; 1975, ch. 38, § 1; 1975, ch. 108, § 1; 1980, ch. 663, § 1; 1980, ch. 851, § 11; T.C.A., § 53-124; Acts 1985, ch. 120, §§ 17, 18; 1989, ch. 279, §§ 1-3; 1994, ch. 569, § 3; 1995, ch. 15, §§ 1-3; 1996, ch. 659, § 6; 1998, ch. 842, § 1.

Cross-References. Genetic testing, title 68, ch. 5, part 5.

Issuance of oral contraceptives and drugs relating to sexually transmitted diseases by professional nurse, § 63-7-124.

Newborn testing and metabolic defects, title 68, ch. 5, part 4.

Reporting requirement satisfied by notice to general assembly members of publication of report, § 3-1-114.

Statewide early intervention program for infants and toddlers with disabilities and their families, § 49-10-702.

68-1-702. Participation of public and private agencies and individuals — Rules and regulations.

  1. The commissioner of health is authorized to contract with and otherwise seek participation from appropriate public and private agencies and institutions and individuals, as the commissioner may deem necessary, to accomplish the purposes of this part. Particular attention will be given to educational functions to improve health care manpower distribution.
  2. The commissioner is authorized to adopt, promulgate and enforce rules and regulations under which primary care centers shall be operated, and to effectuate the purposes and provisions of this part.

Acts 1973, ch. 165, § 2; 1975, ch. 108, § 2; 1980, ch. 663, § 2; T.C.A., § 53-125.

68-1-703. Approval by state and local agencies required.

In order to ensure cooperation and acceptance of the purposes of this part by the community to be served, the sponsor of any new primary health care center shall, prior to the establishment of a new primary health care center in a community, obtain the approval of the appropriate health systems agency and the primary care advisory board, including those centers that utilize, or plan to utilize, federal funds, either as grants, or as fees receivable as reimbursements for services delivered for medicare or medicaid patients.

Acts 1973, ch. 165, § 3; 1980, ch. 663, § 3; T.C.A., § 53-126.

Compiler's Notes. The primary care advisory board, referred to in this section, is apparently the primary health care centers advisory board, established by former § 68-1-701(b)-(d). Those subsections were repealed and the board was terminated by Acts 1998, ch. 842, § 1, effective April 29, 1998.

Part 8
Perinatal and Neonatal Care

68-1-801. Part definitions.

As used in this part, unless the context otherwise requires:

  1. “Commissioner” means the commissioner of health or the commissioner's designated representative;
  2. “Committee” means the perinatal advisory committee;
  3. “Department” means the department of health; and
  4. “Perinatal” means the period from time of conception through the first year of life of the infant and sixty (60) days post partum for the mother.

Acts 1974, ch. 645, § 1; 1977, ch. 327, § 1; T.C.A., § 53-127.

Cross-References. Genetic testing, title 68, ch. 5, part 5.

Newborn testing and metabolic defects, title 68, ch. 5, part 4.

Statewide early intervention program for infants and toddlers with disabilities and their families, § 49-10-702.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, VII. Protection of Minors (Neil P. Cohen), 45 Tenn. L. Rev. 489.

68-1-802. Development of plan for perinatal care.

  1. The department is directed to develop a plan to establish a program for the diagnosis and treatment of certain life-threatening conditions present in the perinatal period.
  2. The program shall assist pregnant women and their fetuses and newborn infants by developing a regionalized system of care, including highly specialized personnel, equipment, and techniques, that will decrease the existing high mortality rate, neonatal death rate, pre-term birth rate, and the lifelong disabilities that currently prevail in surviving newborn infants.
  3. No programs shall be planned except those that are specifically funded by appropriations in the annual budget.

Acts 1974, ch. 645, § 2; 1977, ch. 327, § 2; T.C.A., § 53-128; Acts 2019, ch. 240, § 1.

Amendments. The 2019 amendment, in (b), added a comma following  “equipment” and substituted “high mortality rate, neonatal death rate, pre-term birth rate, and the lifelong disabilities” for “high mortality rate and the life-long disabilities”.

Effective Dates. Acts 2019, ch. 240, § 5. April 30, 2019.

Cross-References. Genetic testing, title 68, ch. 5, part 5.

Newborn testing and metabolic defects, title 68, ch. 5, part 4.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, VII. Protection of Minors (Neil P. Cohen), 45 Tenn. L. Rev. 489.

68-1-803. Appointment of advisory committee — Terms — Travel expenses.

  1. The commissioner shall appoint a perinatal advisory committee to consult with the department in the administration of this part.
  2. The committee shall be composed of the director, or the director's designee, of each obstetrical and each newborn unit of each regional perinatal center within the state, as designated by the commissioner, in addition to at least one (1) representative from each of the following categories:
    1. Medical schools;
    2. Health and environment agencies;
    3. Hospital administrators;
    4. Medical specialists in obstetrical and newborn conditions;
    5. Family physicians;
    6. Obstetrical and neonatal intensive care nurses; and
    7. The general public.
  3. Total membership of the committee shall not exceed twenty-one (21).
  4. Each member shall hold office for a term of four (4) years and until the member's successor is appointed and qualified.
  5. Any person appointed to fill a vacancy occurring prior to the expiration of the term for which the person's predecessor was appointed shall be appointed for the remainder of the term.
  6. The committee shall meet as frequently as the commissioner deems necessary, but not less than once each year.
  7. The committee members shall receive no compensation, but shall be reimbursed for travel expenses, in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.

Acts 1974, ch. 645, § 3; 1976, ch. 806, § 1(86); 1977, ch. 327, § 3; 1979, ch. 172, § 1; T.C.A., § 53-129.

Code Commission Notes.

The former last part of subsection (d) and former subsection (h), regarding the expiration of members' terms when the committee was formed and when new members were added in 1977, respectively, were deleted as obsolete by authority of the code commission in 2006.

Compiler's Notes. The perinatal advisory committee, created by this section, terminates June 30, 2025. See §§ 4-29-112, 4-29-246.

Cross-References. Genetic testing, title 68, ch. 5, part 5.

Newborn testing and metabolic defects, title 68, ch. 5, part 4.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, VII. Protection of Minors (Neil P. Cohen), 45 Tenn. L. Rev. 489.

68-1-804. Items to be considered for inclusion in program.

The department, with the advice of the committee, shall, in developing the plan for this program, consider the feasibility of designing this program so as to:

  1. Develop standards for determining eligibility for diagnosis and treatment under this program;
  2. Assist in the regional development, expansion and maintenance of newborn centers, including purchase of equipment, for the diagnosis and treatment of high-risk pregnant women and their fetuses and newborn infants;
  3. Extend financial assistance in order to provide diagnosis of and treatment for pregnant women and their fetuses and newborn infants, by providing necessary medical, surgical, hospital, outpatient clinic and ambulatory services;
  4. Develop a regional system or systems of rapid transportation and referral to the obstetrical and newborn centers from throughout the state for pregnant women and their fetuses and newborns who require life-sustaining care;
  5. Develop or expand regional education and training activities to further facilitate meeting the intent of this part;
  6. Employ all necessary administrative personnel as may be provided in the budget to carry out this part;
  7. Promulgate all rules and regulations necessary to effectuate the purposes of this part;
  8. Develop or expand a communication/consultation system or systems;
  9. In consultation with organizations representing state pediatric physicians, develop appropriate standards for the dissemination of information and educational material about conditions and diseases that commonly affect newborn infants, such as respiratory syncytial virus; and
  10. Assist in the regional development, expansion, and maintenance of specialty level II birthing centers in every health region with certified obstetricians and pediatricians available who are trained in the prevention, early diagnoses, treatment, and stabilization of complications of pregnancy and childbirth.

Acts 1974, ch. 645, § 4; 1977, ch. 327, § 4; T.C.A., § 53-130; Acts 2008, ch. 874, § 1; 2019, ch. 240, § 2.

Amendments. The 2019 amendment added (10).

Effective Dates. Acts 2019, ch. 240, § 5. April 30, 2019.

Cross-References. Genetic testing, title 68, ch. 5, part 5.

Newborn testing and metabolic defects, title 68, ch. 5, part 4.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, VII. Protection of Minors (Neil P. Cohen), 45 Tenn. L. Rev. 489.

68-1-805. Report regarding births involving neonatal abstinence syndrome and opioid use by women of childbearing age.

On or before January 15, 2018, the commissioner of health, in consultation with the perinatal advisory committee and with the assistance of relevant state agencies, shall report to the health committee of the house of representatives and the health and welfare committee of the senate concerning the following aspects of births involving neonatal abstinence syndrome and opioid use by women of childbearing age for the last two (2) available fiscal years or calendar years, as may be available:

  1. From data available to the bureau of TennCare, the number of births involving neonatal abstinence syndrome to enrollees in the TennCare program, the lengths of stay in a hospital for infants born with neonatal abstinence syndrome to enrollees in the TennCare program, and the costs to the program of those births;
  2. From information available to managed care organizations participating in the TennCare program, a description of any initiatives by the managed care organizations to address health outcomes, costs, and other issues raised by births involving neonatal abstinence syndrome and opioid use by women of childbearing age;
  3. From data available to the department of health, and district and county health departments, the number of women with a substance abuse diagnosis involving opioid use who received family planning services and the number of those women who received long acting reversible contraceptives;
  4. From data available to the department of children's services, the number of cases involving investigations that included an infant born with neonatal abstinence syndrome, the number of such infants in custody of the department, and the number of visits made by the department to families with an infant born with neonatal abstinence syndrome; and
  5. From data available to the bureau of TennCare and the department of health, the number of cases in which the source of opiates in the mother of an infant born with neonatal abstinence syndrome can be reasonably associated with a substance prescribed to the mother.

Acts 2017, ch. 483, § 2.

Effective Dates. Acts 2017, ch. 483, § 4. June 6, 2017.

68-1-806. Report on quality and outcomes in perinatal care.

On or before March 1 of each year the bureau of TennCare, in consultation with the perinatal advisory committee and with the assistance of relevant state agencies, shall report to the health committee of the house of representatives and the health and welfare committee of the senate concerning the following aspects of quality and outcomes in perinatal care for the last two (2) available fiscal years or calendar years, as may be available:

  1. From information available to managed care organizations participating in the TennCare program, a description of any initiatives by the managed care organizations to improve key performance indicators of perinatal care outcomes such as maternal deaths, neonatal and fetal perinatal deaths, and pre-term births; and
  2. From vital statistical data available to the bureau of TennCare and the department, a determination of the effectiveness of managed care organizations' initiatives toward improving perinatal care outcomes to residents in each health region.

Acts 2019, ch. 240, § 3.

Effective Dates. Acts 2019, ch. 240 § 5. April 30, 2019.

Part 9
Medical Care Division

68-1-901. Director of division — Assistants and employees.

  1. The director of the medical care division shall be duly licensed in accordance with the laws of Tennessee to practice medicine in Tennessee, and shall have been engaged in the active practice of the director's profession for not less than five (5) years immediately preceding the director's appointment.
  2. It is the duty of the commissioner of health, in conjunction with the director of the medical care division, and after consultation with the public health council [repealed] of the department of health, to appoint such assistants and employees as may be necessary to carry on the work of the medical care division, and all the assistants and employees shall hold office and receive compensation in accordance with provisions of title 4, chapter 4, governing the tenure and compensation of like employees in other departments.

Acts 1939, ch. 102, § 1; mod. C. Supp. 1950, § 328.1 (Williams, § 255.68a); T.C.A. (orig. ed.), § 53-201.

Compiler's Notes. The public health council, referred to in this section, was terminated by Acts 2008, ch. 951, § 2, effective July 1, 2008.

68-1-902. Administration and disbursement of funds — Medical care fund established.

  1. The medical care division, subject to supervision by the department of health, as provided in this part, shall administer and expend all funds appropriated by the general assembly or made available by allotment by the federal government to the state, or from contributions from counties, cities or other local units of government, or from other sources, appropriated, allotted or contributed for medical care in accordance with any future act of the general assembly or the congress of the United States, having as its object the inauguration of a state or national program of medical care.
  2. It is the duty of the state treasurer, whenever funds are available for carrying out this part, to set up in the state treasury a separate fund to be known as the “medical care fund,” and credit to the fund all appropriations, allotments or contributions, from whatever source specially designated and identified as funds for medical care or medical service, in accordance with the purpose specified in this part, and to preserve this separate fund for disbursement and expenditure solely and alone at the discretion of the commissioner of health, medical care division, in the manner provided by law.
  3. This section shall not apply to funds allocated for medical care where federal laws or regulations require administration by another state administrative unit.

Acts 1939, ch. 102, § 2; C. Supp. 1950, § 328.2 (Williams, § 255.68b); Acts 1957, ch. 78, § 1; T.C.A. (orig. ed.), § 53-202.

68-1-903. Application of part.

  1. The enforcement of this part shall in no way interfere with or supersede any existing law or cooperative federal, state or local program carried on under the Social Security Act, compiled in 42 U.S.C. § 301 et seq., or other federal acts, or any other state, federal or local law.
  2. Nothing in this part shall apply to or affect medical care or medical service furnished wards of the state, who are inmates of any state institution, such as state prisons, mental health institutes, developmental centers, home for the blind, homes for the deaf, or juvenile correction institutions, but this part shall apply with respect to medical care or medical service furnished at public expense to any other person not an inmate of a state institution having an established and organized medical staff in regular attendance upon the inmates of the institution; it being the purpose of this part to coordinate, improve and better supervise the expenditure of public funds appropriated and designed for medical care and medical service to citizens of the state generally, who under future laws shall become entitled to receive medical care or medical service at public expense under the proposed national program of medical care; and is not intended to interfere with or interrupt the established and organized routine or special medical care and medical service rendered by the state to its wards regularly residing in any sort of state institution.

Acts 1939, ch. 102, § 3; C. Supp. 1950, § 328.3 (Williams, § 255.68c); impl. am. Acts 1977, ch. 123, § 1; T.C.A. (orig ed.), § 53-203.

68-1-904. “Medical care” and “medical service” defined and limited — Unlicensed individuals administering medication.

  1. “Medical care” and “medical service,” as used in this part, are intended to describe and define care or services rendered an individual for the relief of some disease or abnormality, and are intended to be distinguished from the services customarily rendered by health departments.
  2. “Medical service” includes all legally authorized branches of healing as exist by any statute of Tennessee.
    1. The department of intellectual and developmental disabilities, may, based upon its determination of available resources and need, provide training for unlicensed individuals who administer medications to individuals incapable of self-administration. The training shall be provided only to unlicensed individuals who are employed by agencies that are both licensed under title 33 and under contract to provide residential or adult day programs for persons with intellectual disability, and to unlicensed individuals employed by community-based licensed intermediate care facilities for persons who have intellectual disability who will administer medication only at a location other than the community-based facility. The employees of the community-based licensed intermediate care facilities for persons who have intellectual disability may additionally receive medication administration training specific to the person served. For the purposes of this subsection (c), when administered by employees of intermediate care facilities, medications shall be packaged in individual doses labeled with the name of the individual patient, the time of administration and the drug name and dosage.
    2. The department of children's services may, based on its determination of available resources and need, provide training for unlicensed individuals who assist children and youth with the self-administration of medication in group home settings. The training shall be provided only to those unlicensed individuals who are employed by agencies that are both licensed under title 37 and under contract to provide services to children in the department's custody in a group home setting.
    3. The unlicensed personnel referenced in subdivision (c)(1) shall not administer intravenous, intramuscular, and certain subcutaneous injectable medications, as defined by rule. The unlicensed personnel referenced in subdivision (c)(2) shall not assist with the self administration of vaginal medications, rectal medications, intravenous, intramuscular, and certain subcutaneous injectable medications, as defined by rule. The department of intellectual and developmental disabilities, in consultation with the board of nursing, shall promulgate rules, including emergency rules, to provide for competency-based training, education, and appropriate monitoring of the unlicensed personnel covered by this subsection (c) who shall have the authority to perform the services provided for in this subsection (c), notwithstanding any other statute or rule. The unlicensed personnel shall be exempt from the licensing requirements contained in and rules promulgated pursuant to title 63, chapter 7, part 1.

Acts 1939, ch. 102, § 4; C. Supp. 1950, § 328.4 (Williams, § 255.68d); T.C.A. (orig. ed.), § 53-204; Acts 1997, ch. 478, § 4; 2005, ch. 210, § 1; 2007, ch. 364, §§ 1, 2; 2009, ch. 477, § 1; 2009, ch. 566, § 12; 2010, ch. 1100, § 103; 2011, ch. 158, § 34.

Compiler's Notes. Acts 2009, ch. 477, § 1, directed the code commission to change all references from “division of mental retardation services” to “division of intellectual disabilities services” and to include the changes in supplements and replacement volumes for the Tennessee Code Annotated.

Acts 2009, ch. 566, § 12 provided that the Tennessee code commission is directed to change all references to public necessity rules, wherever such references appear in this code, to emergency rules, as sections are amended and volumes are replaced.

Acts 2010, ch. 1100, § 153 provided that the commissioner of mental health and developmental disabilities, the commissioner of mental health, the commissioner of intellectual and developmental disabilities, and the commissioner of finance and administration are authorized to promulgate rules and regulations to effectuate the purposes of the act. All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Part 10
Tennessee Cancer Reporting System Act of 1983

68-1-1001. Short title.

This part shall be known and may be cited as the “Tennessee Cancer Reporting System Act of 1983.”

Acts 1983, ch. 124, § 1.

Cross-References. Toxic Art Supplies Labeling Act, title 68, ch. 131, part 3.

Law Reviews.

Selected Tennessee Legislation of 1983 (N. L. Resener, J. A. Whitson, K. J. Miller), 50 Tenn. L. Rev. 785 (1983).

68-1-1002. Part definitions.

As used in this part, unless the context otherwise requires:

  1. “Cancer” means and includes, but is not limited to:
    1. A large group of diseases characterized by uncontrolled growth and spread of abnormal cells;
    2. Any condition of tumors having the properties of anaplasia, invasion, and metastasis;
    3. A cellular tumor, the natural course of which is fatal;
    4. Malignant neoplasm; and
    5. In-situ cancer.
  2. “Commissioner” means the commissioner of health;
  3. “Department” means the department of health;
  4. “Facility” means a health care facility in which diagnosis or treatment services are provided to patients with cancer, including, but not limited to, an ambulatory surgical treatment center (ASTC), a freestanding cancer treatment center, a radiation therapy center, a chemotherapy treatment center, a nursing home, an oncology or dermatology clinic, a laboratory, or any other facility that provides screening, detection, diagnostic or therapeutic services to patients with cancer;
  5. “Health care practitioner” means a physician, surgeon, or other health care professional licensed under title 63 who is engaged in diagnosing and treating patients who have cancer;
  6. “Hospital” means an institution as defined by § 68-11-201;
  7. “In-situ cancer” means an abnormality of development and organization of cells. It is a condition of early cancer, without the invasion of neighboring tissue;
  8. “Laboratory” means a facility where tests are performed identifying anatomical and cytological changes, and where specimens are interpreted and pathological diagnoses are made; and
  9. “Medical, scientific and academic research communities” means those institutions that devote a substantial part of their activity to research and that have internal procedures providing for the collection, study and protection of data.

Acts 1983, ch. 124, § 3; 1985, ch. 85, § 1; 2000, ch. 775, §§ 2-6.

68-1-1003. Purpose of chapter — Reports to department — Format and contents of reports — Persons authorized to have access to patients medical records — Reimbursement — Failure to report or give access to records.

  1. The purpose of this part is to ensure an accurate and continuing source of data concerning cancer and to provide appropriate data to members of the medical, scientific, and academic research communities for purposes of authorized institutional research, approved by the appropriate research committee of the applying institution, into the causes, types and demography of cancer, including, but not limited to, the occupation, family history, and personal habits of persons diagnosed with cancer.
  2. In order to accomplish the purpose described in (a), all hospitals, laboratories, facilities, and health care practitioners shall report to the department, within six (6) months after the date of diagnosis of cancer in a patient, information contained in the medical records of patients who have cancer; provided, that health care practitioners are not required to report information on patients with cancer who are directly referred to or have been previously admitted to a hospital or a facility for cancer diagnosis or treatment.
  3. The reports required by this section shall be made in the format and shall contain the information required by the department. The department shall make available the necessary information regarding format and data to enable hospitals, laboratories, facilities, and health care practitioners to make accurate reports to the department.
  4. The commissioner or the commissioner's authorized representative may take the steps necessary to avoid duplicate reporting of information on the same patients, including, but not limited to, waiving the requirement for a health care practitioner to report information on cancer patients who are hospitalized or confined to a nursing home, where information on those patients has been reported by the hospital, nursing home, or other reporting source.
  5. The commissioner or the commissioner's authorized representative shall be permitted to have access to the medical records of cancer patients that are maintained by hospitals, laboratories, facilities, and health care practitioners where necessary, to identify cases of cancer and to establish the characteristics of the cancer, the treatment of the cancer, or the medical status of an identified cancer patient.
  6. If a hospital, laboratory, facility, or health care practitioner fails to report the required information to the department in an acceptable format by the required deadline, the commissioner or the commissioner's authorized representative may obtain the information by a direct examination of those patients' medical records. In those cases, the hospital, laboratory, facility, or health care practitioner shall reimburse the department for the department's reasonable expenses incurred in obtaining the information in this manner. The commissioner shall establish, by rule, the maximum amount of reimbursement that may be sought. A hospital, laboratory, facility, or health care practitioner from whom reimbursement is sought may appeal the assessment of expenses under the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  7. A hospital, laboratory, facility, or health care practitioner that fails to report information or allow access to records, as required by this section, shall be informed by the department that compliance with the requirements of this part is mandatory.

Acts 1983, ch. 124, § 4; 1985, ch. 85, § 2; 2000, ch. 775, § 7.

68-1-1004. Reports to department — Rules and regulations.

  1. The department shall require the reporting of cancer and the submission of such specified additional information on reported cases as the commissioner deems necessary and appropriate.
  2. The commissioner shall promulgate rules and regulations, including emergency rules, that are necessary for carrying out the duties and responsibilities of the department under this part. The promulgation of rules and regulations shall be in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 1983, ch. 124, § 5; 2000, ch. 775, § 8; 2009, ch. 566, § 12.

Compiler's Notes. Acts 2009, ch. 566, § 12 provided that the Tennessee code commission is directed to change all references to public necessity rules, wherever such references appear in this code, to emergency rules, as sections are amended and volumes are replaced.

68-1-1005. [Repealed.]

Compiler's Notes. Former § 68-1-1005 (Acts 1983, ch. 124, § 6; 1985, ch. 85, § 3; 2000, ch. 775, § 9), concerning the cancer reporting advisory committee, was repealed by Acts 2001, ch. 40, § 3, effective July 1, 2001.

68-1-1006. Confidentiality of data.

    1. All data obtained from the reports required by this part are for the confidential use of the department and persons that the commissioner determines are necessary to carry out the intent of this part.
    2. Information that could possibly identify individuals whose medical records have been used for collecting data may not be included in materials available to the public.
  1. In order to carry out the legislative intent set out in § 68-1-1003, that the data obtained from the reports required by this part are also to be made available for valid research projects, the commissioner, with the advice of the advisory committee established by this chapter, is authorized to make available to members of the research community, pursuant to § 68-1-1003, specific and personally identifiable portions of the data collected; provided, that the following guidelines are observed:
    1. The researcher sets out clearly the uses for which the data are desired;
    2. The researcher clearly states the reasons for which confidential and personally identifiable portions of the data are necessary;
    3. The researcher assures that the data received from the department will be maintained by the researcher with the same level of confidentiality as that maintained by the department; and
    4. Upon completion of the research project, all data provided by the department and all copies of the data shall be destroyed.
  2. Guidelines for such research applications shall be set out by departmental regulations. For the purposes of this part, those approved to obtain data for research shall not be considered agents of the commissioner.

Acts 1983, ch. 124, § 7; 1985, ch. 85, § 4.

Compiler's Notes. The cancer reporting advisory committee, referred to in this section, was  repealed by Acts 2001, ch. 40, § 3, effective July 1, 2001.

Cross-References. Confidentiality of public records, § 10-7-504.

68-1-1007. Liability for release of information — Compliance not violative of confidentiality.

A hospital, laboratory, facility, or health care practitioner that reports information to the department or allows the commissioner or the commissioner's authorized representative access to the medical records of cancer patients, as required by this part, shall not be held liable to any person for the release of the information to the department, nor shall the release of the information to the department be construed as a violation of any requirement of law or professional obligation to maintain the confidentiality of patient information.

Acts 1983, ch. 124, § 8; 2000, ch. 775, § 10.

Cross-References. Confidentiality of public records, § 10-7-504.

68-1-1008. Tests and supervision of patients prohibited.

No patient whose medical records are the subject of data collected in the reports required by this part shall be subjected to any medical examination or case supervision by the commissioner or the commissioner's agents for the purposes of this part.

Acts 1983, ch. 124, § 9.

68-1-1009. Violations — Penalties — Enforcement.

  1. Any person receiving information containing the personal identity of any patient, who willfully divulges that identity, except as lawfully provided for in this chapter, commits a Class C misdemeanor.
  2. It is the duty of the district attorney general to prosecute a suit, based on subsection (a), when requested by the commissioner, the county health officer or local board of health.

Acts 1985, ch. 85, § 5; 1989, ch. 591, § 113.

Cross-References. Penalty for Class C misdemeanor, § 40-35-111.

68-1-1010. Interstate sharing of information — Confidentiality.

  1. In order to obtain complete information on Tennessee cancer patients who have been diagnosed or treated in other states, and in order to provide information to other states regarding their residents who have been diagnosed or treated for cancer in Tennessee, the commissioner or the commissioner's authorized representative is authorized to enter into appropriate written agreements with other states that maintain statewide cancer registries, allowing the exchange of information on cancer patients.
  2. Each state with which the commissioner agrees to exchange information must agree in writing to keep all patient-specific information confidential and to require any research personnel to whom the information is made available to keep it confidential.

Acts 2000, ch. 775, § 11.

Cross-References. Confidentiality of public records, § 10-7-504.

68-1-1011. Annual publishing of reports.

The department shall annually compile and publish reports utilizing the data collected pursuant to this part and shall make these reports available to the governor, the general assembly, and the public.

Acts 2000, ch. 775, § 12.

Cross-References. Reporting requirement satisfied by notice to general assembly members of publication of report, § 3-1-114.

Part 11
Sudden, Unexplained Child Death Act

68-1-1101. Short title — Legislative findings — Definitions.

  1. This part shall be known and may be cited as the “Sudden, Unexplained Child Death Act.”
  2. The legislature finds and declares that:
    1. Protection of the health and welfare of the children of this state is a goal of its people and the unexpected death of a child is an important public health concern that requires legislative action;
    2. The parents, guardians, and other persons legally responsible for the care of a child who dies unexpectedly have a need to know the cause of death;
    3. Collecting accurate data on the cause and manner of unexpected deaths will better enable the state to protect children from preventable deaths, and thus will help reduce the incidence of such deaths; and
    4. Identifying persons responsible for abuse or neglect resulting in unexpected death will better enable the state to protect other children who may be under the care of the same persons, and thus will help reduce the incidence of such deaths.
  3. As used in this part and in § 68-3-502, unless the context otherwise requires:
    1. “Certified child death pathologist” means a pathologist who is board certified or board eligible in forensic pathology, and who has received training in, and agrees to follow, the autopsy protocol, policies and guidelines for child death investigation, as prescribed by the chief medical examiner for the state of Tennessee;
    2. “Chief medical examiner” means the individual appointed pursuant to title 38, chapter 7; and
    3. “Sudden infant death syndrome” means the sudden death of an infant under one (1) year of age that remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.

Acts 2001, ch. 321, § 1.

Compiler's Notes. Former § 68-1-1101 (Acts 1983, ch. 390, § 2), concerning definitions applicable to sudden infant death syndrome, was repealed by Acts 2001, ch. 321, § 1 effective July 1, 2001.

Cross-References. Aggravated child abuse and aggravated child neglect or endangerment, § 39-15-402.

Child abuse and child neglect or endangerment, § 39-15-401.

Child sexual abuse, title 37, ch. 1, part 6.

Mandatory child abuse reports, title 37, ch. 1, part 4.

68-1-1102. Purpose — Training — Notice and investigation — Autopsy.

  1. The purpose of this part is to help reduce the incidence of injury and death to infants by accurately identifying the cause and manner of death of infants under one (1) year of age. This shall be accomplished by requiring that a death investigation be performed in all cases of all sudden, unexplained deaths of infants under one (1) year of age.
  2. The chief medical examiner shall develop and implement a program for training of child death pathologists. The protocol and policies shall be based on nationally recognized standards.
  3. All emergency medical technicians and professional firefighters shall receive training on the handling of cases of sudden, unexplained child death as a part of their basic and continuing training requirements. The training, which shall be developed jointly by the departments of health and children's services, shall include the importance of being sensitive to the grief of family members.
  4. All law enforcement officers shall receive training on the investigation and handling of cases of sudden, unexplained child death as part of their basic training requirements. The training, which shall be developed jointly by the departments of health and children's services, shall include the importance of being sensitive to the grief of family members and shall be consistent with the death scene investigation protocol approved by the chief medical examiner. Additionally, whenever changes occur in policies or procedures pertaining to sudden infant death syndrome investigations, the department of health shall promptly notify the various law enforcement associations within the state. Such changes shall then be communicated in a timely manner to the respective law enforcement agencies for dissemination to their enforcement personnel.
  5. In the case of every sudden, unexplained death of an infant under one (1) year of age, the attending physician or coroner shall notify the county medical examiner, who shall coordinate the death investigation.
  6. The county medical examiner shall inform the parent or parents or legal guardian of the child, if an autopsy is authorized.
  7. The county medical examiner shall ensure that the body is sent for autopsy to a child death pathologist as defined in this part. Parents or legal guardians who refuse to allow an autopsy based on the grounds of religious exemption shall personally file a petition for an emergency court hearing in the general sessions court for the county in which the death occurred.
  8. The county medical examiner shall contact the appropriate local law enforcement personnel to conduct a death scene investigation according to the protocol developed by the chief medical examiner. The investigation shall be initiated within twenty-four (24) hours of the time the local law enforcement personnel are contacted by the county medical examiner.
  9. The county medical examiner shall send a copy of the death scene investigation and the medical history of the child to the pathologist conducting the autopsy.
  10. A copy of the completed autopsy, medical history, and death scene investigation shall be forwarded to the chief medical examiner.
  11. The cause of death, as determined by the certified child death pathologist, may be reported to the parents or legal guardians of the child. A copy of the autopsy results, when available, may be furnished to the parent or parents or legal guardian of the child, upon request, within forty-eight (48) hours of the request, except where the cause of death may reasonably be attributed to child abuse or neglect, in the judgment of the certified child death pathologist.
  12. Sudden infant death syndrome shall not be listed as the cause of death of a child, unless the death involves an infant under one (1) year of age that remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the child's clinical history.
  13. Any individual or entity providing information pertinent to the investigation and related autopsy in a suspected case of sudden, unexplained infant death syndrome shall not be civilly liable for breach of confidentiality concerning the release of the information.

Acts 2001, ch. 321, § 2; 2002, ch. 591, §§ 1, 2.

Compiler's Notes. Former § 68-1-1102 (Acts 1983, ch. 390, § 3), concerning the sudden infant death syndrome program, was repealed by Acts 2001, ch. 321, § 2 effective July 1, 2001.

Cross-References. Aggravated child abuse and aggravated child neglect or endangerment, § 39-15-402.

Child abuse and child neglect or endangerment, § 39-15-401.

Childhood immunizations, conflict with religious tenets and practices of parent,  § 37-10-402.

Confidentiality of public records, § 10-7-504.

Newborn testing, exemptions for religious beliefs, § 68-5-403.

Post-mortem examinations, title 38, ch. 7.

68-1-1103. Implementation.

In order to implement this part, the commissioner of health shall:

  1. Promulgate rules and regulations in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, as may be necessary to obtain in proper form all information relating to the occurrence of a sudden, unexplained child death that is relevant and appropriate for the establishment of a reliable statistical index of the incidence, distribution and characteristics of cases of sudden, unexplained child death;
  2. Promulgate rules and regulations in accordance with the Uniform Administrative Procedures Act that establish minimum standards for conducting and completing an investigation, including an autopsy if deemed necessary, into the sudden, unexplained death of any child from birth to age seventeen (17). Initial rules promulgated pursuant to this subdivision (2) are authorized to be promulgated as emergency rules, pursuant to § 4-5-208. In promulgating the rules, the commissioner may rely, in whole or in part, on any nationally recognized standards regarding such investigations. Compliance with the rules shall make county governments eligible for reimbursement, to the extent authorized by those rules, of the costs of any autopsy deemed necessary;
  3. Collect factual information from physicians, coroners, medical examiners, hospitals, and public health officials who have examined any child known or believed to have experienced sudden, unexplained death; provided, that no information shall be collected or solicited that reasonably could be expected to reveal the identity of the child;
  4. Make information collected pursuant to subdivision (3) available to physicians, coroners, medical examiners, hospitals, public health officials, and educational and institutional organizations conducting research as to the causes and incidence of sudden, unexplained child death;
  5. Cause appropriate counseling services to be established and maintained for families affected by the occurrence of sudden infant death syndrome;
  6. Conduct educational programs to inform the general public of any research findings that may lead to the possible means of prevention, early identification, and treatment of sudden infant death syndrome; and
  7. Develop educational literature to inform the general public of the risks and prevalence of sudden infant death syndrome and other infant sleep-related deaths that are sometimes mislabeled as sudden infant death syndrome, so that such information may lead to the possible means of prevention. The commissioner shall make the literature set out in this subdivision (7) available on the department of health's website.

Acts 2001, ch. 321, § 3; 2005, ch. 356, § 1; 2009, ch. 566, § 12; 2018, ch. 667, § 1.

Amendments. The 2018 amendment added (7).

Effective Dates. Acts 2018, ch. 667, § 2. April 12,  2018.

Part 12
Public School Nurse Program

68-1-1201. Creation.

  1. There is created within the department of health the Tennessee public school nurse program.
  2. The chief medical officer for the state, appointed pursuant to § 68-1-102(c), shall serve as executive director of the program.
  3. In order to attain the highest level of school attendance, to promote excellence of academic performance and achievement, and to significantly reduce school dropout rates, the executive director, acting through the program, shall strive to improve and safeguard the physical and mental health and well-being of the student population of Tennessee's public schools.

Acts 1988, ch. 988, § 1.

Cross-References. Parental consent for abortions by minors, title 37, ch. 10, part 3.

School nutrition standards, title 49, ch. 6, part 23.

Sexually transmitted diseases, title 68, ch. 10.

Collateral References.

Propriety of prophylactic availability programs. 52 A.L.R.5th 477.

68-1-1202. Duties of executive director.

It is the duty and responsibility of the executive director of the program to:

  1. Assist local education agencies (LEAs) in the development, implementation and coordination of student health policies with regard to first aid emergencies, medications, acute illnesses and infection control;
  2. Provide LEAs with information, advice and technical assistance pertaining to student and parental instruction on topics related to health and wellness, including, but not necessarily limited to:
    1. Family life education;
    2. Sexually transmitted diseases;
    3. Substance abuse;
    4. Nutrition;
    5. Infection control; and
    6. Depression;
  3. Assist LEAs in the provision of student health services, including, but not necessarily limited to:
    1. Medical screenings;
    2. Acute care;
    3. Health opinions for teacher referrals;
    4. Child abuse assessments;
    5. Counseling for students with chronic diseases; and
    6. Counseling for students who are engaging in, or who may be at risk of engaging in, behavioral patterns that jeopardize physical or mental health and well-being;
  4. Assist and encourage LEAs in developing and implementing efficient and effective policies and procedures to ensure parental notification, knowledge and endorsement of school health services and programs, including, but not limited to, efficient and effective policies and procedures to require and obtain prior parental consent for student participation in the health services and programs offered by each LEA; to fully encourage and maximize parental interest and involvement in all matters pertaining to the physical and mental health and well-being of students; and to ensure full parental access to the school health records of their children;
  5. Promote the exchange of information and referrals between LEAs and physicians, health care professionals and sources of health care financial assistance;
  6. Assist the department of education in planning, developing and implementing the program of family life education technical support and assistance, as required by § 49-1-205;
  7. Assist the department of mental health and substance abuse services in providing suitable programs of alcohol and drug education and prevention for LEAs, as required by § 33-10-103;
  8. Report, on or before December 31 each year, to the governor, to each member of the general assembly, and to each member of the state board of education concerning implementation of this section, and also concerning issues and recommendations relating to the physical and mental health and well-being of the state's public school students;
  9. Promote and encourage awareness and involvement of parents, civic groups, community organizations, private businesses and religious institutions on matters pertaining to the physical and mental health and well-being of the state's public school students;
  10. Engage in such other activities to improve and safeguard physical and mental health and well-being as may be necessary in order to attain the highest level of school attendance, to promote excellence of academic performance and achievement, and to significantly reduce school dropout rates;
      1. Encourage and support public and nonprofit agencies in the development of model rural and urban comprehensive school health programs through a system of competitive, state administered grants.
      2. The availability of grants during any fiscal year shall be subject to the ability of the executive director to raise sufficient funds from other than state sources, including, but not limited to, federal sources and private foundations. To qualify for receipt of any such competitive, state administered grant, each model comprehensive school health program must provide preventive and primary health care services designed to attain the goals set forth in § 68-1-1201(c), and must also conform to the policies set forth in § 68-1-1205. The staff of each model program must also include, at a minimum, a certified pediatric or family nurse practitioner with adequate physician backup, and, when possible, should also include a certified health education specialist and a master social worker with adequate psychiatric backup. Each model program must also form a local advisory committee that includes, but is not necessarily limited to, representatives of the LEA and the local offices of the departments of health and children's services. Each advisory committee shall strongly encourage active participation of parents and community-based providers of children and adolescent services. Each advisory committee shall undertake appropriate activities to encourage coordination of services and continued support for the model program. Each model program shall adopt and implement policies and procedures to assure parental consent, confidentiality, quality assurance and program evaluation;
      1. Organize and convene, acting jointly with the commission on children and youth, an interdepartmental committee to:
  1. Develop policies, procedures, and criteria to govern selection of model comprehensive school health programs;
  2. Undertake appropriate activities to solicit grant applications from qualified public and nonprofit agencies;
  3. Develop policies, procedures and criteria for ensuring that grant recipients fully utilize all available sources of federal, state and local financial assistance and assistance from private foundations; and
  4. Design and implement policies to assure collection and analysis of data needed to evaluate the efficiency and effectiveness of individual model programs as well as the efficiency and effectiveness of the grant program;

The interdepartmental committee shall include representation by the departments of mental health and substance abuse services, intellectual and developmental disabilities, education, children's services, labor and workforce development, the governor's council on physical fitness and health, the governor's drug-free task force, and the division of health access within the department of health, and shall also include one (1) citizen member who shall be a parent of a school-aged child, the citizen member to be appointed by the executive director of the public school nurse program, who, prior to making the appointment, shall receive recommendations pertaining to the appointment from interested persons and groups; and

Make available to the department of education educational materials appropriate for distribution so that information about meningococcal disease and the effectiveness of vaccination against meningococcal disease can be provided to parents and guardians. This information shall include the causes, symptoms, and the means by which meningococcal disease is spread and the places where parents and guardians may obtain additional information and vaccinations for their children. The department of education may provide this information, at its discretion, electronically or on its web site. Nothing in this subdivision (12) shall be construed to require the department of education to provide or purchase vaccine against meningococcal disease.

Acts 1988, ch. 988, § 1; 1989, ch. 373, § 1; 1991, ch. 508, § 1; 1996, ch. 1079, § 147; 1999, ch. 520, § 46; 2000, ch. 947, § 6; 2005, ch. 177, § 5; 2008, ch. 748, § 6; 2010, ch. 1100, §§ 104, 105; 2011, ch. 410, § 5(b); 2012, ch. 575, § 1.

Code Commission Notes.

Former subdivision (7) was deemed in 1999 to be void and of no effect, due to the deletion of § 49-1-302(f) mentioned in that subdivision. Former subdivision (7) read: “Aid the department of education in planning, developing and implementing technical support and consultative services to local education agencies, as required by § 49-1-302(f).”

Compiler's Notes. Acts 2010, ch. 1100, § 153 provided that the commissioner of mental health and developmental disabilities, the commissioner of mental health, the commissioner of intellectual and developmental disabilities, and the commissioner of finance and administration are authorized to promulgate rules and regulations to effectuate the purposes of the act. All such rules and regulations shall be promulgated in accordance with the provisions of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

For the Preamble to the act concerning the prohibition against establishment of a special committee if there is a standing committee on the same subject, please refer to Acts 2011, ch. 410.

Cross-References. Abstinence, prevention of AIDS and sexually transmitted diseases, § 49-6-1008.

Children at risk for obesity, title 49, ch. 6, part 14.

Confidentiality of public records, § 10-7-504.

Coordinated school health improvement, title 49, ch. 1, part 10.

Dietetics and nutrition, title 63, ch. 25.

Drug abuse resistance education, title 49, ch. 1, part 4.

Family life curriculum, title 49, ch. 6, part 13.

Informational services regarding second or subsequent pregnancies, targeting potential at-risk first time teen parents, § 37-3-521.

Parental consent for abortion by minor, title 37, ch. 10, part 3.

Public school nurses, duties as to instructing students as to abstinence, § 68-1-1205.

Reporting requirement satisfied by notice to general assembly members of publication of report, § 3-1-114.

School nutrition standards, title 49, ch. 6, part 23.

Sexually transmitted diseases, title 68, ch. 10.

Support and assistance for family life education, § 49-1-205.

Teenage pregnancy, title 37, ch. 3, part 5.

68-1-1203. New positions.

  1. As additional funding is made available for the school nurse program within the general appropriation acts, new school nurse positions may be created within the program. However, in order to ensure orderly, efficient, and effective development, expansion of the program shall occur incrementally and shall not, in any given year, exceed the level at which quality of service or standards of supervisory control may be lowered.
    1. Nurses within the program shall be administratively attached and assigned to the various county and district health departments or local education agencies (LEAs) across the state; however, such nurses shall remain under the supervisory control and direction of the executive director of the school nurse program.
    2. Until such time as the program shall employ school nurses in sufficient numbers to adequately provide services, i.e., a ratio of at least one (1) permanent, full time, school nurse per three thousand (3,000) students, but in no case, less than one (1) permanent, full time, school nurse for each county-wide system, to all LEAs, the executive director shall give priority in the assignment of school nurses to those health departments or LEAs that serve counties that are plagued by problems of poverty, unemployment and underemployment and are medically underserved to the greatest degree.
    1. In order to supplement the personnel resources otherwise available to the program, the executive director is authorized to enter into internship or residency agreements with any nursing school, accredited by the board of nursing, that offers a program of education and training for students preparing to become school nurses.
    2. In the event of any such agreement, the executive director shall formulate guidelines to ensure that the activities of the student nurses are appropriately supervised and reviewed by departmental personnel.

Acts 1988, ch. 988, § 1.

Code Commission Notes.

Former subdivision (a)(1), concerning transfer of personnel to the program, was deleted as obsolete by authority of the code commission in 2006.

68-1-1204. Rules and regulations — Public school nurse advisory council.

  1. The commissioner of health, acting in consultation with the executive director of the program, is authorized to promulgate rules and regulations necessary to efficiently and effectively implement this part.
    1. The rules and regulations shall include, but shall not necessarily be limited to, policies and procedures whereby a public school nurse advisory council may be created by a local education agency (LEA) with one (1) or more full-time school nurses.
    2. The primary purpose of the advisory council shall be to develop and submit recommendations to the executive director of the school nurse program and to the governing board of the LEA concerning the effective and efficient utilization and coordination of state and local school nurse personnel and resources.
    3. The membership of the advisory council shall include both locally employed school nurses and state employed school nurses.
    4. All rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 1988, ch. 988, § 1; 1989, ch. 356, § 1.

68-1-1205. Compliance with laws pertaining to abortion or birth control referrals or information by employees — Abstinence.

Each employee of the program, including each intern resident employed pursuant to § 68-1-1203(c), shall at all times remain in compliance with, and shall fully abide by, all applicable federal, state and local statutes, rules, regulations, ordinances and policies pertaining to abortion. Furthermore, each employee of the program, including each intern or resident employed pursuant to § 68-1-1203(c), shall at all times remain in compliance with and shall fully abide by all applicable federal, state and local statutes, rules, regulations, ordinances and policies pertaining to birth control devices and contraceptives. While present on the property or premises of any local education agency (LEA) or while otherwise engaged in the activities of the program, no such employee shall at any time make abortion referrals or otherwise advocate or encourage abortion nor prescribe any form of birth control device or contraceptive. It shall be the policy of the program, and of each employee engaged in the activities of the program, including each intern or resident employed pursuant to § 68-1-1203(c), to vigorously encourage and urge students to abstain from entering into any sexual relationship or activity.

Acts 1988, ch. 988, § 1.

Cross-References. Abstinence, prevention of AIDS and sexually transmitted diseases, § 49-6-1008.

Parental consent for abortion by minor, title 37, ch. 10, part 3.

68-1-1206. Local agencies not preempted.

This part shall not be construed to terminate the ability of a local education agency (LEA) to locally employ and supervise school nurses who are not employees of the program.

Acts 1988, ch. 988, §§ 2, 3.

Part 13
Down Syndrome Information Act of 2018

68-1-1301. Short title.

This part shall be known and may be cited as the “Down Syndrome Information Act of 2018.”

Acts 2018, ch. 773, § 1.

Code Commission Notes.

Acts 2018, ch. 773, § 1 purported to enact a new part 26 in title 68, ch. 1, §§ 68-1-260168-1-2604; however, that part was enacted as part 13, in title 68, ch. 1, §§ 68-1-130168-1-1304, by authority of the code commission.

Compiler's Notes. Former part 13, §§ 68-1-130168-1-1305, concerning the Tennessee environmental protection fund, was transferred to title 68, ch. 203 in 1992.

Effective Dates. Acts 2018, ch. 773, § 2. July 1, 2018.

68-1-1302. Part definitions.

As used in this part:

  1. “Department” means the department of health; and
  2. “Down syndrome” means a chromosomal condition caused by an error in cell division that results in the presence of an extra whole or partial copy of chromosome 21.

Acts 2018, ch. 773, § 1.

Code Commission Notes.

Acts 2018, ch. 773, § 1 purported to enact a new part 26 in title 68, ch. 1, §§ 68-1-260168-1-2604; however, that part was enacted as part 13, in title 68, ch. 1, §§ 68-1-130168-1-1304, by authority of the code commission.

Compiler's Notes. Former part 13, §§ 68-1-130168-1-1305, concerning the Tennessee environmental protection fund, was transferred to title 68, ch. 203 in 1992.

Effective Dates. Acts 2018, ch. 773, § 2. July 1, 2018.

68-1-1303. Information regarding Down syndrome to be made available.

  1. The department shall, within existing resources, make available up-to-date, evidence-based information about Down syndrome. The online information must include:
    1. Information regarding first-call programs;
    2. Links to organizations providing information and resources related to Down syndrome; and
    3. Other educational and support programs.
  2. The department may make available this information on the department's website.
  3. The intent of this section is to make information available to individuals who render prenatal care, postnatal care, or genetic counseling to any person who has received a prenatal or postnatal diagnosis of Down syndrome.

Acts 2018, ch. 773, § 1.

Code Commission Notes.

Acts 2018, ch. 773, § 1 purported to enact a new part 26 in title 68, ch. 1, §§ 68-1-260168-1-2604; however, that part was enacted as part 13, in title 68, ch. 1, §§ 68-1-130168-1-1304, by authority of the code commission.

Compiler's Notes. Former part 13, §§ 68-1-130168-1-1305, concerning the Tennessee environmental protection fund, was transferred to title 68, ch. 203 in 1992.

Effective Dates. Acts 2018, ch. 773, § 2. July 1, 2018.

68-1-1304. Positive test result for Down syndrome — Information provided to expectant or new parent.

  1. A healthcare provider who renders prenatal or postnatal care or a genetic counselor who renders genetic counseling may, upon receipt of a positive test result from a test for Down syndrome, provide the expectant or new parent with the information provided by the department under this part.
  2. Nothing in this section creates a duty of care or other legal obligation beyond the requirements set forth in this section.

Acts 2018, ch. 773, § 1.

Code Commission Notes.

Acts 2018, ch. 773, § 1 purported to enact a new part 26 in title 68, ch. 1, §§ 68-1-260168-1-2604; however, that part was enacted as part 13, in title 68, ch. 1, §§ 68-1-130168-1-1304, by authority of the code commission.

Compiler's Notes. Former part 13, §§ 68-1-130168-1-1305, concerning the Tennessee environmental protection fund, was transferred to title 68, ch. 203 in 1992.

Effective Dates. Acts 2018, ch. 773, § 2. July 1, 2018.

Part 14
Tennessee Resource Mothers Program

68-1-1401. Established.

There is established within the department of health the “Tennessee resource mothers program.”

Acts 1992, ch. 990, § 2a.

Cross-References. Abstinence, prevention of AIDS and sexually transmitted diseases, § 49-6-1008.

Family life curriculum, title 49, ch. 6, part 13.

Informational services regarding second or subsequent pregnancies, targeting potential at-risk first time teen parents, § 37-3-521.

Project RAP, title 71, ch. 3, part 7.

Support and assistance for family life education, § 49-1-205.

Teenage pregnancy, title 37, ch. 3, part 5.

68-1-1402. Legislative intent.

  1. It is the intention of the general assembly that the program:
    1. Be designed with the main emphasis of the program aimed at reducing the infant mortality and low birth weight rates in the state;
    2. Facilitate good health practices and the utilization of health care services through prenatal and well-child visits and compliance with medical recommendations;
    3. Be targeted to reach teenagers pregnant with their first child, but may also serve high risk pregnant women on a limited basis;
    4. Be structured to provide services at least through the infant's first birthday; and
    5. Be structured to ensure that participation by those persons targeted to be reached by the program be totally voluntary.
  2. It is further the intention of the general assembly that the following results be attained:
    1. A decrease in the percentage of low weight births;
    2. An increase in the proportion of postpartum teens returning to school;
    3. A reduction in smoking and other risk behaviors among teenagers served; and
    4. Improvement in parenting skills.

Acts 1992, ch. 990, § 2b.

68-1-1403. Elements of program.

The program shall contain the following elements:

  1. Lay women from the community shall be recruited and provided with intensive training to serve as “resource mothers” for pregnant and parenting teens;
    1. The resource mother's role is to become a support person for the teenager and the teenager's family. Through a plan of scheduled home visits, the resource mother is to perform the following tasks:
      1. Identify pregnant teens and get them into prenatal care early in their pregnancy;
      2. Assist pregnant teens in obtaining medicaid, WIC, family planning, education, and other community services;
      3. Ensure that teens and infants keep health care appointments, providing help with transportation and babysitting, if needed;
      4. Reinforce recommendations of health care providers and give basic health information and advice in areas such as nutrition, avoidance of smoking and alcohol, infant development, and infant care; and
      5. Instruct the teenager in good parenting skills;
    2. Failure of a pregnant or parenting teen to heed advice, rendered by a resource mother pursuant to subdivision (2)(A)(iv) does not, in and of itself, constitute neglect sufficient to justify removal of the infant from the custody of such teen;
  2. Qualifications to be a resource mother include:
    1. A high school diploma or equivalency degree;
    2. A valid driver license and transportation;
    3. A telephone in the home; and
    4. The ability to relate well with teenagers;
  3. In order to avoid duplication of services and to enhance the delivery of services under the program, services may also be provided through employees of the departments of health and children's services, coordinating their efforts with programs currently in existence that serve the targeted population; and
  4. The department of health shall, to the greatest extent possible, utilize medicaid records and services and assistance from the department of children's services in providing the needed training and provision of services under this part.

Acts 1992, ch. 990, § 2c; 1996, ch. 1079, § 148.

68-1-1404. Training.

The resource mothers shall initially be trained in prenatal care and related health topics, infant development and parenting, community resources, and communication skills. Ongoing supervision and in-service training of the resource mother shall continue as long as the resource mother provides services under the program.

Acts 1992, ch. 990, § 2d.

68-1-1405. Coordination of services.

In order to avoid duplication of services, the resource mothers program shall, to the greatest extent possible, coordinate the delivery of services with a model teenage pregnancy program that was created pursuant to former § 37-3-111 [repealed], if any, in operation in the area to be served by the resource mothers designated site.

Acts 1992, ch. 990, § 2e.

Compiler's Notes. Section 37-3-111, referred to in this section, was repealed by Acts 1987, ch. 445, § 4.

68-1-1406. Evaluation of program — Report.

The department of health shall evaluate the resource mothers program through site visits and prepare written quarterly reports on the program site objectives. The report shall include a review of the following statistics:

  1. The number of pregnant teens entering the program;
  2. The number of infants entering the program;
  3. The number of infant deaths;
  4. The number and percent of low weight births;
  5. The number and percent of teens entering the program in the first trimester of pregnancy; and
  6. The number and percent of postpartum teens returning to school.

Acts 1992, ch. 990, § 2f.

68-1-1407. Gifts and donations.

The department of health is authorized to accept gifts or donations of money, goods or services from private individuals or organizations to accomplish the purposes of this part, under such reasonable terms and conditions as the commissioner may establish.

Acts 1992, ch. 990, § 2g.

68-1-1408. Implementation — Model program — Sites.

The Tennessee resource mothers program shall be implemented initially as a model program in one (1) urban and one (1) rural area. The targeted sites for the model program shall be based on a high incidence of morbidity and mortality related to teenage mothers and infants.

Acts 1992, ch. 990, § 2h.

Part 15
Osteoporosis Prevention and Treatment Education Act

68-1-1501. Short title.

This part shall be known and may be cited as the “Osteoporosis Prevention and Treatment Education Act.”

Acts 1995, ch. 81, § 1.

Cross-References. Bone mass measurement coverage, § 56-7-2506.

Office of women’s health, title 68, ch. 1, part 18.

68-1-1502. Legislative findings.

  1. The general assembly finds the following:
    1. Osteoporosis, a bone-thinning disease, is a major public health problem that poses a threat to the health and quality of life to as many as twenty-five million (25,000,000) Americans;
    2. The one million five hundred thousand (1,500,000) fractures each year that result from osteoporosis cause pain, disability, immobility and social isolation, affecting quality of life and threatening people's ability to live independently;
    3. Because osteoporosis progresses silently and without sensation over many years, and many cases remain undiagnosed, its first symptom is often a fracture, typically of the hip, spine or wrist;
    4. One (1) of every two (2) women and one (1) of every five (5) men will suffer an osteoporotic fracture in their lifetime;
    5. A woman's risk of hip fracture is equal to the woman's combined risk of breast, uterine and ovarian cancer;
    6. The annual direct and indirect costs of osteoporosis to the health care system were estimated to be as high as eighteen billion dollars ($18,000,000,000) in 1993, and are expected to rise to sixty to eighty billion dollars ($60,000,000,000 — $80,000,000,000) by the year 2020;
    7. Since osteoporosis progresses silently and currently has no cure, prevention, early diagnosis and treatment are key to reducing the prevalence of and devastation from this disease;
    8. Although there exists a large quantity of public information about osteoporosis, it remains inadequately disseminated and not tailored to meet the needs of specific population groups;
    9. Most people, including physicians, health care providers and government agencies, continue to lack knowledge in the prevention, detection and treatment of the disease;
    10. Experts in the field of osteoporosis believe that, with greater awareness of the value of prevention among medical experts, service providers and the public, osteoporosis will be preventable and treatable in the future, thereby reducing the costs of long-term care;
    11. Osteoporosis is a multi-generational issue, because building strong bones during youth and preserving them during adulthood may prevent fractures in later life; and
    12. Educating the public and health care community throughout this state about this potentially devastating disease is of paramount importance and is in every respect in the public interest and to the benefit of all residents of this state.
  2. By this enactment, it is the intent of the general assembly to:
    1. Create and foster a multi-generational, statewide program to promote public awareness and knowledge about the causes of osteoporosis, personal risk factors, the value of prevention and early detection and the options available for treatment;
    2. Facilitate and enhance knowledge and understanding of osteoporosis by disseminating educational materials, information about research results, services and strategies for prevention and treatment to patients, health professionals and the public;
    3. Utilize educational and training resources and services that have been developed by organizations with appropriate expertise and knowledge of osteoporosis and to use available technical assistance;
    4. Evaluate existing osteoporosis services in the community and assess the need for improving the quality and accessibility of community-based services;
    5. Provide easy access to clear, complete and accurate osteoporosis information and referral services;
    6. Educate and train service providers, health professionals and physicians;
    7. Heighten awareness about the prevention, detection and treatment of osteoporosis among state and local health and human service officials, health educators and policy makers;
    8. Coordinate state programs and services to address the issue of osteoporosis;
    9. Promote the development of support groups for osteoporosis patients and their families and caregivers;
    10. Adequately fund these programs; and
    11. Provide lasting improvements in the delivery of osteoporosis health care, thus providing patients with an improved quality of life and society with the containment of health care costs.

Acts 1995, ch. 81, § 2.

68-1-1503. Osteoporosis prevention and treatment program — Duties of commissioner and department of health.

  1. The commissioner of health may:
    1. Assure adequate staffing for implementation of the osteoporosis prevention and treatment education program;
    2. Assure appropriate training for osteoporosis prevention and treatment education program staff;
    3. Identify the appropriate entities to carry out the program;
    4. Base the program on the most up-to-date scientific information and findings;
    5. Work to improve the capacity of community-based services available to osteoporosis patients;
    6. Work with governmental offices, community and business leaders, community organizations, health care and human service providers and national osteoporosis organizations to coordinate efforts and maximize state resources in the areas of prevention, education and treatment of osteoporosis; and
    7. Identify and, when appropriate, replicate or use successful osteoporosis programs and procure related materials and services from organizations with appropriate expertise and knowledge of osteoporosis, as described in subdivisions (b)(5)(A) and (B).
  2. The department of health may establish, promote and maintain an osteoporosis prevention and treatment education program in order to raise public awareness, educate consumers, educate and train health professionals, teachers and human services providers, and for other purposes.
    1. The department shall use, but is not limited to, the following strategies for raising public awareness of the causes and nature of osteoporosis, personal risk factors, value of prevention and early detection and options for diagnosing and treating the disease:
      1. An outreach campaign utilizing print, radio and television public service announcements, advertisements, posters and other materials;
      2. Community forums;
      3. Health information and risk factor assessment at public events;
      4. Targeting at-risk populations;
      5. Providing reliable information to policy makers; and
      6. Distributing information through county health departments, schools, area agencies on aging, employer wellness programs, physicians, hospitals and health maintenance organizations, women's groups, nonprofit organizations, community health agencies, community-based organizations and departmental regional offices.
    2. The department shall use, but is not limited to, the following strategies for educating consumers about risk factors, diet and exercise, diagnostic procedures and their indications for use, risks and benefits of drug therapies currently approved by the food and drug administration, environmental safety and injury prevention and the availability of diagnostic, treatment and rehabilitation services:
      1. Identify and obtain educational materials, including brochures and videotapes which translate accurately the latest scientific information on osteoporosis in easy-to-understand terms;
      2. Build a statewide capacity to provide information and referral on all aspects of osteoporosis, including educational materials and counseling;
      3. Establish state linkage with an existing toll-free hotline for consumers;
      4. Facilitate the development and maintenance of osteoporosis support groups; and
      5. Conduct workshops and seminars for lay audiences.
    3. The department shall use, but is not limited to, the following strategies for educating physicians and health professionals and training community service providers on the most up-to-date, accurate scientific and medical information on osteoporosis prevention, diagnosis and treatment, therapeutic decision-making, including guidelines for detecting and treating the disease in special populations, risks and benefits of medications and research advances:
      1. Identify and obtain education materials for the professional that translate the latest scientific and medical information into clinical applications;
      2. Raise awareness among physicians and health and human services professionals as to the importance of osteoporosis prevention, early detection, treatment and rehabilitation;
      3. Identify and use available curricula for training health and human service providers and community leaders on osteoporosis prevention, detection and treatment;
      4. Provide workshops and seminars for in-depth professional development in the field of the care and management of the patient with osteoporosis; and
      5. Conduct a statewide conference on osteoporosis at appropriate intervals.
      1. The department shall conduct a needs assessment study to identify:
        1. Research being conducted within the state;
        2. Available technical assistance and educational materials and programs nationwide;
        3. The level of public and professional awareness about osteoporosis;
        4. Needs of osteoporosis patients, their families and caregivers;
        5. Needs of health care providers, including physicians, nurses, managed care organizations and other health care providers;
        6. Services available to osteoporosis patients;
        7. Existence of osteoporosis treatment programs;
        8. Existence of osteoporosis support groups;
        9. Existence of rehabilitation services; and
        10. Number and location of bone density testing equipment.
      2. Based on the needs assessment study, the department shall develop and maintain a list of osteoporosis-related services and osteoporosis health care providers with specialization in services to prevent, diagnose and treat osteoporosis. This list shall be disseminated with a description of diagnostic testing procedures, appropriate indications for their use, drug therapies currently approved by the food and drug administration and a cautionary statement about the current status of osteoporosis research, prevention and treatment. The statement shall also indicate that the department does not license, certify or in any way approve osteoporosis programs or centers in the state.
      1. The department may replicate and use successful osteoporosis programs and enter into contracts and/or purchase materials or services from organizations with appropriate expertise and knowledge of osteoporosis for such services and materials as, but not limited to, the following:
        1. Educational information and materials on the causes, prevention, detection, treatment and management of osteoporosis;
        2. Training of staff;
        3. Physician and health care professional education and training, and clinical conferences;
        4. Conference organization and staffing;
        5. Regional office development and staffing;
        6. Nominations for advisory panels;
        7. Support group development;
        8. Consultation;
        9. Resource library facilities;
        10. Training home health aides and nursing home personnel; and
        11. Training teachers.
      2. The department may enter into an agreement or agreements to work with a national organization or organizations with expertise in osteoporosis to establish and staff an office or offices of that organization in the state to implement parts of the osteoporosis program.

Acts 1995, ch. 81, § 3; 2003, ch. 355, §§ 47, 48; 2008, ch. 668, § 2.

Compiler's Notes. Acts 2003, ch. 355, § 66 provided that no expenditure of public funds pursuant to the act shall be made in violation of the provisions of Title VI of the Civil Rights Act of 1964, as codified in 42 U.S.C. § 2000d.

Acts 2003, ch. 355, § 73 provided that there is established within the general fund the state-shared revenue reduction mitigation account. Any amounts in the state-shared revenue reduction mitigation account shall be applied by the commissioner of finance and administration to offset reductions in state-shared revenues allocated to local governments pursuant to the provisions of the act so that such reductions shall not exceed nine percent (9%) of state-shared revenues that otherwise would have been allocated to any such local government. Funds shall be restored on a pro rata basis taking into account the percentage reduction to each local government from each state-shared revenue source.

Cross-References. Bone mass measurement, insurance coverage, § 56-7-2506.

68-1-1504. Sources of grants, services and property — Federal waivers.

  1. The commissioner may accept grants, services and property from the federal government, foundations, organizations, medical schools and other entities as may be available for the purposes of fulfilling the obligations of this program.
  2. The commissioner shall seek any federal waiver or waivers that may be necessary to maximize funds from the federal government to implement this program.

Acts 1995, ch. 81, § 4.

Part 16
Area Health Education Centers (AHECs)

68-1-1601. Legislative findings — Need for health care professionals in underserved communities.

The general assembly declares that the activities and program specified in this part have been proven effective in Tennessee and the nation as means to recruit individuals from rural and urban underserved communities to enter primary health care professions and to choose to practice and continue practicing in rural and urban underserved communities. By increasing the number of primary health care professionals and retaining existing practitioners in rural and urban underserved communities, the area health education centers, referred to as AHECs in this part, programs of Tennessee will improve the ability, accessibility and quality of health care in these communities. The general assembly also declares that improved health among Tennessee's rural and urban underserved community residents will contribute to more viable and economically productive communities.

Acts 1998, ch. 928, § 2.

Cross-References. Program for health care professional development for underserved and disadvantaged populations, § 68-1-117.

68-1-1602. Legislative findings — State financial support.

The general assembly further finds and declares the state financial support for AHEC activities within Tennessee is an essential criterion of the federal government in determining the eligibility for continued federal financial support. The intent of the federal government is that the state assume financial responsibility for AHEC programs after receiving federal funds for initial planning, development and start-up. State financial support is also necessary to generate matching federal contributions that may be as much as a one-to-one match of state dollars.

Acts 1998, ch. 928, § 3.

68-1-1603. Attachment to department of health — Mission of programs.

There is established the AHEC programs of Tennessee. For administration purposes only, the AHEC programs shall be attached to the department of health. The mission of the AHEC programs shall be to use educational interventions through community academic partnerships. The AHEC programs shall accomplish this mission by promoting wellness, disease prevention, primary care and the recruitment of minority and underprivileged individuals into health care professions.

Acts 1998, ch. 928, § 4.

68-1-1604. Accomplishment of mission through enhanced recruitment and educational programs.

The mission of the AHEC programs of Tennessee shall be accomplished by:

  1. Enhancement of programs to recruit primary, secondary and postsecondary students into primary health care professions;
  2. Enhancement of programs designed to recruit health professions students and primary care medical residents to practice primary care in rural and urban underserved communities in Tennessee; and
  3. Development of educational programs designed to support practicing health care professionals in rural and urban underserved communities.

Acts 1998, ch. 928, § 5.

68-1-1605. Program development by university medical centers.

  1. In order to effectuate §§ 68-1-1603 and 68-1-1604, Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, shall be charged to initiate or further develop programs designed in this part through individual AHEC programs inclusive of existing centers.
  2. For the purposes of subsection (a), responsibility for the AHEC programs shall be as follows:
    1. Meharry Medical College — the middle grand division; and the AHEC program of the East Tennessee Area Health Education Center, Inc. shall serve the counties of Anderson, Bledsoe, Blount, Bradley, Grundy, Hamilton, Knox, Loudon, Marion, McMinn, Meigs, Monroe, Polk, Rhea, Roane, Sequatchie and Sevier.
    2. East Tennessee State University — the AHEC program of the Northeast Tennessee Area Health Education Center shall serve the counties of Campbell, Carter, Claiborne, Cocke, Grainger, Greene, Hamblen, Hancock, Hawkins, Jefferson, Johnson, Morgan, Scott, Sullivan, Unicoi, Union and Washington; and
    3. The University of Tennessee, Memphis — the western grand division.

Acts 1998, ch. 928, § 6.

Cross-References. Grand divisions, title 4, chapter 1, part 2.

68-1-1606. Health careers manual — Youth recruitment programs.

  1. In order to effectuate § 68-1-1604(1), the AHEC programs of Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, with funding from this part, shall collaboratively develop a health careers manual targeted at the youth of Tennessee. The health careers manual shall be updated biennially.
  2. The AHEC programs of Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, shall also develop and implement programs designed to interest the youth of Tennessee in entering primary health care professions. These programs may include, but shall not be limited to, health fairs, mentoring programs, field experiences, and enrichment activities.

Acts 1998, ch. 928, § 7.

68-1-1607. Community-based education and training programs for health professions students and medical residents.

  1. In order to effectuate § 68-1-1604(2), the AHEC programs of Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, may maintain and enhance existing programs and develop new community-based education and training programs for health professions students and primary care medical residents in rural and urban underserved communities throughout Tennessee. The programs shall be made available to health professions students and primary care medical residents from all health professions training institutions within Tennessee. Students from non-Tennessee institutions may also participate in the training programs on an at-cost basis, based upon the availability of spaces; provided, that no student from a Tennessee institution shall be displaced from participation in the programs by the participation of an out-of-state student.
  2. To promote an increasing number of medical school graduates to enter the primary care specializations of family medicine, general internal medicine, and general pediatrics and to practice in rural and urban underserved communities of Tennessee, the three (3) institutions receiving funding from this part shall be required to place their medical students in a AHEC sponsored one-week preceptorship with a primary care physician during each student's freshman and sophomore years. Development of the AHEC preceptorship is contingent upon the appropriation of adequate resources to fund the preceptorship experiences.
  3. To ensure the health professions students and primary care medical residents receive quality training experiences in rural and urban underserved communities, the AHEC programs of Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, shall recruit, train, and provide professional support for community-based faculty.
  4. To promote health professions students' and primary care medical residents' participation in community-based training experiences, the AHEC programs of Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, may collaboratively develop and maintain a computerized database of clinical sites available within Tennessee for health professions students' and primary care medical residents' field experiences. All health professions training institutions within Tennessee shall be permitted access to the computerized listing of community-based field training sites.
  5. To promote health profession students' and primary care medical residents' interest in practicing in rural and urban underserved communities, individuals participating in field experiences shall be eligible for reimbursement for travel expenses and living expenses actually incurred as a result of their participation in field experiences. All reimbursements for travel expenses and living expenses shall be in accordance with the comprehensive state travel regulations promulgated by the commissioner of finance and administration. The AHEC programs at Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, shall be responsible for administering all eligible health professions students' and primary care medical residents' field experiences funded by this part.
  6. In response to the changing health care systems in Tennessee and the nation that increasingly utilize multi-disciplinary team approaches to health care delivery, the AHEC programs of Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, shall promote multi-disciplinary training of health professions students and medical residents in AHEC supported activities.

Acts 1998, ch. 928, § 8.

68-1-1608. Professional development programs for professionals in underserved communities.

  1. In order to effectuate § 68-1-1604(3), the AHEC programs of Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, shall develop and present professional development programs that address the local needs of primary health care professionals in rural and urban underserved communities in Tennessee. The purpose of professional development programs is to improve the health status of Tennesseans in rural and urban underserved communities by promoting wellness, primary care, disease prevention, and quality of health care delivery.
  2. Because quality health care delivery is dependent upon health care professionals' timely access to information about the latest medical and health care discoveries, and because the isolation and difficulties associated with practicing in rural and urban underserved communities limit health care professionals' access to information about the latest discoveries in their fields, the AHEC programs of Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, may develop and enhance existing information dissemination systems. These information dissemination systems shall use appropriate technologies, including telecommunications technologies, to ensure that health care professionals in rural and urban underserved communities have timely access to the latest medical and health care discoveries. The three (3) institutions receiving funding as part of this part are encouraged to link their respective health science centers via telecommunication technologies with health care providers and institutions in rural and urban underserved communities to provide clinical and educational opportunities.

Acts 1998, ch. 928, § 9.

68-1-1609. Consumer health promotion programs.

To promote wellness and reduce health care costs in Tennessee's rural and urban underserved communities, the AHEC programs at Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, shall develop consumer health promotion programs. The consumer education programs shall be thoroughly integrated with the AHEC's educational programs and targeted health professions students, primary care medical residents, and practicing health care professionals.

Acts 1998, ch. 928, § 10.

68-1-1610. Annual reports to department of health.

The AHEC programs of Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, shall individually report to the department of health on an annual basis.

Acts 1998, ch. 928, § 11.

68-1-1611. Programs under this part not to duplicate existing programs.

The activities and programs authorized by this part shall not duplicate other services, programs, or activities provided by any department, board, commission, or other governmental authority or entity of government.

Acts 1998, ch. 928, § 12.

68-1-1612. Income to be retained by programs.

Any income generated as a result of programs or activities authorized by this part shall not revert to the general fund at the end of the fiscal year, but shall be maintained by the individual AHEC programs at Meharry Medical College, East Tennessee State University, and the University of Tennessee, Memphis, and shall be reinvested to further the mission of the programs as stated in this part.

Acts 1998, ch. 928, § 13.

68-1-1613. Annual appropriations — Allocation of funds.

  1. The appropriation provided for the AHEC program in any fiscal year shall be as set in the general appropriations act.
  2. For fiscal years beginning on and after July 1, 1998, funds appropriated for the individual AHEC programs shall be allocated as follows:
    1. Sixteen and sixty-seven thousandths percent (16.67%) to East Tennessee State University for the Northeast Tennessee AHEC program;
    2. Sixteen and sixty-seven thousandths percent (16.67%) to Meharry Medical College for the East Tennessee AHEC program;
    3. Thirty-three and thirty-three thousandths percent (33.33%) to Meharry Medical College for the Middle Tennessee AHEC program; and
    4. Thirty-three and thirty-three thousandths percent (33.33%) to the University of Tennessee, Memphis, for the West Tennessee AHEC program.
  3. From the funds appropriated, the institutions shall distribute not less than seventy-five percent (75%) of the funds to the local AHEC programs. The institutions shall not require any organizational changes in the local AHEC programs unless federal law so requires such changes.

Acts 1998, ch. 928, § 14.

68-1-1614. Rules and regulations.

The commissioner of health is authorized to promulgate rules and regulations to effectuate the purpose of this part. All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 1998, ch. 928, § 15.

Part 17
“Strike out Stroke” Pilot Project [Obsolete]

68-1-1701. [Obsolete.]

Code Commission Notes.

Former part 17, § 68-1-1701 (Acts 1998, ch. 989, § 1; 1999, ch. 418, § 1) was deleted as obsolete by authority of the code commission in 2006.

Part 18
Office of Women's Health ACT of 2000

68-1-1801. Short title — Purpose — Creation.

This part shall be known and may be cited as “The Office of Women's Health Act of 2000” and is enacted for the purpose of educating the public concerning women's health issues and for advocating initiatives to enhance the quality of life for women in the state. This office shall be operated from existing resources of the department of health.

Acts 2000, ch. 954, § 2.

68-1-1802. Part definitions.

As used in this part, unless the context otherwise requires:

  1. “Commissioner” means the commissioner of health;
  2. “Department” means the department of health; and
  3. “Office” means the office of women's health designated by this part.

Acts 2000, ch. 954, § 3.

68-1-1803. Purpose.

The office of women's health is designated for the following purposes:

  1. To continue to educate and advocate for women's health by establishing appropriate forums, programs, and initiatives designed to educate the public regarding women's health issues with an emphasis on preventive health and healthy lifestyles;
  2. To assist the commissioner in identifying, coordinating, and establishing priorities for programs, services, and resources the state should provide for women's health issues and concerns relating to the reproductive, menopausal, and post-menopausal phases of a woman's life with an emphasis on post-menopausal health;
  3. To serve as a clearinghouse and resource for information on women's health by maintaining a current list of applicable resources and referring persons to the proper locations for obtaining such information. Information shall include, but not be limited to, the following:
    1. Diseases that significantly impact women, including heart disease, cancer, and osteoporosis;
    2. Menopause;
    3. Mental health;
    4. Substance abuse;
    5. Sexually transmitted diseases; and
    6. Sexual assault and domestic violence;
  4. To collect, classify, and analyze relevant research information and data conducted or compiled by the department or other entities in collaboration with the department, as well as to provide, except as prohibited by law, interested persons with information regarding research results;
  5. To develop and recommend funding and program activities for educating the public on women's health initiatives, including, but not limited to, the following:
    1. Health needs throughout a woman's life;
    2. Diseases which significantly affect women, including heart disease, cancer, and osteoporosis;
    3. Access to health care for women;
    4. Poverty and women's health;
    5. The leading causes of morbidity and mortality for women; and
    6. Special health concerns for minority women;
  6. To make recommendations to the commissioner regarding programs that address women's health issues for inclusion in the department's annual budget and strategic planning;
  7. To seek funding from various entities to carry out the purposes of this part;
  8. To conduct public educational forums in conjunction with other public health events and conferences in the state to raise public awareness and educate citizens about women's health issues; and
  9. To coordinate the activities and programs of the office with other entities that focus on women's health or women's issues.

Acts 2000, ch. 954, § 4; 2017, ch. 326, § 5.

Amendments. The 2017 amendment deleted “, including the state economic council on women,” following “conferences in the state” in (8); and substituted “entities that focus on” for “entities, including the state economic council on women, which focus on” in (9).

Effective Dates. Acts 2017, ch. 326, § 6. July 1, 2017.

68-1-1804. Creation of advisory committee — Appointment of committee members.

  1. The commissioner may appoint an advisory committee on women's health to assist in advising the office regarding the duties required under this part.
  2. The advisory committee shall be comprised of persons with expertise in and knowledge of women's health issues in the state. If the advisory committee is established, the commissioner shall determine the number of persons to serve on the committee; appoint a chair or co-chairs for the committee; and establish the policies and procedures under which the committee shall operate.

Acts 2000, ch. 954, § 5.

Compiler's Notes. The advisory committee on women’s health, created by this section, terminates June 30, 2015. See §§ 4-29-112, 4-29-236.

Act 2015, ch. 30,  § 2 provided that, notwithstanding § 4-29-112, the advisory committee on women’s health, created by § 68-1-1804, shall terminate and shall cease to exist upon March 27, 2015.

Acts 2009, ch. 63, § 3 provided that, on or before August 13, 2010, a representative of the department of health shall appear before the general welfare, health and human services joint subcommittee of the government operations committee to provide an update on the advisory committee's response to the sunset public hearing questions submitted to it by the division of state audit of the comptroller of the treasury in advance of the August 13, 2008, joint subcommittee review.

68-1-1805. Legislative intent — Statewide initiative to increase gynecological cancer awareness.

  1. It is the intent of the general assembly to promote greater awareness of women to the risks of gynecological cancers by increasing their knowledge of the signs of such types of cancers and the benefits of early detection. The general assembly recognizes the traditional and significant role played by the department of health in educating the public about health issues and their relevance to maintaining a good quality of life for all citizens.
  2. The department of health is directed to develop and implement a statewide initiative to increase awareness of women regarding gynecological cancers. Through the department's office of women's health, the department shall work with other state and federal programs, such as the Tennessee breast and cervical cancer early detection program and the National Cervical Cancer Coalition, to encourage all women to have regular screening examinations and to follow good health practices which may prevent gynecological cancers.
  3. During national cervical health awareness month, the department shall further the public's knowledge and understanding of the signs of gynecological cancers and the importance of early detection through regular examinations by utilizing print, electronic, audio, or other media, as deemed appropriate by the department. The department shall encourage appropriate physicians and other health care providers to actively educate their patients regarding gynecological cancers through dissemination of information about these diseases and their detection and prevention, as well as through participation in the initiative by providing free cervical cancer screening on “Free Pap Smear Day.” Where feasible, the department shall work with similar national campaigns which are directed toward women's health issues, as well as partner with health care professional organizations and governmental entities to enhance the department's efforts related to gynecological cancers.

Acts 2002, ch. 872, § 1.

68-1-1806. [Obsolete.]

Acts 2006, ch. 921, § 1.

Code Commission Notes.

Former §  68-1-1806, concerning the cervical cancer elimination subcommittee, was deleted as obsolete by authority of the code commission in 2013.

Part 19
Stroke Care, Education, and Outreach Collaborative

68-1-1901. Establishment of collaborative — Members.

The commissioner of health shall establish a stroke care, education, and outreach collaborative in each grand division of the state. The members of the collaborative shall be hospitals and health care providers providing stroke care in the grand division. The collaborative shall develop and support a program of education and outreach focused on helping community hospitals acquire the skills and resources necessary to qualify them as stroke centers, equipped for the treatment of a patient with acute stroke. The program will be targeted to hospitals and providers in the grand division.

Acts 2001, ch. 442, § 1.

Cross-References. Grand divisions, title 4, chapter 1, part 2.

68-1-1902. Education and outreach program focus.

  1. Stroke care education and outreach shall be focused on performance and process improvement, shall employ the use of multidisciplinary teams of care, and shall be knowledge-based and patient-centered. The program shall be comprehensive in its approach, utilizing neurology, cardiology, diagnostic services, rehabilitation services, community resources, and service providers. The collaborative shall designate at least one (1) hospital to be an education site and have resources dedicated to its educational outreach program.
  2. Each collaborative shall provide a stroke education program based on:
    1. Best current practice developed through research and medical literature and the study of best practice in acute stroke treatment and therapy;
    2. Best medical practice that is tailored to meet the patient population served at the center reflecting the cultural, psychosocial, economic and lifestyle characteristics;
    3. Clinical guidelines and protocols for standardized care;
    4. Benchmarks to monitor quality care practices;
    5. Performance improvement for better patient outcomes; and
    6. Increased capacity for stroke research.

Acts 2001, ch. 442, § 1.

68-1-1903. Statewide stroke database — Report.

  1. The East Tennessee State University College of Public Health, in cooperation with the Tennessee stroke systems task force, shall maintain a statewide stroke database that compiles information and statistics on stroke care involving prevalence, mortality and performance metrics that align with the stroke consensus metrics developed and approved by the American Heart Association, centers for disease control and prevention and the joint commission. The College of Public Health shall make aggregate data available to the public health community via an annual report. The College of Public Health shall support this data platform based on nationally available stroke registry tools that are based on nationally recognized, evidence-based guidelines. To every extent possible, the College of Public Health shall coordinate with national voluntary health organizations involved in stroke quality improvement to avoid duplication and redundancy.
  2. Beginning in July 2017 and for each subsequent year, comprehensive stroke centers and primary stroke centers shall, and all other hospitals are encouraged to, report data quarterly consistent with nationally recognized stroke consensus measures on the treatment of individuals with confirmed stroke to the East Tennessee State University College of Public Health.
    1. This section shall not be construed as a medical practice guideline and shall not be used to restrict the authority of a hospital to provide services for which it has received a license to provide such services under state law.
    2. This section shall not be construed to authorize any disclosure of information that would be prohibited pursuant to the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), compiled in 42 U.S.C. § 1320d et seq.
    3. The College of Public Health shall not disclose any hospital-specific information reported to it.

Acts 2008, ch. 1186, § 2; 2017, ch. 5, § 1.

Compiler's Notes. Acts 2008, ch. 1186, § 1 provided that the act, which enacted this section, shall be known and may be cited as the “Tennessee Stroke Registry Act of 2008.”

Amendments. The 2017 amendment rewrote (b), which read: “(b) Beginning with calendar year 2009 and for each subsequent calendar year, hospitals are encouraged to annually report the following information to the College of Public Health: “(1) The number of patients evaluated; “(2) The number of patients receiving acute interventional therapy; “(3) The amount of time from patient presentation to delivery of acute interventional therapy; “(4) Patient length of stay; “(5) Patient functional outcome; “(6)  Patient morbidity; “(7) The number of deep vein thrombosis prophylaxes given; “(8) The number of patients discharged on antiplatelet or antithrombotics, or both; “(9) The number of patients with atrial fibrillation receiving anticoagulation therapy; “(10) The number of tissue plasminogen activators (tPA) administered;“(11) The number of times antithrombotic medication was administered within forty-eight (48) hours of hospitalization;“(12) The number of lipid profiles ordered during hospitalization; “(13) The number of screens for dysphagia performed; “(14) The number of times stroke education was provided; “(15) The number of times a smoking cessation program was provided or discussed; “(16) The number of patients assessed for rehabilitation and whether a plan for rehabilitation was considered; “(17) The number of emergency medical services (EMS) stroke patients transported to the facility; “(18) The number of EMS stroke patients admitted to the hospital; “(19) The number of strokes by type, including ischemic, hemorrhagic, transient ischemic attack (TIA) or stroke of uncertain type; and “(20) The number of patients discharged on cholesterol reducing medications.”

Effective Dates. Acts 2017, ch. 5, § 2. March 15, 2017.

Attorney General Opinions. Disclosure of information reported to the Tennessee stroke database.  OAG 10-57, 2010 Tenn. AG LEXIS 57 (4/28/10).

Part 20
Obesity Study and Prevention Act [Repealed]

68-1-2001 — 68-1-2005. [Repealed.]

Compiler's Notes. Former part 20, §§ 68-1-200168-1-2005 (Acts 2002, ch. 658, §§ 2-5; 2004, ch. 850, § 1) was repealed effective July 1, 2008. Acts 2002, ch. 658, § 8, as amended by Acts 2004, ch. 850, § 1, provided that the provisions of the part shall be repealed July 1, 2008, unless funding to conduct the study has been obtained pursuant to § 68-1-2004(b). Funding was never provided according to the department of health.

Part 21
Statewide Palliative Care Consumer and Professional Information and Education Program [Expired]

68-1-2101. [Expired.]

Acts 2017, ch. 420, § 2; expired by Acts 2017, ch. 420, § 2 effective June 30, 2018.

Code Commission Notes.

Former part 21, §§ 68-1-210168-1-2106 concerned the statewide palliative care consumer and professional information and education program and expired pursuant to § 68-1-2104, effective June 30, 2018.

68-1-2102. [Expired.]

Acts 2017, ch. 420, § 2; expired by Acts 2017, ch. 420, § 2 effective June 30, 2018.

Code Commission Notes.

Former part 21, §§ 68-1-210168-1-2106 (Acts 2003, ch. 302, § 1), concerning a study of sepsis, was deleted as obsolete, effective July 1, 2004. The department of health informed the code commission that no funding to conduct the study was obtained.

Acts 2017, ch. 420, § 2 enacted a new part 26, §§ 68-1-260168-1-2604,  but the part has been redesignated as part 21, §§ 68-1-210168-1-2104 by authority of the Code Commission.

Former part 21, §§ 68-1-210168-1-2106 concerned the statewide palliative care consumer and professional information and education program expired by the provisions of § 68-1-2104, effective June 30, 2018.

68-1-2103. [Expired.]

Acts 2017, ch. 420, § 2; expired by Acts 2017, ch. 420, § 2 effective June 30, 2018.

Code Commission Notes.

Former part 21, §§ 68-1-210168-1-2106 (Acts 2003, ch. 302, § 1), concerning a study of sepsis, was deleted as obsolete, effective July 1, 2004. The department of health informed the code commission that no funding to conduct the study was obtained.

Acts 2017, ch. 420, § 2 enacted a new part 26, §§ 68-1-260168-1-2604,  but the part has been redesignated as part 21, §§ 68-1-210168-1-2104 by authority of the Code Commission.

Former part 21, §§ 68-1-210168-1-2106 concerned the statewide palliative care consumer and professional information and education program expired by the provisions of § 68-1-2104, effective June 30, 2018.

68-1-2104. [Expired.]

Acts 2017, ch. 420, § 2; expired by Acts 2017, ch. 420, § 2 effective June 30, 2018.

Code Commission Notes.

Former part 21, §§ 68-1-210168-1-2106 (Acts 2003, ch. 302, § 1), concerning a study of sepsis, was deleted as obsolete, effective July 1, 2004. The department of health informed the code commission that no funding to conduct the study was obtained.

Acts 2017, ch. 420, § 2 enacted a new part 26, §§ 68-1-260168-1-2604,  but the part has been redesignated as part 21, §§ 68-1-210168-1-2104 by authority of the Code Commission.

Former part 21, §§ 68-1-210168-1-2106 concerned the statewide palliative care consumer and professional information and education program expired by the provisions of § 68-1-2104, effective June 30, 2018.

Part 22
Office of Minority Health Act of 2004

68-1-2201. Short title — Purpose — Resources.

This part shall be known and may be cited as the “Office of Minority Health Act of 2004” and is enacted for the purpose of educating the public concerning health issues regarding the minority populations in this state and for advocating initiatives to enhance the quality of life and address any disparity of health services available for minorities in this state. This office shall be operated from existing resources of the department of health.

Acts 2004, ch. 564, § 1.

68-1-2202. Part definitions.

As used in this part, unless the context otherwise requires:

  1. “Commissioner” means the commissioner of health;
  2. “Department” means the department of health;
  3. “Minorities” include, but are not limited to, African American, Hispanic, Asian American, American Indian, Alaskan Native, Middle Eastern American and the underserved regardless of age, race, economics, gender, language or geographic location; and
  4. “Office” means the office of minority health designated by this part.

Acts 2004, ch. 564, § 1.

68-1-2203. Functions.

The office of minority health is designated for the following purposes:

  1. To assist the commissioner in the assessment of the health needs of the minority populations within the state;
  2. To recommend to the commissioner methods and programs that are sensitive and relevant to the unique linguistic, cultural and ethnic characteristics of minority populations;
  3. To provide consultation, technical assistance, training, and reference materials regarding health issues of minorities to service providers, organizations and other agencies;
  4. To promote awareness of minority health concerns and encourage, promote and aid in the establishment of services to address those concerns;
  5. To disseminate information on available minority services;
  6. To provide adequate and effective opportunities for minorities to express their views on departmental policy development and program implementation;
  7. To coordinate with other agencies providing services to minority populations in an effort to make available services designed to meet the needs of minority residents;
  8. To develop local coalitions throughout the state that provide local networks of health organizations and associated agencies, and act as a community focus for minority health related programs; and
  9. To seek funding from various entities or sources to carry out or further the purposes of this part.

Acts 2004, ch. 564, § 1.

68-1-2204. Appointment of advisory council.

  1. The commissioner may appoint an advisory council on minority health to assist in advising the office regarding the duties required under this part.
  2. The advisory council shall be comprised of community leaders and persons with expertise in and knowledge of minority health issues in the state. If the advisory committee is established, the commissioner shall determine the number of persons to serve on the committee; appoint a chair or co-chairs for the committee; and establish the policies and procedures under which the committee shall operate.

Acts 2004, ch. 564, § 1.

Part 23
Child Nutrition and Wellness Act of 2006

68-1-2301. Short title — Purpose.

This part shall be known and may be cited as the “Child Nutrition and Wellness Act of 2006,” and is enacted for the purpose of educating the public concerning child nutrition and wellness issues and for advocating initiatives to improve the nutrition and wellness of children.

Acts 2006, ch. 886, § 2.

Compiler's Notes. Acts, 2006, ch. 886, § 7 provided that the provisions of the act shall not be construed to be an appropriation of funds and no funds shall be obligated or expended pursuant to the act unless such funds are specifically appropriated by the general appropriations act. Funding was provided by Acts 2006, ch. 963, § 12, item 7.

Comparative Legislation. Child nutrition:

N.C. Gen. Stat. § 115C-264.3

68-1-2302. Part definitions.

As used in this part, unless the context otherwise requires:

  1. [Deleted by 2014 amendment.]
  2. “Commissioner” means the commissioner of health;
  3. “Department” means the department of health; and
  4. “Office” means the office of child nutrition and wellness in the department, which is created in § 68-1-2304.

Acts 2006, ch. 886, § 3; 2014, ch. 514, § 2.

Compiler's Notes. Acts, 2006, ch. 886, § 7 provided that the provisions of the act shall not be construed to be an appropriation of funds and no funds shall be obligated or expended pursuant to the act unless such funds are specifically appropriated by the general appropriations act. Funding was provided by Acts 2006, ch. 963, § 12, item 7.

Amendments. The 2014 amendment deleted the definition of “advisory council” which read: “‘Advisory council’ means an advisory council on child nutrition and wellness to be appointed by the commissioner;”.

Effective Dates. Acts 2014, ch. 514, § 6. March 6, 2014.

68-1-2303. [Repealed.]

Acts 2006, ch. 886, § 4; repealed by Acts 2014, ch. 514, § 3, effective March 6, 2014.

Compiler's Notes. Former § 68-1-2303 concerned the advisory council on child nutrition and wellness.

Acts 2014, ch. 514, § 5, provided that notwithstanding § 4-29-112 or any other law to the contrary, the advisory council on child nutrition and wellness, created by § 68-1-2303, shall terminate and shall cease to exist upon March 6, 2014.

68-1-2304. Office of child nutrition and wellness.

  1. The office of child nutrition and wellness shall be created in the department, but only upon sufficient funding being appropriated for the office.
  2. The office shall perform the following functions:
    1. Assist the commissioner in identifying and establishing priorities for programs, services, and resources to promote better child nutrition and wellness;
    2. Serve as a clearinghouse for information on child nutrition and wellness;
    3. Identify and recommend sources of funding for promotion of child nutrition and wellness and seek funding from the sources;
    4. Make recommendations to the commissioner regarding programs that address child nutrition and wellness for inclusion in the department's annual budget; and
    5. Conduct public educational forums to raise public awareness about child nutrition and wellness issues.

Acts 2006, ch. 886, § 5; 2014, ch. 514, § 4.

Compiler's Notes. Acts, 2006, ch. 886, § 7 provided that the provisions of the act shall not be construed to be an appropriation of funds and no funds shall be obligated or expended pursuant to the act unless such funds are specifically appropriated by the general appropriations act. Funding was provided by Acts 2006, ch. 963, § 12, item 7.

Amendments. The 2014 amendment deleted “shall coordinate the meetings of the advisory council and” preceding “shall perform” in the introductory paragraph of (b).

Effective Dates. Acts 2014, ch. 514, § 6. March 6, 2014.

Part 24
Tennessee Nurse Home Visitor Program Act

68-1-2401. Short title.

This part shall be known and may be cited as the “Tennessee Nurse Home Visitor Program Act.”

Acts 2007, ch. 530, § 1.

Compiler's Notes. Acts 2007, ch. 530, § 1, provided that the provisions of the act shall be subject to the funding being provided by the general appropriations act. Funding was provided by Acts 2007, ch. 603, § 12, item 7.

68-1-2402. Legislative findings — Legislative intent.

  1. The general assembly finds that, in order to adequately care for their newborns and young children, new mothers may often benefit from receiving professional assistance and information. Without such assistance and information, a young mother may develop habits or practices that are detrimental to her health and well-being and the health and well-being of her child. The general assembly further finds that inadequate prenatal care and inadequate care in infancy and early childhood often inhibit a child's ability to learn and develop throughout childhood and may have lasting, adverse affects on the child's ability to function as an adult. The general assembly recognizes that implementation of a nurse home visitor program that provides educational, health, and other resources for new young mothers during pregnancy and the first years of their infants' lives has been proven to significantly reduce the amount of drug, including nicotine, and alcohol use and abuse by mothers, the occurrence of criminal activity committed by mothers and their children under fifteen (15) years of age, and the number of reported incidents of child abuse and neglect. Such a program has also been proven to reduce the number of subsequent births, increase the length of time between subsequent births, and reduce the mother's need for other forms of public assistance.
  2. It is the intent of the general assembly that such a program be established for the state, beginning with a limited number of participants and expanding by the year 2017 to be available to all low-income, first-time mothers in the state who consent to receiving services.

Acts 2007, ch. 530, § 1.

Compiler's Notes. Acts 2007, ch. 530, § 1, provided that the provisions of the act shall be subject to the funding being provided by the general appropriations act. Funding was provided by Acts 2007, ch. 603, § 12, item 7.

68-1-2403. Part definitions.

As used in this part, unless the context otherwise requires:

  1. “Department” means the department of health;
  2. “Entity” means any nonprofit, not-for-profit, or for-profit corporation, religious or charitable organization, institution of higher education, visiting nurse association, existing visiting nurse program, local health department, county department of social services, political subdivision of the state, or other governmental agency or any combination thereof;
  3. “Health care and services facility” means a health care entity or facility identified pursuant to § 68-1-2405 to assist the department in administering the program;
  4. “Low-income” means an annual income that does not exceed two hundred percent (200%) of the federal poverty level;
  5. “Nurse” means a person licensed as a professional nurse pursuant to title 63, chapter 7; and
  6. “Program” means the nurse home visitor program established in this part.

Acts 2007, ch. 530, § 1.

Compiler's Notes. Acts 2007, ch. 530, § 1, provided that the provisions of the act shall be subject to the funding being provided by the general appropriations act. Funding was provided by Acts 2007, ch. 603, § 12, item 7.

68-1-2404. Establishment of program — Participation — Rules and regulations.

    1. There is established the nurse home visitor program to provide regular, in-home, visiting nurse services to low-income, first-time mothers, with their consent, during their pregnancies and through their children's second birthday. The program training requirements, program protocols, program management information systems, and program evaluation requirements shall be based on research-based model programs that have been replicated in multiple, rigorous, randomized clinical trials and in multiple sites that have shown significant reductions in:
      1. The occurrence among families receiving services through the model program of infant behavioral impairments due to use of alcohol and other drugs, including nicotine;
      2. The number of reported incidents of child abuse and neglect among families receiving services through the model program;
      3. The number of subsequent pregnancies by mothers receiving services through the model program;
      4. The receipt of public assistance by mothers receiving services through the model program; and
      5. Criminal activity engaged in by mothers receiving services through the model program and their children.
    2. The program shall provide trained visiting nurses to help educate mothers on the importance of nutrition and avoiding alcohol and drugs, including nicotine, and to assist and educate mothers in providing general care for their children and in improving health outcomes for their children. In addition, visiting nurses may help mothers in locating assistance with educational achievement and employment. Any assistance provided through the program shall be provided only with the consent of the low-income, first-time mother, and she may refuse further services at any time. The program should be significantly modeled on the national Nurse-Family Partnership program.
  1. The program shall be administered in a community or communities by an entity or entities selected under this part. For the purpose of this pilot program, if the commissioner determines that it is necessary in order to implement a pilot project for the program, then the commissioner is authorized to make a grant or grants without competitive bidding. If selection is made on a competitive basis, any entity that seeks to administer the program shall submit an application to the department as provided in § 68-1-2406. The entity or entities selected pursuant to § 68-1-2407 for implementing the project shall be expected to provide services for up to one hundred (100) low-income, first-time mothers in the community in which the entity administers the program. A mother shall be eligible to receive services through the program if she is pregnant with her first child, and her gross annual income does not exceed two hundred percent (200%) of the federal poverty level.
  2. The department may promulgate rules pursuant to Uniform Administrative Procedures Act, compiled in title 4, chapter 5, for the implementation of the program.
  3. Notwithstanding subsection (c), the department may adopt rules pursuant to which a nurse home visitation program that is in operation in the state as of July 1, 2007, may qualify for participation in the program if it can demonstrate that it has been in operation in the state for a minimum of five (5) years and that it has achieved a reduction in the occurrences specified in subsection (c). Any program so approved shall be exempt from the rules adopted regarding program training requirements, program protocols, program management information systems, and program evaluation requirements, so long as the program continues to demonstrate a reduction in the occurrences specified in subsection (a).

Acts 2007, ch. 530, § 1; 2008, ch. 1126, § 1.

Compiler's Notes. Acts 2007, ch. 530, § 1, provided that the provisions of the act shall be subject to the funding being provided by the general appropriations act. Funding was provided by Acts 2007, ch. 603, § 12, item 7.

68-1-2405. Health care and services facility to assist with program.

  1. The commissioner of health shall select the national service organization of the Nurse-Family Partnership program as the health care and services facility with the knowledge and experience necessary to assist the department in selecting entities from among the applications, if any, submitted pursuant to § 68-1-2406 and in monitoring and evaluating the implementation of the program in communities throughout the state.
  2. The health care and services facility shall monitor the administration of the program by the selected entities to ensure that the program is implemented according to the program training requirements, program protocols, program management information systems, and program evaluation requirements established by the department. The health care and services facility shall evaluate the overall implementation of the program and include the evaluation, along with any recommendations concerning the selected entities or changes in the program training requirements, program protocols, program management information systems, or program evaluation requirements, in the annual report submitted to the department pursuant to § 68-1-2408.
  3. The department shall compensate the health care and services facility for the costs incurred in performing its duties under this part. The compensation shall be included in the actual costs incurred by the department in administering the program and paid out of the amount allocated to the department for administrative costs.

Acts 2007, ch. 530, § 1; 2008, ch. 1126, § 2.

Compiler's Notes. Acts 2007, ch. 530, § 1, provided that the provisions of the act shall be subject to the funding being provided by the general appropriations act. Funding was provided by Acts 2007, ch. 603, § 12, item 7.

68-1-2406. Application to administer program.

  1. Any entity that seeks to administer the program in a community pursuant to any competitive bidding process shall submit an application to the department. At a minimum, the application shall specify the basic elements and procedures that the entity shall use in administering the program. Basic program elements shall include, but are not limited to, the following:
    1. The specific training to be received by each nurse employed by the entity to provide home nursing services through the program;
    2. The protocols to be followed by the entity in administering the program;
    3. The management information system to be used by the entity in administering the program;
    4. The reporting and evaluation system to be used by the entity in measuring the effectiveness of the program in assisting low-income, first-time mothers; and
    5. An annual report to both the health care and services facility and the community in which the entity administers the program that reports on the effectiveness within the community and is written in a manner that is understandable for both the health care and services facility and members of the community.
  2. Any program application submitted pursuant to this section shall demonstrate strong, bipartisan public support for and a long-term commitment to operation of the program in the community.
  3. The department shall initially review any applications received pursuant to this section and submit to the health care and services facility for review those applications that include the basic program elements. Following its review, the health care and services facility shall submit to the department the name of the entity or entities that the health care and services facility recommends to administer the program.

Acts 2007, ch. 530, § 1; 2008, ch. 1126, § 3.

Compiler's Notes. Acts 2007, ch. 530, § 1, provided that the provisions of the act shall be subject to the funding being provided by the general appropriations act. Funding was provided by Acts 2007, ch. 603, § 12, item 7.

68-1-2407. Selection of entities recommended by the health care and services facility — Grants — Creation of fund.

  1. The department shall select the entities that will administer the program.
    1. The entity or entities selected to operate the program shall receive grants in amounts specified by the department. The grants may include operating costs, including, but not limited to, development of the information management system, necessary to administer the program. The number of entities selected and the number of communities in which the program shall be implemented shall be determined by moneys available in the nurse home visitor program fund created in subdivision (b)(2).
    2. Grants awarded pursuant to subdivision (b)(1) shall be payable from the nurse home visitor program fund, which fund is hereby created in the state treasury. The nurse home visitor program fund, referred to in this section as the fund, shall consist of moneys appropriated to the fund by the general assembly from general revenue and moneys received from the federal government. Any revenues or moneys deposited in the fund shall remain in the fund until expended for purposes consistent with this part and shall not revert to the general fund on any June 30. In addition, the state treasurer may credit to the fund any public or private gifts, grants, or donations received by the department for implementation of the program. The fund shall be subject to annual appropriation by the general assembly to the department for grants to entities for operation of the program. Notwithstanding any other law, all interest derived from the deposit and investment of moneys in the fund shall be credited to the fund.

Acts 2007, ch. 530, § 1; 2008, ch. 1126, § 4.

Compiler's Notes. Acts 2007, ch. 530, § 1, provided that the provisions of the act shall be subject to the funding being provided by the general appropriations act. Funding was provided by Acts 2007, ch. 603, § 12, item 7.

68-1-2408. Program oversight — Reporting.

Entities receiving grants shall report to the health care and services facility as often as the department determines to be beneficial to program oversight. The health care and services facility shall report to the department as often as the department determines to be beneficial to program oversight, but at least annually. The department shall report in writing on an annual basis to the general assembly.

Acts 2007, ch. 530, § 1.

Compiler's Notes. Acts 2007, ch. 530, § 1, provided that the provisions of the act shall be subject to the funding being provided by the general appropriations act. Funding was provided by Acts 2007, ch. 603, § 12, item 7.

Part 25
Autism Spectrum Disorder Taskforce [Repealed]

68-1-2501. Repealed.

Acts 2014, ch. 1010, § 1; repealed by Acts 2017, ch. 86, § 2, effective July 1, 2017.

Compiler's Notes. Acts 2017, ch. 86, § 3 provided that notwithstanding  any law to the contrary, including § 4-29-112, the autism spectrum disorder taskforce created by Title 68, Chapter 1, Part 25, shall terminate on June 30, 2017.

Former section 68-1-2501 concerned taskforce creation and purpose.

68-1-2502. Repealed.

Acts 2014, ch. 1010, § 1; repealed by Acts 2017, ch. 86, § 2, effective. July 1, 2017.

Compiler's Notes. Former section 68-1-2502 concerned members, meetings and quorum requirement, vacancies, compensation and reimbursement of expenses.

68-1-2503. Repealed.

Acts 2014, ch. 1010, § 1; repealed by Acts 2017, ch. 86, § 2, effective. July 1, 2017.

Compiler's Notes. Former section 68-1-2503 duties.

Cross-References. Reporting requirement satisfied by notice to general assembly members of publication of report, § 3-1-114.

Chapter 2
Local Health Services

Part 1
County Health Departments [Repealed]

68-2-101 — 68-2-111. [Repealed.]

Compiler's Notes. Former part 1, §§ 68-2-101—68-2-111 (Acts 1885, ch. 95, §§ 1-6; 1891, ch. 181, § 1; 1895, ch. 206, § 1; 1915, ch. 50, §§ 1, 2; 1921, ch. 89, §§ 1, 5-7; 1933, ch. 140, § 1; 1935 (E.S.), ch. 37, §§ 1, 2; 1961, ch. 179, § 1; 1963, ch. 228, § 1; 1970, ch. 584, § 1; 1971, ch. 248, §§ 1-4; 1975, ch. 90, § 1; 1977, ch. 297, § 1; 1977, ch. 350, § 1; 1979, ch. 47, § 1; 1980, ch. 630, § 1; 1932 Code, §§ 5775-5783, 5786-5788; C. Supp. 1950, §§ 5775-5782 (Williams, §§ 5782-5788a); Shan., §§ 3106-3111a1, 3111a5-3111a7; T.C.A. (orig. ed.), §§ 53-301 — 53-314), concerning county health departments, was repealed by Acts 1985, ch. 172, § 1. For present provisions concerning county health departments, see title 68, ch. 2, part 6. For provisions relating to county physicians, see § 68-2-1001.

Part 2
Municipal Boards of Health [Repealed]

68-2-201, 68-2-202. [Repealed.]

Compiler's Notes. Former part 2, §§ 68-2-201, 68-2-202 (Acts 1877, ch. 28, § 1; 1877, ch. 98, § 7; Code 1932, §§ 5770, 5771; Shan., §§ 3101, 3102; T.C.A. (orig. ed.), §§ 53-315, 53-316), concerning municipal boards of health, was repealed by Acts 1985, ch. 172, § 1.

Part 3
District Health Departments [Repealed]

68-2-301 — 68-2-305. [Repealed.]

Compiler's Notes. Former part 3, §§ 68-2-301—68-2-305 (Acts 1933, ch. 131, §§ 1-5; 1935 (E.S.), ch. 38, §§ 1, 3; 1961, ch. 179, §§ 2, 3; 1971, ch. 248, §§ 5, 6; C. Supp. 1950, §§ 5788.1-5788.5; T.C.A. (orig. ed.), §§ 53-317 — 53-321), concerning district health departments, was repealed by Acts 1985, ch. 172, § 1. For present provisions relating to district health departments, see part 7 of this chapter.

Part 4
Local Health Service Stabilization [Repealed]

68-2-401 — 68-2-404. [Repealed.]

Compiler's Notes. Former part 4, §§ 68-2-401—68-2-404 (Acts 1941, ch. 25, §§ 1-4; 1947, ch. 22, § 1; 1949, ch. 25, § 1; 1961, ch. 179, § 4; 1963, ch. 63, §§ 1, 2; 1965, ch. 173, § 1; C. Supp. 1950, §§ 5788.6-5788.9; T.C.A. (orig. ed.), §§ 53-322 — 53-325), concerning local health service stabilization, was repealed by Acts 1985, ch. 172, § 1. For present provisions relating to an allocation plan for local health resources, see title 68, ch. 2, part 9.

Part 5
Fees for Services for the Ill and Aged [Repealed]

68-2-501 — 68-2-503. [Repealed.]

Compiler's Notes. Former part 5, §§ 68-2-501—68-2-503 (Acts 1963, ch. 57, §§ 1-3; T.C.A. (orig. ed.), §§ 53-326 — 53-328), concerning fees for services for the ill and the aged, was repealed by Acts 1985, ch. 172, § 1. For programs and services for elderly persons, see title 71, ch. 2.

Part 6
County Health Departments

68-2-601. County board of health — Members — Powers and duties.

  1. The county legislative body of each county may establish a board of health. The board shall consist of the following:
    1. The county mayor;
    2. The director of schools or a designee appointed annually by the director;
    3. Two (2) physicians licensed to practice in the state of Tennessee, who shall be nominated by the medical society serving that county;
    4. One (1) dentist licensed to practice dentistry in the state of Tennessee, who shall be nominated by the dental society serving that county;
    5. One (1) pharmacist licensed to practice in the state of Tennessee, who shall be nominated by the pharmaceutical society serving that county;
    6. One (1) registered nurse licensed to practice in the state of Tennessee, who shall be nominated by the nurses association serving that county;
    7. The county health director and the county health officer shall serve as ex officio members to the board, with the county health director serving as secretary to the board. In the absence of a duly appointed county health director, the county health officer shall serve as secretary. In the absence of the duly appointed county health officer, the commissioner of health or the commissioner's designee shall serve in that capacity. The board shall elect a chair at its first meeting and annually thereafter. It is the duty of the chair to call all meetings of the board;
    8. The county legislative body may, by resolution, provide for the election of a doctor of veterinary medicine as an additional member of the county board of health. The county legislative body may also, by resolution, provide for the election of a citizen representative as another additional member of the county board of health. The citizen representative shall not, at the time of such citizen representative's election, previous to such citizen representative's election, nor during the term of such citizen representative's office, be a health provider or the spouse of a health provider; and
    9. In the event a nomination is not timely made, the county legislative body may proceed to elect an otherwise qualified member.
  2. All members, except ex officio members, shall be residents of the county. In the event that the required members are not available from within the county to serve on the board of health, the board would remain duly constituted.
  3. The members shall be appointed by the county legislative body for a term of four (4) years. All vacancies shall be filled by the legislative body to serve the remainder of the unexpired term. A majority of the board shall constitute a quorum.
  4. The county legislative body may remove an appointed member for cause.
  5. In counties which fail to establish an active board of health pursuant to subsection (a), the commissioner of health may establish a health advisory committee to function as provided in § 68-2-802; however, the commissioner or the commissioner's designee retains all powers and duties of the board of health.
  6. The powers and duties of county boards of health are to:
    1. Govern the policies of full-time county health departments established in accordance with this chapter;
    2. Through the county health director or the county health officer, or both, enforce such rules and regulations as may be prescribed by the commissioner essential to the control of preventable diseases and the promotion and maintenance of the general health of the county;
    3. Adopt rules and regulations as may be necessary or appropriate to protect the general health and safety of the citizens of the county. The regulations shall be at least as stringent as the standard established by a state law or regulation as applicable to the same or similar subject matter. Regulations of a county board of health supersede less stringent or conflicting local ordinances; and
    4. Require that an annual budget be prepared and, when this budget has been approved by the county board of health, submit the same to the county legislative body for consideration and subsequent provision of necessary funds to meet all obligations under the adopted budgets.
  7. Any county that, on July 1, 1985, has a board of health meeting this section shall remain in existence without additional action on the part of the county legislative body, and any regulations adopted by this board prior to July 1, 1985, shall remain in full force and effect.

Acts 1985, ch. 172, § 1; 1999, ch. 397, § 1; 2003 ch. 90, § 2; Acts 2003, ch. 90, § 2.

Compiler's Notes. Acts 2003, ch. 90, § 2, directed the code commission to change all references from “county executive” to “county mayor” and to include all such changes in supplements and replacement volumes for the Tennessee Code Annotated

Cross-References. Establishment of clinics for vaccinations, violations, §§ 68-5-105, 68-5-106.

Persons infected with sexually transmitted diseases, requiring examination and treatment, § 68-10-104.

Collateral References.

Contagious disease, general delegation of power to guard against spread of. 8 A.L.R. 836.

68-2-602. Violations of rules and regulations of county board — Penalty.

Any person who violates a county board of health regulation commits a Class C misdemeanor.

Acts 1985, ch. 172, § 1; Acts 1989, ch. 591, § 113.

Cross-References. Penalty for Class C misdemeanor, § 40-35-111.

68-2-603. Establishment of county health department — County health director — County health officer.

    1. Each county shall establish a county health department which shall be headed by, and under the immediate direction of, a county health director.
    2. The county health director shall be appointed by the commissioner of health or by the commissioner's designee, act as the administrative officer of the county health department, take actions and make determinations necessary to properly execute the state department of health's programs, and adequately enforce the rules and regulations established by the commissioner and the county board of health.
    3. The county health director shall be a health professional who possesses the necessary education and experience in public health administration as determined by the state department of health and approved by the department of human resources.
    4. The county health director shall have compensation paid, all or in part, by the state department of health.
    5. If the county health director is a qualified physician, such county health director may also serve as a county health officer.
    6. If the commissioner appoints a county health director pursuant to this subsection (a), the appointment shall be made by the commissioner in concurrence with the county mayor of the county for which the appointment is made.
  1. It is the county health director's duty to enforce the regulations of the county board of health and the state department of health in counties which fail to establish a board of health.
  2. The commissioner may appoint a county health officer responsible for providing medical direction including medical enforcement actions. The county health officer shall be a graduate doctor of medicine or osteopathy, schooled and experienced in public health work and licensed to practice in the state of Tennessee. The county health officer shall have compensation paid, all or in part, by the state department of health.
  3. Any person who undertakes to hold the position of county health officer without being qualified as provided in this section commits a Class C misdemeanor.
  4. In the absence of a duly-appointed county health officer, the commissioner or the commissioner's designee shall appoint a physician who shall provide medical direction, including the authority outlined in § 68-2-609.
  5. In the absence of an epidemic or immediate threat of an epidemic, any person who shall file with the county board of health a signed, written statement that a specific regulation pertaining to personal medical treatment conflicts with the person's religious tenets and practices, affirmed under penalty of perjury, shall be exempted from the regulation.

Acts 1985, ch. 172, § 1; 1989, ch. 591, § 113; 2003, ch. 90, § 2.

Compiler's Notes. Acts 2003, ch. 90, § 2, directed the code commission to change all references from “county executive” to “county mayor” and to include all such changes in supplements and replacement volumes for the Tennessee Code Annotated

Cross-References. Indemnity insurance procured by commissioner of finance and administration for heads of county health departments, § 68-1-107.

Isolation and quarantine of dogs suspected of being rabid, § 68-8-109.

Isolation and quarantine of tubercular infected persons, title 68, ch. 9, part 2.

Isolation or quarantine of persons infected with sexually transmitted diseases, establishment and termination, § 68-10-106.

Penalty for Class C misdemeanor, § 40-35-111.

Quarantine or destruction of diseased or infected animals, title 44, ch. 2, part 1.

Quarantines, inspection and establishment, § 68-5-104.

Attorney General Opinions. Requirement of local governments to provide police, fire, and medical services.  OAG 10-03, 2010 Tenn. AG LEXIS 3 (1/19/10).

Collateral References.

Contagious disease, general delegation of power to guard against spread of. 8 A.L.R. 836.

68-2-604. Office facilities for county department of health — Appropriations.

  1. The county legislative body is required to provide necessary office facilities, and to appropriate money necessary for the maintenance of the county health department.
  2. The state department of health may participate with the county in the cost of construction and renovation of county health department facilities, subject to availability of state funds.

Acts 1985, ch. 172, § 1.

68-2-605. Municipal maintenance of county health departments — Taxes.

Municipalities located in counties establishing county health departments are empowered to cooperate in the maintenance of county health departments, and to have the county health departments serve as departments for the municipalities, and are authorized to incur the expenses necessary for their proportionate part in the establishment and maintenance of the county health departments, and to levy and collect taxes upon all of the property within the jurisdiction of the municipalities, as may be necessary to meet and pay the expenses.

Acts 1985, ch. 172, § 1.

68-2-606. Private acts continue in effect.

All private acts relative to county boards of health or county health departments, in effect on July 1, 1985, shall remain in effect.

Acts 1985, ch. 172, § 1.

68-2-607. Contracts and gifts.

  1. County health departments may enter into agreements, contracts or arrangements with governmental entities or other persons as necessary or appropriate to assist the county health department in carrying out its duties and functions, unless otherwise prohibited by law, and in accordance with the law, rules and procedures of this state and the local governing entity.
    1. County health departments may accept gifts, grants, bequests and other donations for use in performing the county health department's programs.
    2. Funds or property accepted shall be used as directed by its donor and in accordance with the law, rules and procedures of this state and the local governing entity.

Acts 1985, ch. 172, § 1.

68-2-608. Administrative orders and judicial remedies of county health director.

    1. Whenever it appears to the county health director that a condition or activity exists or is threatened that may violate the laws, regulations, resolutions, ordinances, permits or licenses that are within the enforcement responsibility of the county health director, the county health director may, after notice and opportunity for a hearing, issue an order for any of the following:
      1. Cessation of the activity;
      2. Correction of the condition or activity;
      3. Removal of the condition in whole or in part;
      4. Revocation, suspension or imposition of conditions on a license or permit; or
      5. Abatement of a nuisance that involves a violation of the health laws of the state and that can be reasonably expected to adversely affect the health of the public.
    2. Any person served with an order pursuant to subdivision (a)(1) shall immediately comply with the order at the person's own expense.
  1. Whenever a condition or activity exists or is threatened that, in the opinion of the county health director, causes or threatens an imminent or immediate danger to the public health under circumstances in which an opportunity for prior hearing might further seriously endanger the health of the public, the county health director may issue an order requiring the actions listed in subdivision (a)(1). The person to whom the order is addressed shall immediately comply with the order. However, such person shall be provided an opportunity for a hearing as promptly as is reasonable under the circumstances.
  2. The county health director may petition the appropriate chancery court for injunctive relief and any other remedy available at law or equity as necessary to enforce an order issued pursuant to this section, or to otherwise require compliance with the laws, regulations, resolutions, ordinances, permits or licenses that are within the enforcement responsibility of the county health director. It shall not be necessary that an order be issued prior to seeking relief in chancery court. The court shall have the power to assess the cost of corrective measures against any and all persons failing to comply with the order.

Acts 1985, ch. 172, § 1.

Cross-References. Injunctions, remedies and special proceedings, title 29, ch. 23.

68-2-609. Orders of county health officer.

The county health officer is empowered to order:

  1. The quarantine of any place or person, if the county health officer finds that quarantine is necessary to protect the public health from an epidemic;
  2. The closure of any public establishment, facility or building if the county health officer finds unsanitary conditions of such a nature and extent to significantly threaten the public health; or
  3. The closure of any public establishment, facility or building, if the county health officer is otherwise authorized by law to take that action.

Acts 1985, ch. 172, § 1.

Cross-References. Isolation or quarantine of persons infected with sexually transmitted diseases, § 68-10-106.

Quarantine of HIV, § 39-13-108.

Quarantine of person with communicable or contagious disease, § 68-5-103.

Quarantine, tuberculosis, title 68, ch. 9, part 2.

68-2-610. Fees for vector control.

  1. In any county having a population in excess of eight hundred thousand (800,000), according to the 2000 federal census or any subsequent federal census, that has a health department operating an urban and rural sanitation program to prevent or reduce the transmission of vector borne disease, the county legislative body is authorized to establish a vector control fee, which may be assessed and collected from each rate payer in the county. This fee shall not exceed one dollar ($1.00) per rate payer per month and shall be used exclusively by the county for the operation of the program to prevent or reduce the transmission of vector borne disease. In any such county with multiple utilities, the fee shall be assessed by only one (1) utility as determined by the county legislative body.
  2. The county providing the service is authorized to enter into a contract for the collection of the vector control fees, or to bill and collect vector control fees as a designated item on its utility bill, with:
    1. Any public or private corporation or municipal utilities board or commission operating a water, gas or electric system, other than an electric cooperative incorporated under the Rural Electric and Community Services Cooperative Act, compiled in title 65, chapter 25, part 2 in the area in which vector control services are provided; or
    2. Any other city, town or utility district.

Acts 2005, ch. 186, § 1.

Compiler's Notes. For tables of U.S. decennial populations of Tennessee counties, see Volume 13 and its supplement.

Part 7
District Health Departments

68-2-701. Joint district health departments — Powers and duties — Municipal support.

  1. Two (2) or more contiguous counties may, by resolution duly approved by a majority vote of each respective county legislative body, combine and contract, each with the other, for the purpose of forming a district health department, having all the powers, responsibilities and duties conferred upon county health departments by the provisions and statutes prescribing these powers, duties and responsibilities, where the combination can be economically administered as determined by the commissioner of health.
  2. Municipalities in any component county of the health district are authorized to cooperate in the support of the district health department through the county government of the component county, and to enter into an agreement with the county by which the district health department shall also serve as the health department for the municipality.

Acts 1985, ch. 172, § 1.

68-2-702. Joint district board of health created — Members.

  1. There may be created for the health district so formed, a joint district board of health consisting of the county mayor, the county director of schools, and one (1) physician, licensed to practice in Tennessee from each county of the district. The physician member from each county shall be nominated by the medical society and elected by the county legislative body of the county in which the physician member resides. In counties operating under a county council or commission form of government, the chair of the county council or commission shall serve as a member of the district board of health.
  2. A district board of health shall be considered duly constituted and empowered as soon as the several physician members from the respective counties have been elected by the respective county legislative bodies.

Acts 1985, ch. 172, § 1; 2003, ch. 90, § 2.

Compiler's Notes. Acts 2003, ch. 90, § 2, directed the code commission to change all references from “county executive” to “county mayor” and to include all such changes in supplements and replacement volumes for the Tennessee Code Annotated

68-2-703. District health director — District health officer.

  1. District health departments shall be headed by, and under the immediate direction of, a district health director, who shall be appointed by the commissioner of health.
  2. The district health director shall act as the administrative officer of the district health department and shall take actions and make determinations necessary to properly execute the state department of health's programs and adequately enforce the rules and regulations established by the commissioner and the district board of health.
  3. The commissioner may also appoint a district health officer responsible for providing medical direction including medical enforcement actions.

Acts 1985, ch. 172, § 1.

68-2-704. Qualifications of district health director and district health officer — Powers and duties.

  1. The district health director shall be a health professional who possesses the necessary education and experience in public health administration as determined by the state department of health and approved by the department of human resources. If the district health director is a qualified physician, the district health director may also serve as district health officer. The district health director shall have compensation paid, all or in part, by the state department of health.
  2. The district health officer shall be a doctor of medicine or osteopathy, schooled and experienced in public health work and licensed to practice in the state of Tennessee. The district health officer shall have compensation paid, all or in part, by the state department of health.
  3. Any person who undertakes to hold the position of district health officer, without being qualified as provided in this section, commits a Class C misdemeanor.
  4. The district health director and district health officer shall have the same responsibilities and powers as the county health director and the county health officer, respectively, as provided in §§ 68-2-603, 68-2-608 and 68-2-609.

Acts 1985, ch. 172, § 1; 1989, ch. 591, § 113.

Cross-References. Penalty for Class C misdemeanor, § 40-35-111.

68-2-705. Maintenance of district health department — Appropriations by counties.

  1. The county legislative bodies of counties establishing a district health department are authorized and empowered to appropriate funds necessary for the maintenance of the district health departments and to levy and collect taxes to meet and pay the same.
  2. Each county shall contribute to the maintenance of such district health department, the percentage of contribution by each to be as described in the allocation plans for local health resources, compiled in part 9 of this chapter.

Acts 1985, ch. 172, § 1.

Part 8
Health Advisory Committee

68-2-801. Health advisory committees — Establishment — Members — Powers and duties.

  1. Health advisory committees may be established to represent counties, districts or regions; however, each county must have at least one (1) representative.
  2. Each health advisory committee established in accordance with § 68-2-601(e) shall function in an advisory capacity. The members of the health advisory committee shall consist of citizen and provider representatives who are residents of the county or district served by the health advisory committee. A citizen representative shall not, at the time of the citizen representative's election, previous to the citizen representative's election, nor during the term of the citizen representative's office, be a health provider or the spouse of a health provider. Citizen members represent major purchasers of health care, as well as social, economic, racial and geographic subpopulations. Provider members represent health professionals, health care institutions, health care insurers, health professional schools and allied health professionals. Members of the health advisory committee serve staggered terms.
  3. Where health advisory committees are established, their role is strictly advisory, and the commissioner of health or the commissioner's designee retains enforcement authority.

Acts 1985, ch. 172, § 1.

68-2-802. Functions of health advisory committees.

The functions of the health advisory committee shall be to:

  1. Be informed concerning the operations and programs of the health department;
  2. Assist in informing residents of programs and services;
  3. Advise the health director/health officer of community health needs and resources; and
  4. Advise the health director, health officer, county mayors and the county commissions of potential solutions to problems in the delivery of health services, and to recommend policies designed to improve the operation of the health department.

Acts 1985, ch. 172, § 1; 2003, ch. 90, § 2.

Compiler's Notes. Acts 2003, ch. 90, § 2, directed the code commission to change all references from “county executive” to “county mayor” and to include all such changes in supplements and replacement volumes for the Tennessee Code Annotated

Part 9
Allocation Plan for Local Health Resources

68-2-901. Development of plan — Propositions.

In order to achieve an equitable allocation of local health resources, the department of health shall develop a plan to distribute state grant-in-aid funds to counties. This plan shall be based on the following propositions:

  1. A base allocation shall be made to each county to ensure that a basic level of services can be provided. The base allocation shall provide for a minimum core staff;
  2. A special needs fund shall be maintained for meeting special local health needs as determined by the commissioner of health;
  3. The remainder of the funds shall be allocated based on a plan prescribed by the commissioner of health;
  4. An annual plan shall be developed, which shall be subject to approval by the commissioner of health, the commissioner of finance and administration and the comptroller of the treasury; and
  5. Each county shall submit an annual plan of expenditures pursuant to this section for approval by the commissioner of health.

Acts 1985, ch. 172, § 1.

Cross-References. Federal and state grant-in-aid, § 7-3-102.

Right to receive government funds, application of funds, § 7-21-401.

Part 10
County Physician

68-2-1001. Selection — Term — Duties — Qualifications — Penalties — Compensation.

  1. The county legislative body may elect a county physician for a definite term, not to exceed four (4) years, or may delegate to the county mayor the authority to retain, with the concurrence of the sheriff, a county physician. It is the duty of the county physician to provide medical and surgical attention within a reasonable period of time for persons confined in the county jail, for inmates of county homes for the indigent, and for other indigent persons as may be ordered by the county legislative body.
  2. No person shall be qualified to hold the office of the county physician who is not a physician licensed to practice in Tennessee.
  3. Any person who holds the position of county physician or undertakes to discharge the duties of the office, without being so qualified, commits a Class C misdemeanor. Each day any person undertakes to hold the office, or perform the duties of the office, without being so qualified, constitutes a separate offense.
  4. Compensation of county physicians shall be such as the county legislative body may fix.

Acts 1985, ch. 172, § 1; ch. 591, §§ 1, 6; 2003, ch. 90, § 2.

Compiler's Notes. Acts 2003, ch. 90, § 2, directed the code commission to change all references from “county executive” to “county mayor” and to include all such changes in supplements and replacement volumes for the Tennessee Code Annotated

Cross-References. Penalty for Class C misdemeanor, § 40-35-111.

NOTES TO DECISIONS

Decisions Under Prior Law

1. Services by City Hospital.

2. —County Liability.

Authorization by jail physician and sheriff to hospital to render medical service to prisoner shot in raid on still by county officers did not bind county since only medical service authorized is that rendered by jail physician. Landerdale County v. Memphis, 167 Tenn. 493, 71 S.W.2d 686, 1934 Tenn. LEXIS 6 (1934), superseded by statute as stated in, Williams v. Anderson County, — S.W.2d —, 1988 Tenn. App. LEXIS 828 (Tenn. Ct. App. Dec. 20, 1988).

3. —Liability of Sheriff and Jail Physician.

Jail physician and sheriff who authorized hospital to render services to wounded prisoner under belief that county would pay for same were not individually liable to the hospital. Landerdale County v. Memphis, 167 Tenn. 493, 71 S.W.2d 686, 1934 Tenn. LEXIS 6 (1934), superseded by statute as stated in, Williams v. Anderson County, — S.W.2d —, 1988 Tenn. App. LEXIS 828 (Tenn. Ct. App. Dec. 20, 1988).

4. Removal of Jail Physician.

County legislative body does not have jurisdiction of proceeding to remove jail physician, since removal proceeding can only be instituted in circuit, chancery and criminal courts of county involved. Brock v. Foree, 168 Tenn. 129, 76 S.W.2d 314, 1934 Tenn. LEXIS 28 (1934).

5. Recovery for Services Rendered.

County was entitled to recover the value of services to pauper patient of county hospital for paupers and insane persons prior to the time such patient received inheritance. Jennings v. Davidson County, 208 Tenn. 134, 344 S.W.2d 359, 1961 Tenn. LEXIS 405 (1961).

Chapter 3
Vital Records Act of 1977

Part 1
Definitions and Administration

68-3-101. Short title.

This chapter shall be known and may be cited as the “Vital Records Act of 1977.”

Acts 1977, ch. 128, § 1; T.C.A., § 53-401.

Textbooks. Tennessee Law of Evidence (2nd ed., Cohen, Paine and Sheppeard), Rule 803(9); § 803(9).1.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, (Neil P. Cohen), 45 Tenn. L. Rev. 430, 451.

Comparative Legislation. Vital records:

Ala.  Code § 22-9A-1 et seq.

Ark.  Code § 20-18-101 et seq.

Ga. O.C.G.A. § 31-10-1 et seq.

Ky. Rev. Stat. Ann. § 213.011 et seq.

Miss.  Code Ann. § 41-57-1 et seq.

Mo.  Rev. Stat. § 193.005 et seq.

N.C. Gen. Stat. § 130A-90 et seq.

Va. Code §§ 32.1-249 et seq.

Collateral References. 39 Am. Jur. 2d Health § 51.

39A C.J.S. Health and Environment § 74.

Health and Environment 34.

Marriage 31.

68-3-102. Chapter definitions.

As used in this chapter, unless the context otherwise requires:

  1. “Certificate of birth resulting in stillbirth” means a certificate issued to record the birth of a stillborn child;
  2. “Commissioner” means the commissioner of health;
  3. “Dead body” means a human body from the condition of which it reasonably may be concluded that death occurred;
  4. “Department” means the department of health;
  5. “Fetal death” means death prior to the complete expulsion or extraction from its mother of a product of human conception; the death is indicated by the fact that, after expulsion or extraction, the fetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles;
  6. “File” means to present a vital record provided for in this chapter for registration by the office of vital records;
  7. “Final disposition” means the burial, interment, cremation, removal from the state or other authorized disposition of a dead body or fetus;
  8. “Induced termination of pregnancy” means the intentional termination of pregnancy with the intention other than to produce a live-born infant or to remove a dead fetus;
  9. “Institution” means any establishment, public or private, that provides inpatient or outpatient medical, surgical or diagnostic care or treatment or nursing, custodial or domiciliary care, or to which persons are committed by law;
  10. “Live birth” means the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of the pregnancy, that, after expulsion or extraction, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached. Heartbeats shall be distinguished from transient cardiac contractions, and respirations shall be distinguished from fleeting respiratory efforts or gasps;
  11. “Person in charge of interment” means any person who places or causes to be placed, a deceased person, still-born child, or dead body, or, after cremation, the ashes thereof, in the earth, a grave, tomb, vault, urn or other receptacle, either in a cemetery or at any other place, or disposes otherwise thereof;
  12. “Physician” means a person licensed to practice medicine or osteopathy pursuant to the laws of this state;
  13. “Public health council” means the council established in § 68-1-501 [repealed];
  14. “Registration” means the acceptance by the office of vital records and the incorporation of vital records provided for in this chapter into its official records;
  15. “Stillbirth” means an unintended, intrauterine fetal death after a gestational age of not less than twenty (20) completed weeks or with a weight of three hundred fifty (350) grams or more;
  16. “System of vital records” includes the registration, collection, preservation, amendment, and certification of vital records, and the collection of other reports required by this chapter; and
  17. “Vital records” means certificates or reports of birth, death, marriage, divorce or annulment and other records related thereto.

Acts 1977, ch. 128, § 2; T.C.A., § 53-402; Acts 2005, ch. 146, § 1; 2010, ch. 778, § 1.

Compiler's Notes. Former § 68-1-501, referred to in this section, concerning the public health council, was repealed by Acts 2008, ch. 951, § 2, effective July 1, 2008.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, IX. Abortion (Neil P. Cohen), 45 Tenn. L. Rev. 498.

NOTES TO DECISIONS

1. Mother.

Trial court erred in prohibiting the Tennessee Department of Health from listing a surrogate as mother on the original birth certificate and to list the mother as “unknown” because the definition of “mother” for the purpose of completing the birth certificate was the same as that used in preparing the standard birth certificate promulgated by the National Center for Health Statistics. In re Adoption of Male Child A. F. C., 491 S.W.3d 316, 2014 Tenn. App. LEXIS 414 (Tenn. Ct. App. July 16, 2014), appeal denied, In re Adoption of A.F.C., — S.W.3d —, 2014 Tenn. LEXIS 985 (Tenn. Nov. 20, 2014).

“Mother” to be entered on the certificate of live birth required by the Vital Records Act of 1977 is the same as that used in preparing the standard certificate, i.e., the woman who delivers the child; “mother” as used in the Act is the woman who produced the “live birth,” and using the same definition of mother enables the state and federal governments to collaborate in pursuit of their respective goals. In re Adoption of Male Child A. F. C., 491 S.W.3d 316, 2014 Tenn. App. LEXIS 414 (Tenn. Ct. App. July 16, 2014), appeal denied, In re Adoption of A.F.C., — S.W.3d —, 2014 Tenn. LEXIS 985 (Tenn. Nov. 20, 2014).

68-3-103. Establishment of office of vital records — Rules and regulations — Enforcement — Registration districts — Seal.

The department shall:

  1. Establish an office of vital records with suitable offices, which shall be properly equipped with fireproof vault and filing cases for the preservation of all official records made and received under this chapter or under the regulations of the department;
  2. Make and amend, with the approval of the public health council [repealed], regulations necessary for the creation and efficient performance of an adequate system of vital records, and give instructions and prescribe forms for collecting, transcribing, compiling and preserving vital records;
  3. Enforce this chapter and the regulations made pursuant to this chapter;
  4. Provide a seal of office;
  5. Divide the state into vital records registration districts. The department may from time to time, as conditions justify, change their boundaries. The subdivisions of the state on July 1, 1977, shall be continued until changed by the department; and
  6. Make and amend rules and regulations necessary for the tracking and disposition of an aborted fetus or aborted fetal tissue resulting from surgical abortions.

Acts 1977, ch. 128, § 3; T.C.A., § 53-403; Acts 2016, ch. 1003, § 3.

Compiler's Notes. Acts 2016, ch. 1003, § 7 provided that notwithstanding this act or the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, any rule promulgated to implement the provisions of this act shall be provided to the chairs of the health committee of the house of representatives and the health and welfare committee of the senate by the secretary of state, after approval by the attorney general and reporter, at the same time the text of the rule is made available to the government operations committees of the senate and the house of representatives for purposes of conducting the review required by § 4-5-226 in order for the health committee of the house of representatives and the health and welfare committee of the senate to be afforded the opportunity to comment on the rule.

Amendments.  The 2016 amendment added (6).

Effective Dates. Acts 2016, ch. 1003, § 8. April 27, 2016.

Compiler's Notes. The public health council, referred to in this section, was terminated by Acts 2008, ch. 951, § 2, effective July 1, 2008.

68-3-104. State registrar.

  1. The commissioner shall:
    1. Appoint a state registrar of vital records, referred to as the state registrar in this chapter, who shall be qualified in accordance with classification standards of education and experience; and
    2. In case of a vacancy in the office of state registrar, immediately appoint a successor.
  2. The state registrar:
    1. Under the supervision of the commissioner, shall act as agent of the commissioner and:
      1. Shall have charge of the office of vital records and act as the custodian of all the certificates and records received by the state registrar and perform such other duties as the commissioner may prescribe; and
      2. Shall be charged with the execution of this chapter and of the regulations of the department throughout the state and have supervisory power over the local registrars and deputy local registrars;
    2. Shall prescribe, with the approval of the department, furnish, and distribute forms required by this chapter and the rules and regulations issued under this chapter or prescribe such other means for transmission of records as will accomplish the purpose of complete and accurate registration;
    3. Shall assist in preparing and publishing reports of vital statistics of this state and other reports required by the department;
    4. May establish or designate additional offices in the state to aid in the administration of the statewide system of vital records;
    5. May delegate functions and duties vested in the state registrar to employees of the office of vital records and to employees of an office established or designated under subdivision (b)(4); and
    6. Shall provide copies of certificates or reports required under this chapter or other information derived from the certificates or reports as the state registrar shall determine are necessary to local health agencies for local health planning and program activities. The state registrar shall establish a schedule for transmittal of the copies with each local health agency. The records or other information shall remain the property of the office of vital records and the uses that may be made of the records or other information shall be governed by the state registrar. A schedule for the disposition of the certificates, reports or data provided under this section and § 68-3-103 shall be established by the state registrar.

Acts 1977, ch. 128, § 3; T.C.A., §§ 53-404, 53-405.

Attorney General Opinions. Applicability to documents of invalid marriage, OAG 90-71 (7/16/90).

68-3-105. Violations — Enforcement — Penalties.

    1. The state registrar has the authority to investigate cases of irregularities or violations of law, personally or by an accredited representative, and all registrars shall aid the state registrar, upon request, in investigations.
    2. When the state registrar deems it necessary, the state registrar shall report cases of violations of this chapter to the district attorney general, who shall immediately initiate and follow up the necessary court proceedings against the person alleged to be responsible for the violation of law.
    3. Upon request of the department, the attorney general and reporter shall likewise assist in the enforcement provisions of this chapter.
  1. It is unlawful for any person to:
    1. Willfully and knowingly make any false statement in a certificate, record or report required to be filed under this chapter, or in an application for an amendment of the certificate, record or report, or in an application for a certified copy of a vital record, or willfully and knowingly supply false information, intending that such information be used in the preparation of the report, record or certificate, or amendment of the certificate, record, or report;
    2. Absent lawful authority and with the intent to deceive, make, counterfeit, alter, amend or mutilate any certificate, record or report required to be filed under this chapter or a certified copy of such certificate, record or report;
    3. Willfully and knowingly obtain, possess, use, sell, furnish or attempt to obtain, possess, use, sell or furnish to another, for any purpose of deception, any certificate, record, report or certified copy of a certificate, record or report so made, counterfeited, altered, amended or mutilated;
    4. With the intention to deceive willfully and knowingly obtain, possess, use, sell or furnish to another any certificate of birth or certified copy of a certificate of birth, knowing that such certificate or certified copy was issued upon a certificate that is false, in whole or in part, or that relates to the birth of another person, whether living or deceased;
    5. Willfully and knowingly furnish or process a certificate of birth or certified copy of a certificate of birth, with the knowledge or intention that it be used for the purpose of deception by a person other than the person to whom the certificate of birth relates; or
    6. Without lawful authority, possess any certificate, record or report required by this chapter or a copy or certified copy of such certificate, record or report, knowing the certificate, record, report or copy to have been stolen or otherwise unlawfully obtained.
  2. An offense contained in subsection (b) is a Class C misdemeanor.
  3. A person commits a Class C misdemeanor, who willfully and knowingly refuses to provide information required by this chapter or regulations adopted under this chapter; or willfully and knowingly transports or accepts for transportation, interment or other disposition a dead body without an accompanying permit as provided in this chapter; or willfully and knowingly neglects or violates this chapter or refuses to perform any of the duties imposed upon the person by this chapter.

Acts 1977, ch. 128, § 28; T.C.A., § 53-406; Acts 1989, ch. 591, § 113.

Cross-References. Culpability, title 39, ch. 11, part 3.

Penalty for Class C misdemeanor, § 40-35-111.

68-3-106. Local registrars.

  1. The state registrar shall:
    1. Appoint such number of local registrars for the registration districts as necessary. Full-time local health department personnel may be appointed local registrars;
    2. Remove for cause any local registrar whose services are found to be unsatisfactory; and
    3. Immediately appoint a successor in case of death, resignation, removal from the registration district, or removal for cause of any local registrar.
  2. The local registrars and their deputies are charged with the duty of complying with all instructions of the state registrar, and of checking on the compliance by others with this chapter and with the regulations of the department.
  3. Each local registrar, upon acceptance of such registrar's written appointment, shall recommend a deputy or deputies, and in case of death, resignation or removal of such deputy, a successor, subject to the approval of the state registrar.

Acts 1977, ch. 128, § 5; T.C.A., §§ 53-411 — 53-413.

Part 2
Records — General Requirements

68-3-201. Kinds of information collected and recorded.

The information collected and recorded under this chapter shall be such as will aid the public health of the state, and furnish and preserve evidence affecting personal and property rights of the individual citizen.

Acts 1977, ch. 128, § 5; T.C.A., § 53-421.

Law Reviews.

1985 Tennessee Survey: Selected Developments in Tennessee Law, 53 Tenn. L. Rev. 373 (1986).

68-3-202. Content of certificates and reports — Evidence.

  1. In order to promote and maintain nationwide uniformity in the system of vital records, the forms of certificates, reports and other returns required by this chapter, or by regulations adopted under this chapter, shall include, as a minimum, the items recommended by the federal agency responsible for national vital statistics.
  2. Each certificate, report and form required to be filed and registered under this chapter shall be on a form or in a format prescribed by the state registrar and shall contain the date received for registration.
  3. Each certificate provided for in this chapter, filed within six (6) months after the recorded event occurred, shall be prima facie evidence of the facts stated in the certificate.

Acts 1977, ch. 128, § 4; T.C.A., § 53-422.

Cross-References. Certified copy as prima facie evidence, § 68-3-206.

Textbooks. Tennessee Law of Evidence (2nd ed., Cohen, Paine and Sheppeard), § 803(9).1.

NOTES TO DECISIONS

1. Legal Mother.

Issue presented by intended parents, who was the legal mother of a child conceived with an anonymously donated egg and carried by a gestational carrier for the benefit of the child's genetic father and his wife who arranged for the child and conceived him with the intention to be his parents, was not proper for resolution because such an important and consequential issue had to be left for determination in a case that presented an actual, ongoing controversy or to the legislature. In re Adoption of Male Child A. F. C., 491 S.W.3d 316, 2014 Tenn. App. LEXIS 414 (Tenn. Ct. App. July 16, 2014), appeal denied, In re Adoption of A.F.C., — S.W.3d —, 2014 Tenn. LEXIS 985 (Tenn. Nov. 20, 2014).

Surrogate mother, rather than the intended parent, was to be listed as the legal parent on the birth certificate of twin children because the children were born of the surrogate mother, pursuant to a surrogacy agreement, from an anonymously donated egg and the intended father's sperm. In re Amadi A., — S.W.3d —, 2015 Tenn. App. LEXIS 251 (Tenn. Ct. App. Apr. 24, 2015).

68-3-203. Amendment of records.

  1. In order to protect the integrity and accuracy of vital records, a certificate or record registered under this chapter may be amended only in accordance with this chapter and regulations adopted by the department.
  2. Except as otherwise provided by subsection (f), a certificate or record that is amended under this section shall be marked “amended.” The date of amendment and a summary description of the evidence submitted in support of the amendment shall be endorsed on or made a part of the record. The department shall prescribe, by regulation, the conditions under which additions or minor corrections may be made to certificates or records within one (1) year after the date of the event, without the certificate or record being considered “amended.” “Minor corrections” means amendment of obvious errors, transposition of letters in words of common knowledge, or omissions.
  3. Upon receipt of a certified copy of a court order changing the name of a person born in the state, and upon request of such person or such person's parents, guardian or legal representative, the state registrar shall amend the certificate of birth to show the new name.
  4. The sex of an individual shall not be changed on the original certificate of birth as a result of sex change surgery.
  5. When an applicant does not submit the minimum documentation required in the regulations for amending a vital record, or when the state registrar has reasonable cause to question the validity or adequacy of the applicant's sworn statements or the documentary evidence, and if the deficiencies are not corrected, the state registrar shall not amend the vital record and shall advise the applicant of the reason for this action.
  6. In addition to other methods of amending certificates that may be provided by statute or by duly authorized department rule, the state registrar, if presented by an applicant with evidence that a reasonable person would conclude proves beyond a reasonable doubt that an original entry on a certificate was factually inaccurate at the time of recordation, shall block out the misinformation and make the necessary correction. When such an amendment is made, no record of the amendment shall appear upon the face of the certificate; provided, that a record of all evidence submitted relative to the amendment, along with the registrar's analysis of the evidence, shall be maintained by the office of vital records.
  7. If a form approved, as provided in § 68-3-305(b), acknowledging the paternity of a child is signed by both parents of the child and is submitted to the office of vital records at any time after the original certificate is filed and prior to the child's nineteenth birthday, the legal surname of the father may be entered on the certificate as that of the child, and the father's name and other personal information may be shown on the certificate of birth in the manner prescribed by regulation; provided, that paternity is not already shown on the certificate of birth. The state registrar may mark the record as amended, but not on the portion to be disclosed pursuant to § 68-3-205. Further, a legitimation by subsequent marriage of the individuals shown on the certificate as the father and mother shall not require a new certificate of birth and §§ 68-3-310(3), 68-3-311 and 68-3-313 shall not apply.
  8. In the event a voluntary acknowledgment of paternity is rescinded and a new father is not named, the name and personal information of the originally named father shall be removed by blocking, and the child's surname shall be blocked and the legal surname of the mother at the time of the birth shall be entered as the surname of the child. In the event a voluntary acknowledgment of paternity is rescinded and a new father is named, the changes in the birth certificate shall be made in accordance with subsection (g).

Acts 1977, ch. 128, § 21; 1979, ch. 123, §§ 1, 2; T.C.A., § 53-423; Acts 1985, ch. 11, § 1; 1994, ch. 988, § 13; 1997, ch. 551, § 39.

Cross-References. Paternity and legitimation, title 36, ch. 2, part 3.

Attorney General Opinions. Where designation of a person's sex has been made on police booking sheets, warrants, and other court records in accordance with the person's birth certificate, those documents may not be altered as a result of sex-change surgery.  OAG 14-70, 2014 Tenn. AG Lexis 72 (7/16/14).

68-3-204. Reproduction of records.

  1. To preserve vital records, the state registrar is authorized to prepare typewritten, photographic, electronic or other reproductions of original records and files in the office of vital records.
  2. The reproductions, when certified by the state registrar, shall be accepted as the original records.

Acts 1977, ch. 128, § 22; T.C.A., § 53-424.

Textbooks. Tennessee Law of Evidence (2nd ed., Cohen, Paine and Sheppeard), § 1002.1.

68-3-205. Disclosure of information — Regulations.

    1. To protect the integrity of vital records, to ensure their proper use, and to ensure the efficient and proper administration of the system of vital records, it is unlawful for any person to permit inspection of, or to disclose information contained in, vital records, or to copy or issue a copy of all or part of any such records, except as authorized by this chapter, by regulations promulgated pursuant to this chapter, or as otherwise authorized by law, or by order of a court of competent jurisdiction.
    2. Regulations promulgated pursuant to this chapter shall provide for adequate standards of security and confidentiality of vital records.
  1. The department may authorize, by regulation, the disclosure of information contained in vital records for research purposes.
  2. Appeals from decisions of the custodians of permanent local records refusing to disclose information, or to permit inspection of or copying of records under the authority of this section and regulations issued under this section, shall be made to the state registrar, whose decisions shall be binding upon the local custodians of permanent local records.
    1. As used in this subsection (d), “authenticating document” means the certificate, license, order, decree, report or other document that makes legal, official and final the occurrence of a certain event.
      1. Notwithstanding any other provision of this chapter, or any rule promulgated pursuant to this chapter, to the contrary, an application for a marriage license and the authenticating document for the events of birth, death, marriage, divorce, or annulment of marriage, whether maintained or stored by or in the possession of a county clerk, court clerk, state registrar or other custodian authorized by the state registrar, shall be considered a public record, and further, that verified information from such documents may be provided upon request. Nothing in this section shall be construed to permit the disclosure of information contained in the “Information for Medical and Health Use Only” section of the birth certificate or the “Confidential Information” section of the certificate of marriage or certificate of divorce or annulment, unless specifically authorized by the state registrar for statistical or research purposes. This data is not subject to subpoena or court order and is not admissible before any court or judicial body.
      2. Verified information from birth records may only be provided by the state registrar or the local registrar in a local health department in a county with a population of two hundred fifty thousand (250,000) or greater, according to the 1970 federal census.
      3. Certified or noncertified copies or abstracts of birth certificates of persons in the federal witness protection program shall be provided only to a person requesting a copy of the person's own birth certificate or that person's supervising federal marshal.
      4. A certified copy or other copy of a death certificate containing the cause of death information shall not be issued, except:
        1. Upon specific request of the spouse, children, parents, or other next of kin of the decedent or their respective authorized representatives;
        2. When a documented need for the cause of death to establish a legal right or claim has been demonstrated;
        3. When the request for the copy is made by or on behalf of an organization that provides benefits to the decedent's survivors or beneficiaries;
        4. Upon specific request by local, state, or federal agencies for research or administrative purposes approved by the state registrar;
        5. When needed for research activities approved by the state registrar;
        6. Upon receipt of an order from a court of competent jurisdiction ordering such release; or
        7. Upon receipt of a written request from a department representative authorized by chapter 142, part 1, of this title to obtain the records.
      5. The state registrar and other custodians of vital records authorized by the state registrar to issue certified copies shall, upon receipt of an application, issue a certified copy of a vital record in the registrar's or custodian's custody, or a part of the vital record to the registrant, the registrant's spouse, children, parents, or guardian, or their respective authorized representative. Others may be authorized to obtain certified copies when they demonstrate that the records are needed for the determination or protection of their personal or property rights.
    2. Except as provided in subdivision (d)(2), nothing in this subsection (d) shall be construed as altering the legal status as an open or confidential record of any information, document, record or report used to compile or produce the information contained on the authenticating document, including, but not limited to, applications, medical or law enforcement reports, settlement agreements, or court pleadings and filings.
    3. The state registrar shall promulgate rules to effectuate the provisions and intent of this subsection (d), including rules concerning the provision of verified information from authenticating documents to members of the public.
  3. When one hundred (100) years have elapsed, after the date of birth, or fifty (50) years have elapsed after the date of death, marriage, divorce or annulment of marriage, the records of these events in the custody of the state registrar shall be made available to the public in accordance with regulations that provide for the continued safekeeping of the records.
  4. Any microfilm copy of a vital record in the possession of the state library and archives, or a local library, shall be available for public inspection.

Acts 1977, ch. 128, § 23; T.C.A., § 53-425; Acts 1988, ch. 891, § 1; 1993, ch. 432, §§ 1, 2; 2007, ch. 588, § 1.

Compiler's Notes. For tables of U.S. decennial populations of Tennessee counties, see Volume 13 and its supplement.

Cross-References. Confidentiality of public records, § 10-7-504.

Law Reviews.

Updating Tennessee's Public Records Law (Douglas Pierce), 24 Tenn. B.J. 24 (1988).

Attorney General Opinions. Public access to social security numbers on marriage license applications, OAG 98-065 (3/17/98).

68-3-206. Copies of records.

In accordance with § 68-3-205 and the regulations adopted pursuant to § 68-3-205:

  1. The state registrar and other custodian or custodians authorized by the state registrar to issue certified copies shall, upon receipt of written application, issue a certified copy of a vital record in the state registrar's or custodian's custody or a part of the vital record to any applicant showing a direct and tangible interest in the vital record. Each copy issued shall show the date of registration and copies issued from records marked “delayed” and “amended” shall be similarly marked and show the effective date. All forms and procedures used in the issuance of certified copies of vital records in this state shall be approved or provided by the state registrar;
  2. A certified copy of a vital record or any part of the vital record, issued in accordance with subdivision (1), shall be considered for all purposes the same as the original and shall be prima facie evidence of the facts stated in the vital record;
  3. The federal agency responsible for national vital statistics may be furnished copies or data from the system of vital records it may require for national statistics; provided, that the federal agency shares in the cost of collecting, processing and transmitting the data; and provided further, that the data shall not be used for other than statistical purposes by the federal agency, unless so authorized by the state registrar;
  4. Federal agencies, the state of Tennessee, Tennessee courts and municipal and county law enforcement agencies, upon official request, may be furnished verification of information for statistical or administrative purposes upon such terms or conditions as may be prescribed by regulation; provided, that the copies or information shall not be used for other than the purpose for which it was requested, unless so authorized by the state registrar;
    1. The state registrar may, by agreement, transmit transcripts of records and other reports required by this chapter to offices of vital records outside this state, when the records or other reports relate to residents of those jurisdictions or persons born in those jurisdictions. The agreement shall require that the transcripts be used for statistical and administrative purposes only as specified in the agreement. Any agreement shall provide that the transcripts shall not be retained by the other jurisdiction for more than two (2) years from the date of the event or after the statistical tabulation has been accomplished, whichever time period is shorter;
    2. Transcripts received from other jurisdictions by the office of vital records in this state shall be handled in the same manner as prescribed in subdivision (5)(A);
    1. The department of health shall implement a pilot program to authorize, but not require, county clerks to issue certified copies of computer abstract birth certificates to walk-in customers pursuant to this subdivision (6). The program shall only be implemented in one (1) site within a county.
    2. County clerks may issue certified copies of birth certificates, which copies shall have the force and effect of certified copies issued by the office of vital records. The state registrar may promulgate regulations or emergency rules as may be necessary to effectuate this subdivision (6), including, but not limited to, rules governing the issuance, inventories, and security and confidentiality standards of the birth certificates or certified copies or both, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
    3. The department shall provide state security paper for issuing copies of birth certificates pursuant to this section. The county clerk shall be responsible for all other expenses including, but not limited to, connectivity, hardware and direct cost of training staff; provided, however, that each county clerk is authorized to charge a reasonable fee in addition to the fee established by regulations and paid to the department to defray any reasonable costs associated with issuing the certificates. From the proceeds collected from the fee established by regulations, the county clerk shall remit to the department the portion of the fee due the state and shall remit to any local health department located within the county the portion of the fee due such local health department in the manner prescribed by contract.
    4. County clerks and the department may utilize existing T-carrier signaling schemes for the purpose of transmitting data.
    5. [Deleted by 2014 amendment.]
  5. Local health departments in counties with a population of two hundred fifty thousand (250,000) or greater, according to the 1970 federal census or any subsequent federal census, may issue copies of birth certificates, which copies shall have the force and effect of certified copies issued by the office of vital records. The local health departments in those counties are designated as branch offices of the central office of vital records for the purpose of issuance of copies of birth certificates only, but not for the purpose of alteration of birth certificates;
  6. Local health departments may issue copies of death certificates, which copies have the force and effect of certified copies issued by the office of vital records; and
  7. No person shall prepare or issue any certificate that purports to be an original, certified copy, or copy of a vital record, except as authorized in this chapter or regulations adopted pursuant to this chapter.

Acts 1977, ch. 128, § 24; T.C.A., § 53-426; Acts 2007, ch. 282, §§ 1, 2; 2010, ch. 712, § 1; 2014, ch. 637, §§ 1, 2.

Compiler's Notes. For tables of U.S. decennial populations of Tennessee counties, see Volume 13 and its supplement.

Amendments. The 2014 amendment, in (6), deleted the former second sentence in (A) which read: “The pilot program shall exist only for four (4) years, through the end of fiscal year 2013-2014.” and deleted former (E) which read: “Such pilot program shall apply only in counties having a population in excess of three hundred thousand (300,000), according to the 2000 federal census or any subsequent federal census, and in counties having the following populations, according to the 2000 federal census or any subsequent federal census:not less than  nor more than 17,600 17,67549,000 49,10051,200 51,30058,100 58,20071,100 71,20071,300 71,400105,800 105,900”

Effective Dates. Acts 2014, ch. 637, § 3. April 4, 2014.

Cross-References. Confidentiality of public records, § 10-7-504.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, III. Marriage Formalities (Neil P. Cohen), 45 Tenn. L. Rev. 430.

Collateral References.

Requirement of notice as condition for admission in evidence of summary of voluminous records. 80 A.L.R.3d 405.

68-3-207. Fees for copies and for searches.

    1. The department shall prescribe the fees to be paid for certified copies or certificates or records, or for a search of the files or records when no copy is made, or for copies or information provided for research, statistical or administrative purposes.
    2. The department shall not collect any fee under this section for a copy of a death certificate for a deceased person who was a veteran of an armed service of the United States, if:
      1. The person requesting the copy presents the department with adequate proof of the veteran status of the deceased;
      2. The person requesting the copy is related to the deceased within two (2) degrees of collateral or lineal kinship; and
      3. Not more than two (2) copies of the death certificate have been previously provided on behalf of the deceased veteran without collection of the fee.
  1. Fees collected under this section by the state registrar shall be deposited in the general fund of this state, according to the prevailing procedures governing collection.

Acts 1977, ch. 128, § 25; T.C.A., § 53-427; Acts 1990, ch. 850, § 1.

68-3-208. Medical records.

Medical records will be made available to the state registrar or any direct representative of the registrar for the limited purpose of gathering information on birth certificates, death certificates and reports of fetal deaths.

Acts 1977, ch. 128, § 27; T.C.A., § 53-428.

68-3-209. Applicability to previously received certificates or reports.

This chapter also apply to all certificates of birth, death, marriage, and divorce, dissolution or annulment and reports of fetal death and induced termination of pregnancy previously received by the office of vital records or by any custodian of permanent local records.

Acts 1977, ch. 128, § 29; T.C.A., § 53-429.

Part 3
Births

68-3-301. Registration generally — Attestation to accuracy of data.

  1. A certificate of birth for each live birth that occurs in this state shall be filed with the office of vital records, or as otherwise directed by the state registrar, within ten (10) days after the birth and shall be registered if it has been completed and filed in accordance with §§ 68-3-301 — 68-3-306.
  2. Either parent of the child or any other knowledgeable informant shall attest to the accuracy of the personal data provided in sufficient time to permit the filing of a certificate within the ten (10) days prescribed by §§ 68-3-301 — 68-3-306.

Acts 1977, ch. 128, § 6; T.C.A., § 53-441.

NOTES TO DECISIONS

1 Mother.

1 Mother.

Trial court erred in prohibiting the Tennessee Department of Health from listing a surrogate as mother on the original birth certificate and to list the mother as “unknown” because the definition of “mother” for the purpose of completing the birth certificate was the same as that used in preparing the standard birth certificate promulgated by the National Center for Health Statistics. In re Adoption of Male Child A. F. C., 491 S.W.3d 316, 2014 Tenn. App. LEXIS 414 (Tenn. Ct. App. July 16, 2014), appeal denied, In re Adoption of A.F.C., — S.W.3d —, 2014 Tenn. LEXIS 985 (Tenn. Nov. 20, 2014).

“Mother” to be entered on the certificate of live birth required by the Vital Records Act of 1977 is the same as that used in preparing the standard certificate, i.e., the woman who delivers the child; “mother” as used in the Act is the woman who produced the “live birth,” and using the same definition of mother enables the state and federal governments to collaborate in pursuit of their respective goals. In re Adoption of Male Child A. F. C., 491 S.W.3d 316, 2014 Tenn. App. LEXIS 414 (Tenn. Ct. App. July 16, 2014), appeal denied, In re Adoption of A.F.C., — S.W.3d —, 2014 Tenn. LEXIS 985 (Tenn. Nov. 20, 2014).

Surrogate mother, rather than the intended parent, was to be listed as the legal parent on the birth certificate of twin children because the children were born of the surrogate mother, pursuant to a surrogacy agreement, from an anonymously donated egg and the intended father's sperm. In re Amadi A., — S.W.3d —, 2015 Tenn. App. LEXIS 251 (Tenn. Ct. App. Apr. 24, 2015).

68-3-302. Birth inside institution — Establishing paternity — Acknowledgment of paternity — Report.

  1. When a birth occurs in an institution or en route to an institution, the person in charge of the institution, or that person's designated representative, shall obtain the data required by the certificate, prepare the certificate, certify that the child was born alive at the place and time and on the date stated, either by signature or by an approved electronic process, and file the certificate with the office of vital records or as otherwise directed by the state registrar within the required ten (10) days.
  2. The physician in attendance shall provide the medical information required by the certificate to the institution's designated representative within seventy-two (72) hours after the birth.
  3. Immediately before or after the birth of a child to an unmarried woman in a birthing institution, an authorized representative of the birthing institution shall provide to the mother, and, if present, the biological father:
    1. Written and oral information concerning the alternatives to, the legal consequences of, the rights, and the responsibilities arising from the completion of the voluntary acknowledgment. The information shall be provided to the birthing institution by the department of human services, which shall develop the information in conjunction with the department of health. A videotaped or audio presentation will satisfy the requirement for the oral explanation.
    2. An acknowledgment of paternity on a form approved pursuant to § 68-3-305(b), and shall provide the opportunity to complete and submit to the institution the acknowledgment form.
  4. The birthing institution or other entity receiving the voluntary acknowledgment of paternity shall forward the original, signed acknowledgment of paternity to the office of vital records, and shall send a copy of the signed and notarized acknowledgment of paternity to the Title IV-D child support agency where the mother resides, if the mother or child is receiving temporary assistance pursuant to title 71, chapter 3, part 1, medicaid, TennCare, or any successor programs. Copies of the signed and notarized voluntary acknowledgment of paternity shall also be provided to the mother and father of the child. The copies shall be deemed originals.
  5. The department of health shall annually assess the numbers of acknowledgments of paternity as compared with the numbers of out-of-wedlock births by each birthing institution, and shall prepare a report of the results, which shall be provided to the department of human services or other persons or agencies that request it.
  6. Voluntary paternity establishment services through hospitals and the department of health shall be offered in accordance with federal regulations as prescribed by the secretary of health and human services.

Acts 1977, ch. 128, § 6; T.C.A., § 53-442; Acts 1994, ch. 988, § 11; 1997, ch. 551, §§ 36-38; 1998, ch. 891, § 1; 1998, ch. 1098, § 63; 2001, ch. 139, §§ 1-3; 2004, ch. 432, § 1.

NOTES TO DECISIONS

1. Intestate Succession.

Trial court properly ruled that a child was an heir-at-law of the decedent, who died intestate, because the inclusion of the decedent's name on the child's birth certificate evinced the execution of a voluntary acknowledgment of paternity that constituted a legal finding of paternity; therefore, the child's portion of the estate vested in him immediately upon the decedent's death. In re Estate of Davis, — S.W.3d —, 2016 Tenn. App. LEXIS 235 (Tenn. Ct. App. Mar. 30, 2016).

68-3-303. Birth outside institution.

When a birth occurs outside an institution, the certificate shall be prepared and filed by one (1) of the following, in the indicated order of priority:

  1. The physician in attendance at or immediately after the birth, or in the absence of such person;
  2. Any other person in attendance at or immediately after the birth, or in the absence of such person;
  3. The father, the mother, or, in the absence of the father and the inability of the mother, the person in charge of the premises where the birth occurred.

Acts 1977, ch. 128, § 6; T.C.A., § 53-443.

68-3-304. Birth in moving conveyance.

  1. When a birth occurs on a moving conveyance within the United States and the child is first removed from the conveyance in this state, the birth shall be registered in this state and the place where it is first removed shall be considered the place of birth.
  2. When a birth occurs on a moving conveyance while in international waters or airspace or in a foreign country, and the child is first removed from the conveyance in this state, the birth shall be registered in this state; but the certificate shall show the actual place of birth insofar as can be determined.

Acts 1977, ch. 128, § 6; T.C.A., § 53-444.

68-3-305. Father's name on birth certificate — Surname of child.

    1. If the mother was married at the time of either conception or birth, or anytime between conception and birth, to the natural father of the child, the name of the natural father shall be entered on the certificate and the surname of the child shall be entered on the certificate as one of the following:
      1. The surname of the natural father; or
      2. The surname of the natural father in combination with either the mother's surname or the mother's maiden surname.
    2. If the surname of the child includes the mother's surname, mother's maiden surname, or any combination of those two (2) surnames but does not include the surname of the natural father, it may be so entered, but only upon the concurrent submission of a sworn application to that effect signed by both parents who mutually agree to that surname or combination of surnames.
    3. If a surname is not chosen by the parents within the ten (10) days required for filing of the birth certificate, the father's surname shall be entered on the birth certificate as the surname of the child. Within this ten-day period, the father may file and submit a sworn statement to the hospital that states that the parents do not agree on a surname, in which case the father's surname shall be entered on the birth certificate as the surname of the child.
    4. If, within the first year after the child's date of birth, both the mother and the father sign and submit a sworn statement to the office of vital records that both parents wish to change the child's surname, then the office of vital records shall amend the child's birth certificate in accordance with the parents' request to change the child's surname, if the chosen surname is either:
      1. The surname of the natural father;
      2. The surname of the mother;
      3. The mother's maiden surname; or
      4. Any combination of the surnames listed in subdivisions (a)(4)(A)-(C).
    5. If, within the first year after the child's date of birth, the parents cannot mutually agree on a surname, either one can submit a signed, sworn statement that acknowledges the disagreement, states the father was not available within the time allowed by law for filing of the birth certificate to participate in the choice of his child's surname, and requesting that the name be changed to the father's surname, in which case the father's surname shall be entered on the amended birth certificate as the surname of the child.
    1. If the mother was not married at the time of either conception or birth or between conception and birth, the name of the father shall not be entered on the certificate of birth and all information pertaining to the father shall be omitted, and the surname of the child shall be that of either:
      1. The surname of the mother;
      2. The mother's maiden surname; or
      3. Any combination of the surnames listed in subdivisions (b)(1)(A) and (B).
      1. If an original, sworn acknowledgment signed by both the mother and the biological father of a child, on a form provided by the state registrar or the department of human services, is submitted to the office of vital records at any time prior to the child's nineteenth birthday, the legal surname of the father may be entered on the certificate as that of the child, and the father's name and other personal information may be entered in the spaces provided on the birth certificate, notwithstanding the absence of a marriage relationship between the parents of the child.
      2. The acknowledgment form shall be in the form of an affidavit, shall contain the social security numbers of the mother and father of the child and shall be approved by the state registrar and the department of human services. The state registrar and the department of human services shall modify the form to comply with the minimum regulations for the form, which are finalized by the secretary of health and human services. An acknowledgment executed in conformity with this section shall be valid as long as it is executed on a form approved by the state registrar and the department of human services. A voluntary acknowledgment of paternity may be completed by a minor, if a parent or legal guardian of the minor is present and consents at the time of completion of the acknowledgment.
      3. A legitimation by subsequent marriage of the individuals shown on the certificate of birth as the father and mother shall not require a new certificate of birth; and §§ 68-3-310(3), 68-3-311, and 68-3-313 shall not apply.
    2. Upon request of the department of human services or any of its contractors in the child support program established under Title IV-D of the Social Security Act, compiled in 42 U.S.C. § 651 et seq., the office of vital records shall provide to them a certified copy of the acknowledgment of paternity form executed under this part.
  1. In any case in which paternity of a child is determined by a court of competent jurisdiction, the name of the father and surname of the child shall be entered on the certificate of birth in accordance with the finding and order of the court.
  2. In all other cases, the surname of the child shall be either:
    1. The surname of the mother;
    2. The mother's maiden surname; or
    3. Any combination of the surnames listed in subdivisions (d)(1) and (2).
  3. If the father is not named on the certificate of birth, no other information about the father shall be entered on the certificate.

Acts 1977, ch. 128, § 6; T.C.A., § 53-445; Acts 1985, ch. 11, § 2; 1994, ch. 988, § 12; 1997, ch. 551, §§ 40, 42; 2003, ch. 214, §§ 1, 2.

Cross-References. Acknowledgement of paternity at hospital where child born, § 24-7-113.

Legitimation by marriage of parents, § 36-2-304.

Legitimation, new birth certificate, § 68-3-203.

Legitimation not requiring new birth certificate, § 68-3-203.

Paternity and legitimation, title 36, ch. 2, part 3.

Law Reviews.

1985 Tennessee Survey: Selected Developments in Tennessee Law, 53 Tenn. L. Rev. 373 (1986).

Attorney General Opinions. Surname entered on birth certificate. OAG 14-75, 2014 Tenn. AG LEXIS 79 (8/14/14).

T.C.A. § 68-3-305, which restricts the surnames that may be placed on a child’s birth certificate at the time of the child’s birth, does not violate the First Amendment to the U.S. Constitution. OAG 16-38, 2016 Tenn. AG LEXIS 38 (9/21/2016).

NOTES TO DECISIONS

1. Best Interest.

Trial court did not err in declining to change a nonmarital child's surname to that of the father because the father's desire to form a “concrete bond” with the child and his speculative concern about possible “difficulty or embarrassment” for the child did not show that changing the surname was in the child's best interest; the trial court found that keeping the mother's surname was in the child's best interest because there was a degree of community respect associated with the child's present name. In re Jacob H.C., — S.W.3d —, 2013 Tenn. App. LEXIS 751 (Tenn. Ct. App. Nov. 20, 2013).

Trial court erred in changing the child's surname from the mother's surname to the father's as he failed to carry his burden of proof showing that changing the child's surname was in her best interest because he failed to pay child support until the State filed an action for support on behalf of the mother, was not present at the child's birth, and did not contribute to the mother's prenatal or birth expenses; there was nothing in the record to support the trial court's conclusion that changing the child's surname would enhance her relationship with either parent; and the parties agreed that the mother's surname and the father's surname were equally respected in the community, and the child clearly had no preference at six months of age. In re Mattie H., — S.W.3d —, 2015 Tenn. App. LEXIS 290 (Tenn. Ct. App. Apr. 30, 2015).

It was not error to deny a father's petition to change his nonmarital child's surname by deleting the mother's surname and replacing it with the father's surname because the father did not meet his burden to show the change was in the child's best interest, as he merely said the child's name should reflect “his heritage on both sides,” which was insufficient, as there was no proof (1) changing the child's surname would affect the child's relationship with either parent, (2) that either the surname of the mother or of the father maintained a higher degree of respect than the other or (3) that using the father's surname would be more beneficial to the child than using the mother's surname, and (4) the father did not show the child would encounter difficulties or be subject to harassment or embarrassment if the child used the mother's surname. In re Joseph H., — S.W.3d —, 2015 Tenn. App. LEXIS 684 (Tenn. Ct. App. Aug. 25, 2015), appeal denied, — S.W.3d —, 2015 Tenn. LEXIS 1054 (Tenn. Dec. 10, 2015).

Father failed to prove that it was in the child's best interest to change his surname to that of the father rather than the mother where the child preferred his current surname, the mother and school personnel testified that his present surname was respected in the community, and the child had held his surname for over 11 years. Nelson v. Justice, — S.W.3d —, 2019 Tenn. App. LEXIS 35 (Tenn. Ct. App. Jan. 25, 2019).

Trial court did not err in denying the father's petition to change the surnames of his minor children because, although the father's paternity had been established, the evidence did not preponderate against the trial court's findings or against its ultimate conclusion that the father failed to meet his burden to show that a name change was in the children's best interests as the trial court weighed the evidence and the relevant factors in reaching its findings that the children were accustomed to their current surname; that the children would not be embarrassed if their name was not changed; and that it was just as likely that the children would be embarrassed if their name was not the same last name as their mother. Millmeyer v. Whitten, — S.W.3d —, 2019 Tenn. App. LEXIS 543 (Tenn. Ct. App. Nov. 7, 2019).

Trial court erred in changing the surname of a child from the surname of the unmarried mother to the father's surname because there was no evidentiary support for the court's finding that changing the child's surname was in the child's best interest. There was no evidence that a felony conviction by the mother's half-sibling had caused the mother's family name to lose respect in the community, while the court's intent to discourage the mother from future interference in the father's relationship with the child was insufficient. Knipper v. Enfinger, — S.W.3d —, 2020 Tenn. App. LEXIS 393 (Tenn. Ct. App. Aug. 31, 2020).

2. Intestate Succession.

Trial court properly ruled that a child was an heir-at-law of the decedent, who died intestate, because the inclusion of the decedent's name on the child's birth certificate evinced the execution of a voluntary acknowledgment of paternity that constituted a legal finding of paternity; therefore, the child's portion of the estate vested in him immediately upon the decedent's death. In re Estate of Davis, — S.W.3d —, 2016 Tenn. App. LEXIS 235 (Tenn. Ct. App. Mar. 30, 2016).

3. Acknowledgement.

Although, in its 1994 amendment to the Vital Records Act of 1977, T.C.A. § 68-3-305(b), the Legislature did not use the specific term “voluntary acknowledgment of paternity” that it used in T.C.A. § 24-7-113, the Legislature intended the “sworn acknowledgment” or “affidavit” contemplated in § 68-3-305(b) to receive the legal status of a § 24-7-113 voluntary acknowledgment of paternity. In re Estate of Davis, — S.W.3d —, 2016 Tenn. App. LEXIS 235 (Tenn. Ct. App. Mar. 30, 2016).

With the enactment of T.C.A. § 24-7-113, the “affidavits” that had previously been executed under the Vital Records Act of 1977, T.C.A. § 68-3-305(b), are given the status of voluntary acknowledgments of paternity constituting a legal finding of paternity and are entitled to full faith and credit in any judicial proceeding. In re Estate of Davis, — S.W.3d —, 2016 Tenn. App. LEXIS 235 (Tenn. Ct. App. Mar. 30, 2016).

4. Name Change.

Trial court erred in changing the child's surname to the father's surname because there was no evidence that changing the child's surname would improve the relationship between the child and the father. Howell v. Smithwick, — S.W.3d —, 2017 Tenn. App. LEXIS 71 (Tenn. Ct. App. Feb. 1, 2017).

Trial court did not err in changing the child's surname to a hyphenated named comprised of both the father's and mother's surnames given the provisions of T.C.A. § 68-3-305(b)(1), and the fact that the trial court correctly articulated the standard and carefully walked through each of the factors. In re Jalen O-H, — S.W.3d —, 2017 Tenn. App. LEXIS 212 (Tenn. Ct. App. Mar. 29, 2017).

Juvenile court erred in granting the father's request to change the child's surname to a hyphenated version of both parents'  surnames where the only relevant testimony concerned the father's preference, and while the court could take judicial notice that the child had her original surname for seven years at the time of the hearing, the facts necessary to establish any of the other factors were not the proper subject of judicial notice. In re McKenzie Z., — S.W.3d —, 2018 Tenn. App. LEXIS 162 (Tenn. Ct. App. Mar. 27, 2018).

68-3-306. Birth from artificial insemination.

A child born to a married woman as a result of artificial insemination, with consent of the married woman's husband, is deemed to be the legitimate child of the husband and wife.

Acts 1977, ch. 128, § 6; T.C.A., § 53-446.

Law Reviews.

Legal Rights and Issues Surrounding Conception, Pregnancy and Birth, 39 Vand. L. Rev. 597 (1986).

New-Age Babies and Age-Old Laws: The Need for an Intent-Based Approach in Tennessee to Preserve Parent-Child Succession for Children of Assisted Reproductive Technology (Jane Marie Lewis), 43 U. Mem. L. Rev. 479 (2012).

Note: You Are Not the Father! — Parental Liabilities and Rights of Sperm Donors in Tennessee, 47 U. Mem. L. Rev. 597 (2016).

The Art of Having Three Biological Parents, 50 Tenn. B.J. 36 (2014).

NOTES TO DECISIONS

1. In Vitro.

Supreme court determined that the mother of triplets born from another woman's eggs fertilized with her boyfriend's sperm was the legal mother of the children; the determination was based in part on T.C.A. § 68-3-306, which conferred parental status on a husband even though the child conceived in his wife via artificial insemination was not necessarily genetically related to him. In re C.K.G., 173 S.W.3d 714, 2005 Tenn. LEXIS 812 (Tenn. 2005).

2. Legal Mother.

Surrogate mother, rather than the intended parent, was to be listed as the legal parent on the birth certificate of twin children because the children were born of the surrogate mother, pursuant to a surrogacy agreement, from an anonymously donated egg and the intended father's sperm. In re Amadi A., — S.W.3d —, 2015 Tenn. App. LEXIS 251 (Tenn. Ct. App. Apr. 24, 2015).

3. Construction.

In the context of the broader statutory scheme, the statute does not create the relationship that the non-biological parent advocated or confer any rights of parentage; the marriage-neutral construction she urged was a strained interpretation of the natural and ordinary meaning of the statutory language. Pippin v. Pippin, — S.W.3d —, 2020 Tenn. App. LEXIS 220 (Tenn. Ct. App. May 14, 2020).

Even if the statute were construed to create a right of visitation on the part of the husband of a woman who has given birth to a child by artificial insemination, that right would be predicated upon the child being born to a married woman; inasmuch as the non-biological parent's petition stated that she and the mother were not married at the time of the child's birth nor at any time afterward, the statute did not provide the non-biological parent with standing and thus could not be used to support a claim for visitation with the child. Pippin v. Pippin, — S.W.3d —, 2020 Tenn. App. LEXIS 220 (Tenn. Ct. App. May 14, 2020).

68-3-307. Infants of unknown parentage — Foundling registration.

  1. Whoever assumes the custody of a live-born infant of unknown parentage shall report on a form and in a manner prescribed by the state registrar within ten (10) days to the office of vital records the following information:
    1. The date and place of finding;
    2. Sex, color or race, and approximate birth date of the child;
    3. Name and address of the person or institution with whom the child has been placed for care;
    4. Name given to the child by the custodian of the child; and
    5. Other data required by the state registrar.
  2. The place where the child was found shall be entered as the place of birth.
  3. A report registered under this section shall constitute the certificate of birth for the child.
  4. If the child is subsequently identified and a certificate of birth is found or obtained, the report registered under this section shall not be subject to inspection, except upon order of a court of competent jurisdiction or as provided by regulation.

Acts 1977, ch. 128, § 7; T.C.A., § 53-447.

68-3-308. Delayed registration of birth.

  1. When the birth of a person born in this state has not been filed within the time period provided in §§ 68-3-301 and 68-3-302, a certificate of birth may be filed in accordance with regulations of the office of vital records. The certificate shall be registered subject to such evidentiary requirements as the office of vital records shall, by regulation, prescribe to substantiate the alleged facts of birth.
  2. A certificate of birth registered six (6) months or more after the date of birth shall be marked “delayed” and show on its face the date of the delayed registration.
  3. A summary statement of the evidence submitted in support of the delayed registration shall be endorsed on the certificate.
  4. When an applicant does not submit the minimum documentation required in the regulations for delayed registration or when the state registrar has reasonable cause to question the validity or adequacy of the applicant's sworn statement or the documentary evidence, and if the deficiencies are not corrected, the state registrar shall not register the delayed certificate of birth and shall advise the applicant of the reason for this action.

Acts 1977, ch. 128, § 8; T.C.A., § 53-448.

68-3-309. Judicial determination of facts of birth.

  1. If a delayed certificate of birth is rejected under § 68-3-308, a petition signed and sworn to by the petitioner may be filed with a court of competent jurisdiction for an order establishing a record of the date and place of the birth and the parentage of the person whose birth is to be registered.
  2. The petition shall allege that:
    1. The person for whom a delayed certificate of birth is sought was born in this state;
    2. No certificate of birth can be found in the office of vital records; and
    3. Diligent efforts by the petitioner have failed to obtain the evidence required in accordance with § 68-3-308 and regulations adopted pursuant to § 68-3-308.
  3. The petition shall be accompanied by a statement of the state registrar made in accordance with § 68-3-308 and all documentary evidence that was submitted to the state registrar in support of registration.
  4. The court shall fix a time and place for hearing the petition and shall give the state registrar twenty-one (21) days' notice of the time and place for hearing the petition. The state registrar or the state registrar's authorized representative may appear and testify in the proceeding.
  5. If the court finds, from the evidence presented, that the person for whom a delayed certificate of birth is sought was born in this state, it shall make findings as to the place and date of birth, parentage, and other findings the case may require, and shall issue an order to establish a certificate of birth. This order shall include the birth data to be registered, a description of the evidence presented, and the date of the court's action.
  6. The clerk of the court shall forward each order to the state registrar no later than forty (40) days from entry of the order. The order shall be registered by the state registrar and shall constitute the authority for placing a delayed certificate of birth on file.
  7. The person for whom the delayed certificate of birth is sought or the person's parent or legal guardian shall sign the delayed certificate form furnished by the state registrar before a notary public or other person authorized to administer oaths, unless the registrant is deceased or deemed incompetent.

Acts 1977, ch. 128, § 9; T.C.A., § 53-449.

68-3-310. New certificate of birth — Prerequisites.

The state registrar shall prepare a new certificate of birth for a person born in Tennessee, upon receipt of required legal documents, as provided in the following cases:

  1. Adoption.  A certified copy of adoption or certified copy of final decree of adoption and request for new certificate of birth by adoption;
  2. Legitimation by Court Order in Cases Where the Parents Have Never Married.  A certified copy of an order of legitimation that establishes the relationship of parent and child between the petitioner and child named in the petition, decrees the name the child is to bear, and a request for new certificate of birth by legitimation on a form provided by the state registrar that furnishes information for locating the certificate of birth in the original name and information concerning parents to be entered on the new certificate;
  3. Legitimation by Subsequent Marriage of Parents.  A certified copy of the marriage certificate or certificate of marriage of parents, and affidavits of the mother and father acknowledging paternity on a form provided by the state registrar. The form shall furnish information for locating the certificate of birth in the original name and information concerning the parents to be entered on the new certificate. If the father is deceased, in lieu of the father's affidavit, the state registrar shall accept a certified copy of a bill or petition for divorce or sworn answer to a bill or petition for divorce properly filed, in which the husband, by oath, acknowledged himself as father of the child or children named in the bill or petition for divorce or the answer, or a certified copy of an order, judgment or decree in which the court determined the deceased husband to be the father of the child or children and had acknowledged paternity of the child or children, whether heard on an ex parte or contested proceeding;
  4. Order of Paternity.  A certified copy of an order of paternity or a certificate of paternity on a form provided by the state registrar that furnishes information for locating the certificate of birth in the original name, establishes the name of the father, and decrees the name the child is to bear; and
  5. Report of Foreign Birth.  The state registrar shall prepare a report of foreign birth for a child not born in any state, territory or possession of the United States whose adoptive parents are residents of Tennessee when required adoption papers have been received from a court of competent jurisdiction in Tennessee.

Acts 1977, ch. 128, § 12; T.C.A., § 53-450.

Cross-References. Legitimation not requiring new birth certificate, §§ 68-3-203, 68-3-305.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, V. Children (Neil P. Cohen), 45 Tenn. L. Rev. 451.

68-3-311. New certificate of birth — Adoptions, legitimations, and orders of paternity — Preparation and filing.

    1. New certificates of birth shall be prepared on adoptions, legitimations and orders of paternity only.
    2. All orders of adoption, legitimation and paternity shall be final, and all required legal papers placed on file in the office of vital records.
    3. The certificate of birth in the original name shall be removed from the volume and a record inserted that shall show the original certificate number, date removed and code citation.
    4. The birth shall have occurred in Tennessee and a certificate of birth in the original name shall be on file in the department.
    1. The new certificate shall be prepared on a standard form in current use in the department and shall be signed by the state registrar in the space provided for the signature of the attendant at birth.
    2. The new certificate shall show the date of birth, place of birth, sex, and date of filing as shown on the certificate of birth in the original name.
    3. A new certificate of birth by adoption shall show the residence of the adoptive parent or parents as at the time the final order of adoption was granted.
    1. When a final order of adoption has been granted to only one (1) petitioner and upon receipt of a certified request of the petitioner, the word “adoption” may be entered on the new certificate of birth in the space provided for the information concerning the other parent.
    2. The certified request shall be furnished to the state registrar prior to the preparation of the new certificate.
    3. A new certificate of birth by adoption shall not be prepared if so requested by the court that granted the adoption, the adoptive parent or parents, or the adopted person.
    1. A certificate of birth in the original name that indicates a legitimate birth and another person as father shall not be removed for the preparation of a new certificate of birth by legitimation, unless an order from a court of competent jurisdiction refuting such facts as set forth by regulation is furnished to the state registrar.
    2. A new certificate of birth shall not be prepared for the person in the instance where the person's father and mother were married prior to the birth of the person and the original certificate indicates another person as father or an illegitimate birth.
    3. The certificate of birth in the original name shall be amended in accordance with regulations to show correct facts at the time of the birth.
  1. Upon receipt from the juvenile court clerk of an order of legitimation as provided in § 36-2-206 [repealed], or an order of paternity, a new certificate of birth shall be issued, regardless of the age of the person named in any such order.
  2. When an order of paternity has been granted on an unborn infant, the original certificate of birth shall be prepared and filed in accordance with the laws and regulations of the department, and a new certificate by paternity shall be prepared upon receipt of the required legal papers from the court.

Acts 1977, ch. 128, § 11; T.C.A., § 53-451; Acts 1988, ch. 574, § 1.

Compiler's Notes.  Former § 36-2-206, referred to in this section, was repealed by Acts 1997, ch. 477, § 1, effective July 1, 1997.

Cross-References. Legitimation not requiring new birth certificate, §§ 68-3-203, 68-3-305.

68-3-312. New certificate of birth — Court report of adoption.

  1. For each final decree of adoption by a court of competent jurisdiction in Tennessee, the court shall require the preparation of a report of adoption on a form prescribed and furnished by the state registrar.
  2. For each amendment or annulment of an order of adoption, the clerk of the court shall prepare a report thereon, which shall include such facts as are necessary to identify the original report of adoption and those facts amended in the adoption decree, and forward a certified copy of the report to the state registrar.
  3. The child-placing agency or, in family adoptions, the attorney or petitioners, shall complete, on a form furnished by the state registrar, the request for a new certificate of birth by adoption and shall file this form with the clerk of the court to be forwarded to the state registrar with the certified report of adoption when the final order has been granted. This form shall furnish information for locating the certificate of birth in the original name and information concerning the adoptive parent or parents to be entered on the new certificate. The form shall be signed by the petitioner or petitioners to whom the final decree was granted and, in stepparent adoptions, the adoptive and natural parent.
  4. No later than the tenth day of each calendar month or as directed by the state registrar, the clerk of the court shall forward to the state registrar the certified report of adoption, annulment or amendment to the adoption decree and the request for a new certificate of birth by adoption.
  5. When the state registrar receives a report of adoption, annulment or amendment to the decree of adoption from the clerk of the court for a person born in another state, the report shall be forwarded to the state registrar in the state of birth. If the birth occurred in a foreign country, the report of adoption shall be returned to the attorney or agency handling the adoption for submission to the appropriate federal agency.
  6. Upon receipt of a certified copy of the final decree of adoption, or certified report of adoption prepared in accordance with the laws of another state or foreign country, and the request for a new certificate of birth by adoption, the state registrar shall prepare and file a new certificate of birth in the adopted name for a person born in Tennessee, if not in conflict with Tennessee adoption laws.

Acts 1977, ch. 128, § 10; T.C.A., § 53-452.

68-3-313. New certificate of birth — Sealing of documents.

    1. All legal documents pertaining to the adoption, legitimation or order of paternity, together with the certificate of birth in the original name, shall be placed in an envelope and sealed following the preparation of the new certificate.
    2. These sealed documents shall be preserved in a fireproof vault in the department and shall not be removed from that office, except by order of a court of competent jurisdiction.
    3. The sealed documents shall be opened by the state registrar for the purpose of issuing a copy of the certificate in the name at birth, upon receipt of a certified copy of an order of the court that granted the adoption, legitimation, or order of paternity or in legitimations by subsequent marriage of the parents or upon receipt of a directive from the department of human services consistent with § 36-1-126, § 36-1-127 or § 36-1-130.
    4. Upon receipt of a certified copy of an order from the court of competent jurisdiction ordering the annulment of an order of adoption, legitimation, or order of paternity or the replacement of a certificate of birth in the original name on file, the state registrar shall open the sealed documents, replace the certificate of birth in the original name in the volume of births in which originally filed, remove the new certificate, and place it under seal with the legal documents and the certified copy of the court order.
  1. When a new certificate of birth has been filed by the state registrar, all copies of the record of birth in the original name in the custody of any other party shall be forwarded to the state registrar upon receipt of the state registrar's request.

Acts 1977, ch. 128, § 13; T.C.A. § 53-453; Acts 1995, ch. 532, § 16.

Cross-References. Confidentiality of public records, § 10-7-504.

Legitimation not requiring new birth certificate, §§ 68-3-203, 68-3-305.

68-3-314. Notice to be provided to parent or legal guardian of newborn child regarding security freezes on records of individuals under 16 years of age.

When a birth occurs:

  1. In an institution or en route to an institution, the person in charge of the institution, or that person's designated representative, shall provide the notice described in § 47-18-2111(m), to the mother, father, or legal guardian of the child; or
  2. On a moving conveyance as described in § 68-3-304, the office of vital records shall provide the notice described in § 47-18-2111(m), to the mother, father, or legal guardian of the child in conjunction with any issued certificate of birth.

Acts 2015, ch. 282, § 2.

Effective Dates. Acts 2015, ch. 482, § 2. January 1, 2016.

Part 4
Marriages, Annulments and Divorces

68-3-401. Marriage registration.

  1. A record of each marriage performed in this state shall be filed with the office of vital records and shall be registered, if it has been completed and filed in accordance with this section.
  2. The official who issues the marriage license shall prepare the record on the form prescribed and furnished by the state registrar on the basis of information obtained from the parties to be married. The form for a certificate of marriage shall contain a place for the recording of the married persons' social security numbers, and those numbers shall be recorded on the certificate and on any forms necessary to prepare such certificate. This information shall be provided in the record submitted to the office of vital records by the county clerk.
  3. Every person who performs a marriage shall certify the fact of marriage and return the record to the official who issued the license within three (3) days after the ceremony.
  4. Every official issuing marriage licenses shall complete and forward to the office of vital records, on or before the tenth day of each calendar month, the records of marriages filed with the official during the preceding calendar month.
  5. A marriage record not filed within the time prescribed by statute may be registered in accordance with regulations of the office of vital records.
  6. If a license to marry has been obtained by incorrect identification, the fraudulent record shall be voided and a correct certificate of marriage placed on file by order of the court in the county where the license was issued, in accordance with regulations established by the department.

Acts 1977, ch. 128, § 19; T.C.A., § 53-461; Acts 1997, ch. 551, § 32; 2008, ch. 924, § 15.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, III. Marriage Formalities (Neil P. Cohen), 45 Tenn. L. Rev. 430.

68-3-402. Divorce, dissolution of marriage, and annulment — Registration.

  1. For each divorce, dissolution of marriage, or annulment granted by any court in this state, a record shall be filed by the clerk of the court with the office of vital records and shall be registered, if it has been completed and filed in accordance with this section.
  2. The clerk of the court shall complete and forward to the office of vital records, on or before the tenth day of each calendar month, the record of each divorce, dissolution of marriage, or annulment filed with the clerk during the preceding calendar month. The form for a certificate of divorce shall contain a place for the recording of the divorced persons' social security numbers and such numbers shall be recorded on the certificate and any forms necessary to prepare such certificate. This information shall be provided in the record submitted to the office of vital records by the court clerk.

Acts 1977, ch. 128, § 20; T.C.A., § 53-462; Acts 1997, ch. 551, § 33; 2005, ch. 429, § 16.

Part 5
Deaths

68-3-501. Uniform Determination of Death Act.

  1. This section may be cited as the “Uniform Determination of Death Act.”
  2. An individual who has sustained either:
    1. Irreversible cessation of circulatory and respiratory functions; or
    2. Irreversible cessation of all functions of the entire brain, including the brain stem;

      is dead. A determination of death must be made in accordance with accepted medical standards.

  3. This section shall be applied and construed to effectuate its general purpose to make uniform the law with respect to the subject of this section among states enacting it.

Acts 1976, ch. 780, § 1; 1982, ch. 763, §§ 1-4; T.C.A., § 53-459.

Cross-References. Disposition of dead bodies, title 68, ch. 4.

Textbooks. Pritchard on Wills and Administration of Estates (4th ed., Phillips and Robinson), § 918.

Law Reviews.

Termination of Life Support Systems for Minor Children: Evolving Legal Responses (John M. Scheb), 54 Tenn. L. Rev. 1 (1986).

Cited: State v. Brobeck, 751 S.W.2d 828, 1988 Tenn. LEXIS 96, 76 A.L.R.4th 1137 (Tenn. 1988).

Collateral References.

Judicial power to order discontinuance of life-sustaining treatment. 48 A.L.R.4th 67.

Tests of death for organ transplant purposes. 76 A.L.R.3d 913.

68-3-502. Death registration.

    1. A death certificate for each death that occurs in this state shall be filed with the office of vital records or as otherwise directed by the state registrar within five (5) days after death and prior to final disposition, or as prescribed by regulations of the department. It shall be registered, if it has been completed and filed in accordance with this section.
    2. If the place of death is unknown but the body is found in this state, the death certificate shall be completed and filed in accordance with this section. The place where the body is found shall be shown as the place of death. If the date of death is unknown, it shall be determined by the date the body was found.
    3. When death occurs in a moving conveyance in the United States and the body is first removed from the conveyance in this state, the death shall be registered in this state and the place where it is first removed shall be considered the place of death. When a death occurs on a moving conveyance while in international waters or airspace or in a foreign country and the body is first removed from the conveyance in this state, the death shall be registered in this state; but the certificate shall show the actual place of death insofar as can be determined.
  1. The funeral director, or person acting as funeral director, who first assumes custody of the dead body shall file the death certificate. The funeral director shall obtain the personal data from the next of kin or the best qualified person or source available, and shall obtain the medical certification from the person responsible for medical certification, as set forth in subsection (c).
    1. The medical certification shall be completed, signed and returned to the funeral director by the physician in charge of the patient's care for the illness or condition that resulted in death within forty-eight (48) hours after death, except when inquiry is required by the county medical examiner. In the absence of the physician, the certificate may be completed and signed by another physician designated by the physician or by the chief medical officer of the institution in which the death occurred. In cases of deaths that occur outside of a medical institution and are either unattended by a physician or not under hospice care, the county medical examiner shall investigate and certify the death certificate when one (1) of the following conditions exists:
      1. There is no physician who had attended the deceased during the four (4) months preceding death, except that any physician who had attended the patient more than four (4) months preceding death may elect to certify the death certificate if the physician can make a good faith determination as to cause of death and if the county medical examiner has not assumed jurisdiction; or
      2. The physician who had attended the deceased during the four (4) months preceding death communicates, orally or in writing, to the county medical examiner that, in the physician's best medical judgment, the patient's death did not result from the illness or condition for which the physician was attending the patient.
    2. Sudden infant death syndrome shall not be listed as the cause of death of a child, unless the death meets the definition set forth in chapter 1, part 11 of this title.
      1. In addition to this section, prior to signing medical certification of the cause of death, the physician, chief medical officer or medical examiner shall require screening x-rays of the skull, long bones and chest of any child who was not subject to an autopsy and who died of unknown causes or whose death is suspected to be from sudden infant death syndrome.
      2. The physician, chief medical officer or medical examiner who orders the x-ray examinations pursuant to this section shall be entitled to a reasonable fee as set by the commissioner of health for the costs of the x-ray examinations, to be paid from the funds allotted to the postmortem examiners program in the department of health.
  2. When inquiry is required, the medical examiner shall determine the cause of death and shall complete and sign the medical certification within forty-eight (48) hours after taking charge of the case. On or before January 1, 2013, the commissioner of health shall establish by rule a protocol for use by medical examiners in cases involving death resulting from opiate, illegal or illicit drug overdose, that requires an appropriate report under § 38-7-108. The commissioner is authorized to promulgate such rules in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  3. If the cause of death cannot be determined within forty-eight (48) hours after death, the medical certification shall be completed as provided by regulation. The attending physician or medical examiner shall give the funeral director, or person acting as funeral director, notice of the reason for the delay; and final disposition of the body shall not be made until authorized by the attending physician or medical examiner.
  4. If the death occurs in a military or veteran's hospital or in a state veteran's home in the state of Tennessee, the death certificate may be signed by the attending physician who holds a license in another state.
  5. In the event a person is dead on arrival at a military or veteran's hospital or at a state veteran's home in the state of Tennessee, the death certificate may be signed by a physician who is employed by one (1) of these institutions and who holds a license in another state.
  6. The form for a certificate of death shall contain a place for the recording of the deceased's social security number and the social security number shall be recorded on the certificate and on any forms necessary to prepare the certificate.
    1. Notwithstanding this section to the contrary, this subsection (i) governs manner of death determinations of death investigations for which suicide is suspected or determined to be the manner of death.
    2. If a county medical examiner suspects that suicide may be a potential manner of death, then the medical examiner shall consult the decedent's treating mental health professional or primary care physician, if known and reasonably able to be identified through the decedent's next of kin, prior to determination of manner of death.
      1. After inquiry by a county medical examiner pursuant to title 38, chapter 7, part 1, the medical examiner shall enter the manner of death and file the death certificate. If the manner of death is suicide and the next of kin disagrees with the manner of death determination, then the next of kin may contact the county medical examiner who performed the autopsy to request a meeting. The county medical examiner shall meet with the next of kin within thirty (30) calendar days of that initial contact by the requesting next of kin or, if more time is needed to gather documentation, on a mutually acceptable date. The meeting must be either in person or via teleconference, at the discretion of the requesting next of kin. At the meeting, each party must present the reasons supporting their position with respect to the manner of death, including any relevant documentation.
      2. Within thirty (30) calendar days of the meeting with the next of kin, the county medical examiner shall make a written determination on the manner of death and notify the next of kin. The notification must address the next of kin's specific bases for disagreement, inform the next of kin of their right to seek reconsideration from the office of the state chief medical examiner (OSCME), and include information on how to request the reconsideration. The notification must also inform the next of kin of their right to seek judicial review.
      1. Within one hundred twenty (120) calendar days of the notification of the manner of death from the county medical examiner, the next of kin may request reconsideration from the OSCME in writing.
      2. Within fifteen (15) calendar days of receiving the reconsideration request, the OSCME shall notify the county medical examiner of the reconsideration request and request all records and documentation from the county medical examiner and the next of kin.
      3. The county medical examiner shall send the requested records and documentation to the OSCME within fifteen (15) calendar days of receiving the request.
        1. (a)  Upon receipt of the records and documentation, the state chief medical examiner shall convene a peer review panel to conduct the reconsideration.
        2. The peer review panel shall complete the reconsideration within ninety (90) calendar days of the date the OSCME receives the records and documentation from the county medical examiner. If the initial review indicates a need for additional investigation, then the peer review panel may use an additional ninety (90) calendar days to finalize their findings and must send written notification to the next of kin that the extra ninety-calendar-day period is necessary.
        3. Once the members of the peer review panel have completed the review of the records and documentation, the members shall vote on a manner of death determination. The state chief medical examiner shall not vote except in the event of a tie vote among all other panel members. A manner of death that achieves a simple majority of all panel members prevails, at which time a reconsideration investigation is deemed complete.
        4. The state chief medical examiner shall prepare a written report of the peer review panel's findings and decision and shall detail in the report the panel's reasoning for its decision and an explanation of any additional investigation that was done. The state chief medical examiner shall send a copy of the report to the next of kin and the county medical examiner within fifteen (15) calendar days of the completion of the investigation.
      1. If the findings of a reconsideration conducted pursuant to subdivision (i)(4) support the original manner of death determination made by the county medical examiner, then the next of kin may appeal that decision to a court of competent jurisdiction.
      2. If the findings of a reconsideration conducted pursuant to subdivision (i)(4) support a manner of death determination other than suicide, then the state chief medical examiner shall, no later than fifteen (15) calendar days after the date of the written report, amend the manner of death.
      1. Next of kin may terminate a reconsideration process requested pursuant to this subsection (i) at any time and for any reason by written notice to the OSCME of their intent to terminate the reconsideration.
      2. Next of kin may seek judicial review at any time during the reconsideration process following the receipt of the original death certificate by written notice to the OSCME of their intent to seek judicial review.
    3. By requesting reconsideration under this subsection (i), the next of kin authorizes release of any medical records, hospital records, investigative reports, or other documentary evidence of the deceased that the peer review panel deems necessary to complete the reconsideration.
    4. The department of health shall maintain a notice of decedent's next of kin rights with regard to this subsection (i) on its public website.
    5. As used in this subsection (i), “next of kin” means the person who has the highest priority pursuant to § 62-5-703.
    6. This subsection (i) applies only when the manner of death is suspected or determined to be suicide.
    7. A physician, who acts in good faith to comply with this subsection (i), is immune from individual civil liability in the absence of gross negligence or willful misconduct for actions authorized by this subsection (i).
    8. Unrelated parties have no liability for relying on the original death certificate, without regard to subsequent revision under this part.
    9. OSCME shall maintain statistics on the number of reconsideration requests, the number of manner of death determinations that are upheld or overturned, and the number of next of kin terminations of a reconsideration process before the issuance of final findings. The OSCME may also maintain additional information relative to the reconsideration requests that may assist in carrying out other functions of the office.

The peer review panel must consist of the state chief medical examiner and all chief medical examiners of the regional forensic centers except for the chief medical examiner of the regional forensic center for the region in which the autopsy was performed. The state chief medical examiner shall serve as chair of the peer review panel.

The chief medical examiners of the regional forensic centers may each appoint a designee to serve on the peer review panel. The designee must be a forensic pathologist licensed in this state who is employed by the regional forensic center.

The state chief medical examiner may distribute records and documentation to the peer review panel members by electronic means. The panel may meet remotely via teleconference or video conference.

Acts 1977, ch. 128, § 14; T.C.A., § 53-471; Acts 1992, ch. 886, § 1; 1997, ch. 551, § 34; 1998, ch. 1077, §§ 1, 2; 2001, ch. 321, § 4; 2008, ch. 866, § 1; 2012, ch. 916, § 2; 2017, ch. 493, § 1; 2018, ch. 714, § 1; 2019, ch. 343, § 1.

Compiler's Notes. Acts 2012, ch. 916, § 3 provided that the act, which amended subsection (d), shall be known and may be cited as the  “The Henry Granju Act.”

Acts 2018, ch. 714, § 2 provided that the act, which amended this section, shall apply to request for reconsideration submitted on or after June 13, 2017.

Acts 2019, ch. 343, § 2 provided that the act, which amended this section, applies to manner of death determinations made on or after May 10, 2019.

Amendments. The 2017 amendment added (i).

The 2018 amendment, in (i), inserted “the medical examiner determines a decedent's manner of death to be suicide and” in (2)(A), inserted “pursuant to subdivision (i)(2)(A)” in (2)(B), substituted “after receiving written notice of the reconsideration request pursuant to subdivision (i)(2)(B),” for “after receiving notice of the reconsideration request,” in the first sentence of (3), inserted “made pursuant to subdivision (i)(3),” in (4), substituted “made pursuant to subdivision (i)(3), the county medical examiner does not find that a change in, the manner of death is warranted and” for the comma following “ If, after reconsideration” at the beginning of (5)(A), inserted “made pursuant to subdivision (i)(5)” in (6)(A), and added (9) and (10).

The 2019 amendment rewrote (i) which read: “(i)(1)  When a county medical examiner suspects that suicide may be a potential manner of death, the medical examiner is encouraged to consult the decedent's treating mental health professional, if known or applicable, prior to determination of manner of death.“(2)(A)  If, after inquiry by the county medical examiner pursuant to title 38, chapter 7, part 1, the medical examiner determines a decedent's manner of death to be suicide and the deceased's next of kin disputes the manner of death determination on the death certificate, the next of kin may seek reconsideration of the manner of death determination.“(B)  To seek reconsideration pursuant to subdivision (i)(2)(A), the next of kin must submit a written request for reconsideration to the county medical examiner who signed the death certificate, the chief medical examiner of the regional forensic center where the autopsy was performed, and the commissioner of health, stating the nature and reasons for the reconsideration. If the county medical examiner who signed the death certificate is no longer the county medical examiner, then the notice shall be sent to the current county medical examiner instead. The written request for reconsideration must be submitted within one (1) year of the date the death certificate is filed with the office of vital records and must be supported by a signed affidavit.“(3)  Within thirty (30) days after receiving written notice of the reconsideration request pursuant to subdivision (i)(2)(B), the county medical examiner shall meet with the requesting next of kin. The meeting shall be either in person or via teleconference, at the discretion of the requesting next of kin. At the meeting, each party shall present the reasons supporting their position with respect to the manner of death, including any relevant documentation. The county medical examiner shall make a written determination on the reconsideration within thirty (30) days after the reconsideration meeting and shall notify the requesting next of kin, the chief medical examiner of the regional forensic center where the autopsy was performed, and the commissioner of health in writing. If the medical examiner who signed the medical certification is no longer in a position as county medical examiner, then the current county medical examiner shall participate in the reconsideration meeting and issue the written determination on the reconsideration instead.“(4)  If, after reconsideration made pursuant to subdivision (i)(3), the county medical examiner finds a change in the manner of death determination is warranted, the county medical examiner shall file an affidavit within thirty (30) days directing the office of vital records to issue an amended death certificate to reflect the county medical examiner's findings as to manner of death.“(5)(A)  If, after reconsideration made pursuant to subdivision (i)(3), the county medical examiner does not find that a change in the manner of death is warranted and the determination of manner of death is still disputed by the requesting next of kin, the requesting next of kin may seek further review of the determination by petitioning the chief medical examiner of the regional forensic center in which the autopsy was performed, on a form prescribed by the department of health, to review the medical records, hospital records, death certificate, investigative reports, and any other documentary evidence deemed necessary of the deceased. The chief medical examiner of the regional forensic center shall respond to the requesting next of kin detailing the findings within thirty (30) days with a written report. The report shall state whether the chief medical examiner of the regional forensic center agrees with the determination of manner of death on the death certificate, and, if the chief medical examiner of the regional forensic center disagrees with the determination of manner of death on the death certificate, the report shall detail those findings and the basis for the disagreement. The report shall be sent to the next of kin and the commissioner of health.“(B)  If the chief medical examiner of the regional forensic center finds a change in the manner of death determination is warranted, the chief medical examiner shall file an affidavit within thirty (30) days directing the office of vital records to issue an amended death certificate to reflect the chief medical examiner's findings as to manner of death.“(6)(A)  If, after review by the chief medical examiner of the regional forensic center made pursuant to subdivision (i)(5), the determination of manner of death is unchanged, then the requesting next of kin may seek mediation with the chief medical examiner of the regional forensic center with a Rule 31 mediator under the Rules of the Supreme Court of Tennessee, at the sole expense of the requesting next of kin.“(B)  If the chief medical examiner of the regional forensic center finds a change in the manner of death determination is warranted following mediation, the chief medical examiner shall file an affidavit within thirty (30) days directing the office of vital records to issue an amended death certificate to reflect the chief medical examiner's findings as to manner of death.“(7)  The department of health shall maintain a notice of decedents' next of kin rights with regard to this subsection (i) on its public website.“(8)  As used in this subsection (i), “next of kin” means the person who has the highest priority pursuant to § 62-5-703.“(9)  This subsection (i) applies only when the manner of death is determined to be suicide.“(10)  Unrelated parties have no liability for relying on the original death certificate, without regard to subsequent revision under this part.”

Effective Dates. Acts 2017, ch. 493, § 2. June 13, 2017.

Acts 2018, ch. 714, § 2. April 12, 2018.

Acts 2019, ch. 343, § 2. May 10, 2019.

Cross-References. Disposition of dead bodies, title 68, ch. 4.

Notification of deaths to coordinator of elections, § 2-2-133.

Sudden, unexplained child death, title 68, ch. 1, part 11.

68-3-503. Delayed registration of death.

  1. When a death occurring in this state has not been registered within the time period prescribed by § 68-3-502, a certificate may be filed in accordance with the regulations of the department. The certificate shall be registered subject to such evidentiary requirements as the department shall, by regulation, prescribe to substantiate the alleged facts of death.
  2. Certificates of death registered six (6) months or more after the date of death shall be marked “delayed.”

Acts 1977, ch. 128, § 15; T.C.A., § 53-472.

68-3-504. Reports of fetal death.

    1. Each fetal death of three hundred fifty (350) grams or more or of twenty (20) completed weeks' gestation or more, that occurs in this state, shall be reported to the office of vital records within ten (10) days after delivery.
    2. When a dead fetus is delivered in an institution, the person in charge of the institution, or the person's designated representative, shall prepare and file the report.
    3. When a dead fetus is delivered outside an institution, the physician in attendance at or immediately after the delivery shall prepare and file the report.
  1. The name of the father shall be entered on the fetal death report, in accordance with § 68-3-305.
  2. When a fetal death required to be reported by this section occurs without medical attendance at or immediately after the delivery, or when inquiry is required, the medical examiner shall investigate the cause and shall prepare and file the report.

Acts 1977, ch. 128, § 16; 1979, ch. 117, § 1; T.C.A., § 53-473; Acts 1998, ch. 969, §§ 1, 2; 2010, ch. 778, §§ 2, 4.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, IX. Abortion (Neil P. Cohen), 45 Tenn. L. Rev. 498.

68-3-505. Reports of abortions — Information to be included.

  1. Each induced termination of pregnancy that occurs in this state shall be reported to the office of vital records within ten (10) days after the procedure by the person in charge of the institution in which the induced termination of pregnancy was performed. If the induced termination of pregnancy was performed outside an institution, the attending physician shall prepare and file the report. Each such report shall indicate whether the abortion involved a surgical procedure and, if so, which method was employed, and shall indicate which method authorized by the rules of the board for licensing healthcare facilities was employed to dispose of the aborted fetus or aborted fetal tissue. If the aborted fetus or aborted fetal tissue was transferred to a third party for disposition, the report shall indicate the name and address of the third party and the date of the transfer.
  2. The individual undergoing the induced termination of pregnancy shall not be identified by name on the report, though some means of identification shall be used to provide retrieval of further information if necessary.

Acts 1977, ch. 128, § 17; T.C.A., § 53-474; Acts 2016, ch. 1003, § 4.

Compiler's Notes.  Acts 2016, ch. 1003, § 7 provided that notwithstanding this act or the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, any rule promulgated to implement the provisions of this act shall be provided to the chairs of the health committee of the house of representatives and the health and welfare committee of the senate by the secretary of state, after approval by the attorney general and reporter, at the same time the text of the rule is made available to the government operations committees of the senate and the house of representatives for purposes of conducting the review required by § 4-5-226 in order for the health committee of the house of representatives and the health and welfare committee of the senate to be afforded the opportunity to comment on the rule.

Amendments. The 2016 amendment added the last two sentences in (a).

Effective Dates. Acts 2016, ch. 1003, § 8. April 27, 2016.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, IX. Abortion (Neil P. Cohen), 45 Tenn. L. Rev. 498.

68-3-506. Authorization for final disposition of a dead fetus.

  1. Prior to final disposition of a dead fetus, regardless of the duration of pregnancy, the funeral director, the person in charge of the institution, or other person assuming responsibility for final disposition of the fetus, shall obtain from the mother authorization for final disposition on a form prescribed and furnished, or approved by the state registrar.
  2. When the demise of the fetus is the result of a surgical abortion, a copy of the mother's authorization for disposition, specifying the means of the disposition, shall be appended to the informed consent signed by the mother prior to the procedure pursuant to § 39-15-202.
  3. After final disposition, the authorization shall be retained for a period of three (3) years by the funeral director, the person in charge of the institution, or other person making the final disposition.

Acts 1977, ch. 128, § 18; T.C.A., § 53-475; Acts 2016, ch. 1003, § 5.

Compiler's Notes.  Acts 2016, ch. 1003, § 7 provided that notwithstanding this act or the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, any rule promulgated to implement the provisions of this act shall be provided to the chairs of the health committee of the house of representatives and the health and welfare committee of the senate by the secretary of state, after approval by the attorney general and reporter, at the same time the text of the rule is made available to the government operations committees of the senate and the house of representatives for purposes of conducting the review required by § 4-5-226 in order for the health committee of the house of representatives and the health and welfare committee of the senate to be afforded the opportunity to comment on the rule.

Amendments.  The 2016 amendment substituted “obtain from the mother” for “obtain from the parents” in (a), added (b), and redesignated former (b) as (c).

Effective Dates. Acts 2016, ch. 1003, § 8. April 27, 2016.

Cross-References. Disposition of dead bodies, title 68, ch. 4.

Law Reviews.

A Critical Survey of Developments in Tennessee Family Law in 1976-77, IX. Abortion (Neil P. Cohen), 45 Tenn L. Rev. 498.

68-3-507. Moving body from place of death.

With the consent of the physician or medical examiner who is to certify the cause of death, a body may be moved from the place of death for the purpose of being prepared for final disposition.

Acts 1977, ch. 128, § 18; T.C.A., § 53-476.

Cross-References. Disposition of dead bodies, title 68, ch. 4.

68-3-508. Disinterment and reinterment.

  1. Authorization for disinterment and reinterment, in cases of movement of cemeteries or parts of cemeteries or for reuniting families, shall be required prior to disinterment of a dead body or fetus.
  2. Authorization shall be issued by the state registrar to a licensed funeral director or person acting as funeral director, upon proper application.

Acts 1977, ch. 128, § 18; T.C.A., § 53-477.

68-3-509. Commemorative certificates of nonviable birth.

  1. As used in this section:
    1. “Commemorative certificate” means a document commemorating a nonviable birth;
    2. “Department” means the department of health; and
    3. “Nonviable birth” means an unintentional, spontaneous fetal demise occurring prior to the twentieth week of gestation during a pregnancy that has been verified by a healthcare practitioner.
    1. A healthcare practitioner licensed pursuant to title 63 who attends or diagnoses a nonviable birth, or a healthcare facility licensed pursuant to this title at which a nonviable birth occurs, may, based on the practitioner's best medical judgement and knowledge of the patient, advise a patient who experiences a nonviable birth that the patient may request a commemorative certificate from the department of health as provided in this section. The healthcare practitioner may delegate this duty to the practitioner's designee. The healthcare practitioner or the practitioner's designee shall provide the patient with a form provided by the department pursuant to subdivision (b)(2) and executed by the healthcare practitioner or the practitioner's designee.
    2. The department shall provide on the department's website a form to be executed by a healthcare practitioner or the practitioner's designee affirming that a patient experienced a nonviable birth that the healthcare practitioner attended or diagnosed.
  2. Upon the request of the patient and submission of the executed form, the department shall issue a commemorative certificate within sixty (60) days after receipt of the request. The department shall charge a fee not to exceed its actual cost for issuing the commemorative certificate.
    1. The commemorative certificate must contain the name of the fetus and the sex, if known. If the name is not furnished by the patient, the department shall fill in the commemorative certificate with the name Baby Boy or Baby Girl and the last name of the patient, and if the sex of the child is also unknown, the department shall fill in the commemorative certificate with the name Baby and the last name of the patient.
    2. The following statement must appear on the front of the commemorative certificate:

      This commemorative certificate is not proof of a live birth.

  3. The department shall not register the birth associated with a commemorative certificate issued under this section or use it to calculate live birth statistics. The commemorative certificate is commemorative in nature and has no legal effect.
  4. A commemorative certificate issued under this section must not be used to establish, bring, or support a civil cause of action seeking damages against any person or entity for bodily injury, personal injury, or wrongful death for a nonviable birth.
  5. A commemorative certificate issued under this section is not a public record.

Acts 2019, ch. 156, § 1.

Compiler's Notes. Former § 68-3-509 (Acts 1997, ch. 128, § 18, T.C.A., § 53-478) concerning cremation, was repealed by Acts 1999, ch. 215, § 13, effective July 1, 1999. For general provisions governing cremation, see title 62, chapter 5, part 5.

Effective Dates. Acts 2019, ch. 156, § 2. April 18,  2019.

68-3-510. Records kept by persons releasing, moving or disposing of dead body or fetus.

  1. When a dead body is released or disposed of by an institution, the person in charge of the institution shall keep a record showing the name of the deceased, date of death, name and address of the person to whom the body is released, date of removal from the institution, or if finally disposed of by the institution, the date, place and manner of disposition.
  2. A funeral director, embalmer or other person who removes from the place of death or transports or finally disposes of a dead body or fetus, in addition to filing any certificate or other report required by this chapter or regulations promulgated under this chapter, shall keep a record, which shall identify the body, and such information pertaining to this receipt, removal and delivery of the body as may be provided in regulations adopted by the department.

Acts 1977, ch. 128, § 26; T.C.A., § 53-479.

Cross-References. Disposition of dead bodies, title 68, ch. 4.

Textbooks. Tennessee Law of Evidence (2nd ed., Cohen, Paine and Sheppeard), § 803(9).1.

68-3-511. Death determination and pronouncement by registered nurse.

A registered nurse may make the actual determination and pronouncement of death under the following circumstances:

    1. The deceased was suffering from a terminal illness;
    2. Death was anticipated, and the attending physician or the hospice medical director has agreed in writing to sign the death certificate. The agreement by the attending physician or hospice medical director must be present and with the deceased at the place of death;
    3. Prior to death, the deceased had been receiving the services of a Medicare certified hospice program licensed by the state;
    4. The nurse is licensed by the state; and
    5. The nurse is employed by the attending hospice program;
    1. The deceased was a resident of a nursing home;
    2. Death was anticipated, and the attending physician or nursing home medical director has agreed in writing to sign the death certificate. The agreement by the attending physician or nursing home medical director must be present and with the deceased at the place of death;
    3. The nurse is licensed by the state; and
    4. The nurse is employed by the nursing home in which the deceased resided;
    1. The deceased was receiving the services of a licensed home care organization;
    2. Death was anticipated, and the attending physician has agreed in writing to sign the death certificate. The agreement by the attending physician must be present with the deceased at the place of death;
    3. The nurse is licensed by the state; and
    4. The nurse is employed by the home care organization providing services to the deceased;
    1. The deceased was a patient at a hospital as defined by § 68-11-201;
    2. Death was anticipated, and the attending physician has agreed in writing to sign the death certificate. The agreement by the attending physician must be present with the deceased at the place of death;
    3. The nurse is licensed by the state; and
    4. The nurse is employed by the hospital providing services to the deceased;
    1. The deceased was receiving the services of a program for all-inclusive care for the elderly (PACE) that is a permanent medicare provider as approved by the centers for medicare and medicaid services;
    2. Death was anticipated, and the attending physician has agreed in writing to sign the death certificate. The agreement by the attending physician must be present with the deceased at the place of death;
    3. The nurse is licensed by the state; and
    4. The nurse is employed by a program described in subdivision (5)(A); and
    1. The deceased was a resident of an assisted-care living facility;
    2. Death was anticipated, and the attending physician has agreed in writing to sign the death certificate. The agreement by the attending physician must be present and with the deceased at the place of death;
    3. The nurse is licensed by the state; and
    4. The nurse is employed by the assisted-care living facility in which the deceased resided.

Acts 1998, ch. 858, § 1; 2001, ch. 266, §§ 1, 2; 2003, ch. 85, § 1; 2004, ch. 646, § 1; 2005, ch. 222, § 1.

68-3-512. Death determination and pronouncement by physician assistant.

The determination and pronouncement of death may be made by a physician assistant licensed under title 63, chapter 19, part 1, so long as this task is expressly included in the written protocol developed jointly by the physician assistant and the collaborating physician setting forth the range of services that may be performed by that physician assistant.

Acts 2005, ch. 333, § 1; 2018, ch. 610, § 41.

Amendments. The 2018 amendment substituted “collaborating physician” for “supervising physician”.

Effective Dates. Acts 2018, ch. 610, § 42. July 1, 2018.

68-3-513. Immunity from civil suit.

Any physician who in good faith complies with § 68-3-502(c)-(g) shall be immune from civil suit for damages.

Acts 2008, ch. 866, § 2.

68-3-514. Certificate of birth for stillborn children.

  1. For any stillborn child in this state, the department shall issue a certificate of birth resulting in stillbirth within sixty (60) days after a parent named on a report of fetal death submits a request for a certificate of birth resulting in stillbirth.
  2. The department shall inform applicable persons or entities licensed by the department of the requirements of this section at time of licensure.
  3. The request for a certificate of birth resulting in stillbirth shall be on a form prescribed by the department by rule and must include the date of the stillbirth and the county in which the stillbirth occurred. The request form shall include a space for the parent requesting the certificate of birth resulting in stillbirth to fill in the state file number of the corresponding report of fetal death pursuant to § 68-3-504, if known or applicable.
  4. The certificate of birth resulting in stillbirth shall contain:
    1. The date of the stillbirth;
    2. The county in which the stillbirth occurred;
    3. If a name does not appear on the original or amended report of fetal death and the requesting parent does not wish to provide a name, the office of vital records shall fill in the certificate of birth resulting in stillbirth with the first name left blank and the last name of the parent or parents as provided in part 3 of this chapter;
    4. The state file number of the corresponding report of fetal death; and
    5. The following statement: “This certificate is not proof of live birth.”
  5. A certificate of birth resulting in stillbirth shall not be a public record.
    1. A parent may request that the office of vital records issue a certificate of birth resulting in stillbirth regardless of the date on which the report of fetal death was issued. The requesting party shall be responsible for providing any records necessary for issuing the certificate.
    2. When no report of fetal death is available, then a parent of a stillborn child under this section may request the office of vital records to issue a certificate of birth resulting in stillbirth for a stillbirth that occurred prior to July 1, 2010, if it meets the requirements established by this section. The requesting party shall be responsible for providing any records necessary for issuing the certificate. The office shall issue the certificate if the stillbirth is reported to the office in a manner satisfactory to the office.
  6. It is final agency action, not subject to review under the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, for the office of vital records to refuse to issue a certificate to a person who is not a parent named on the report of fetal death or who is not otherwise entitled to a certificate of birth resulting in stillbirth by this section.
  7. The office of vital records may not use a certificate of birth resulting in stillbirth to calculate live birth statistics.
  8. The registrar shall prescribe by rules promulgated in accordance with the Uniform Administrative Procedures Act the fees, the form and content of and process for issuing the certificate of birth resulting in stillbirth.
  9. The registrar of vital records is authorized to set fees which shall not exceed the reasonable cost incurred by the department for processing and filing a new certificate of birth resulting in stillbirth or report of fetal death pursuant to this section or § 68-3-504.

Acts 2010, ch. 778, § 3.

Part 6
Maternal Mortality Review and Prevention Act of 2016

68-3-601. Short title.

This part shall be known and may be cited as the “Maternal Mortality Review and Prevention Act of 2016.”

Acts 2016, ch. 987, § 2.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

68-3-602. Findings — Definitions.

  1. The general assembly finds that:
    1. Maternal deaths are a serious public health concern and have a tremendous family and societal impact;
    2. Maternal deaths are significantly underestimated and inadequately documented, preventing efforts to identify and reduce or eliminate the causes of death;
    3. No processes exist in this state for the confidential identification, investigation, or dissemination of findings regarding maternal deaths;
    4. The centers for disease control and prevention has determined that maternal deaths should be investigated through state-based maternal mortality reviews in order to institute the systemic changes needed to decrease maternal mortality; and
    5. There is a need to establish a program to review maternal deaths and to develop strategies for the prevention of maternal deaths in this state.
  2. As used in this part:
    1. “Department” means the department of health;
    2. “Maternal death” or “maternal mortality” means a:
      1. Pregnancy-associated death;
      2. Pregnancy-related death; or
      3. Pregnancy-associated but not a pregnancy-related death;
    3. “Pregnancy-associated death” means the death of a woman while pregnant or within one (1) year of the end of her pregnancy, irrespective of the cause of death and regardless of the duration or site of the pregnancy;
    4. “Pregnancy-associated, but not pregnancy-related death” means the death of a woman while pregnant or within one (1) year following the end of pregnancy, due to a cause unrelated to the pregnancy; and
    5. “Pregnancy-related death” means the death of a woman while pregnant or within one (1) year of the end of her pregnancy, regardless of the duration or site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.

Acts 2016, ch. 987, § 3.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

68-3-603. Maternal mortality review program.

The commissioner of health is authorized to create the Tennessee maternal mortality review program. The intent of the Tennessee maternal mortality review program is to identify and address the factors contributing to poor pregnancy outcomes for women and facilitate state systems changes to improve the health of women before, during and after pregnancy.

Acts 2016, ch. 987, § 4.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

68-3-604. Maternal mortality review and prevention team.

There is created the Tennessee maternal mortality review and prevention team, otherwise known as the state team. For administrative purposes only, the state team shall be attached to the department of health.

Acts 2016, ch. 987, § 5.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

68-3-605. Composition of state team.

The composition of the state team shall include:

  1. The commissioner of health or the commissioner's designee;
  2. The state maternal and child health director or the director's designee;
  3. A physician licensed or certified under title 63, chapter 6 or 9, with training in obstetrics;
  4. A physician licensed or certified under title 63, chapter 6 or 9, with training in neonatology;
  5. A hospital-based nurse with experience in obstetrics, labor and delivery, postpartum, or maternity care;
  6. The chief medical examiner or the examiner's designee;
  7. The chair of the health and welfare committee of the senate, or the chair's designee;
  8. The chair of the health committee of the house of representatives, or the chair's designee; and
  9. Additional members as determined by the department, including representatives from multiple disciplines and relevant community-based organizations as necessary to fulfill the intent of this part.

Acts 2016, ch. 987, § 6.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

68-3-606. Voting members — Vacancies.

All members of the state team shall be voting members. All vacancies shall be filled by the appointing or designating authority in accordance with the rules promulgated under § 68-3-612.

Acts 2016, ch. 987, § 7.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

68-3-607. Duties of state team.

The state team shall:

  1. Review maternal deaths according to rules established under this part;
  2. Make determinations regarding the preventability of maternal deaths;
  3. Report at least annually to the governor and the general assembly concerning the state team's activities and its recommendations for changes to any law, rule, or policy that would promote the safety and well-being of women and prevention of maternal deaths; and
  4. Undertake annual statistical studies of the incidents and causes of maternal mortality in this state and disseminate findings and recommendations to policy makers, healthcare providers, healthcare facilities, and the general public.

Acts 2016, ch. 987, § 8; 2020, ch. 679, § 1.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Amendments. The 2020 amendment, in (3), substituted “annually” for “biennially” substituted “or” for “and” preceding “policy”.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

Acts 2020, ch. 679, § 2. June 15, 2020.

68-3-608. Inspection of records — Meetings — Confidentiality requirements.

    1. The department and the state team are public health authorities conducting public health activities pursuant to the federal Health Insurance Portability and Accountability Act (HIPAA) (42 U.S.C. § 1320d et seq.). Notwithstanding §§ 63-2-101(b) and 68-11-1502, and any express or implied contracts, agreements, or covenants of confidentiality based upon §§ 63-2-101(b) and 68-11-1502, the records of all healthcare facilities and providers shall be made available to the state team for inspection and copying as necessary to complete the review of a specific fatality and effectuate the intent of this part.
    2. The state team:
      1. Is authorized to inspect and copy any other records from any source as necessary to complete the review of a specific fatality and effectuate the intent of this part, including, but not limited to, hospital records, outpatient clinic and laboratory records, police investigations data, medical examiner investigative data, vital records cause of death information, social services records, and records from state offices, agencies, and departments; and
      2. May share information with other public health authorities or their designees as the state team may determine necessary to achieve the goals of the program.
  1. The state team may request that persons with direct knowledge of circumstances surrounding a particular fatality provide the state team with information necessary to complete the review of the particular fatality; such persons may include healthcare providers or staff involved in the care of the woman or the person who first responded to a report concerning the woman.
  2. Meetings of the state team shall not be subject to title 8, chapter 44, part 1. Any minutes or other information generated during official meetings of the state team shall be sealed from public inspection. However, the state team may periodically make available, in a general manner that shall not reveal confidential information about individual cases, the aggregate findings of team's reviews and their recommendations for preventive actions.
    1. All information and records acquired by the state team in the exercise of their duties shall be confidential and not subject to discovery or introduction into evidence in any proceedings; provided, however, certain information may be disclosed as necessary to carry out the purposes of the state team.
    2. A member of the state team or attendee of a team meeting shall not:
      1. Release to the public or the news media information discussed at official meetings; or
      2. Testify in any proceeding about details of the team meeting, including any information presented at the meeting, or about opinions formed by the person as a result of the meeting.
    3. This subsection (d) shall not prohibit a person from testifying in a civil or criminal action about matters that occurred in the team meeting; provided, that such testimony shall be based upon the person's independent knowledge.
  3. Each member of the state team and any attendee of a meeting of the state team shall sign a statement indicating an understanding of and adherence to the state team's confidentiality requirements, including potential civil or criminal consequences for a breach of confidentiality pursuant to this part.

Acts 2016, ch. 987, § 9.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

Cross-References. Confidentiality of public records, § 10-7-504.

68-3-609. Staff or consultants.

To the extent of funds available, the state team may hire staff or consultants to assist the state team in completing their duties.

Acts 2016, ch. 987, § 10.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

68-3-610. Immunity.

A person or facility acting in good faith in compliance with this part shall be immune from civil and criminal liability arising from such action.

Acts 2016, ch. 987, § 11.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

68-3-611. Maternal death investigations and reviews.

Nothing in this part shall preclude any maternal death investigations or reviews to the extent authorized by any other law.

Acts 2016, ch. 987, § 12.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

68-3-612. Promulgation of rules.

The commissioner of health is authorized to promulgate such rules, pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, as are necessary to carry out the intent of this part. The rules authorized pursuant to this section may address, but not be limited to, the following:

  1. The procedures by which healthcare providers, healthcare facilities, and other parties identify and report maternal deaths to the department or as directed by the department;
  2. The protocols, procedures, methods, manner, and extent of all investigations and reviews; and
  3. The manner in and extent to which information shall be disseminated in accordance with the intent of this part.

Acts 2016, ch. 987, § 13.

Compiler's Notes. Acts 2016, ch. 987, § 14 provided that the act, which enacted this part, shall apply to deaths occurring on or after January 1, 2017.

Effective Dates. Acts 2016, ch. 987, § 14. January 1, 2017.

Part 7
Suicide Prevention Act of 2018 [Effective until June 30, 2021.]

68-3-701. Short title. [Effective until June 30, 2021.]

This part shall be known and may be cited as the “Suicide Prevention Act of 2018.”

Acts 2018, ch. 1005, § 1.

Compiler's Notes. For Preamble to act concerning suicide prevention, please refer to Acts 2018, ch. 1005.

Acts ch. 1005, § 2 provided that this section shall expire on June 30, 2021.

Effective Dates. Acts 2018, ch. 1005, § 2. January 1, 2019.

68-3-702. Part definitions. [Effective until June 30, 2021.]

As used in this part:

  1. “Department” means the department of health;
  2. “Suicide” means a death caused by self-directed injurious behavior with any intent to die because of the result of the behavior; and
  3. “Suicide mortality” means the number of deaths within this state and the proportion of those deaths to the number of total deaths over the course of a year.

Acts 2018, ch. 1005, § 1.

Compiler's Notes. For Preamble to act concerning suicide prevention, please refer to Acts 2018, ch. 1005.

Acts ch. 1005, § 2 provided that this section shall expire on June 30, 2021.

Effective Dates. Acts 2018, ch. 1005, § 2. January 1, 2019.

68-3-703. Suicide prevention program. [Effective until June 30, 2021.]

  1. The commissioner of health is authorized to create the Tennessee suicide prevention program.
  2. The department shall establish a team that shall:
    1. Compile existing data on suicide deaths;
    2. Review existing resources and programs related to suicide prevention;
    3. Identify evidence-based or promising practices related to the prevention of suicide;
    4. Convene relevant stakeholders to review existing data and existing programs and resources and identify opportunities to improve data collection and analysis and programming; and
    5. Submit a report to the general assembly no later than June 30, 2020, recommending any necessary programs or policies to prevent suicide deaths in this state.

Acts 2018, ch. 1005, § 1.

Compiler's Notes. For Preamble to act concerning suicide prevention, please refer to Acts 2018, ch. 1005.

Acts ch. 1005, § 2 provided that this section shall expire on June 30, 2021.

Effective Dates. Acts 2018, ch. 1005, § 2. January 1, 2019.

Chapter 4
Disposition of Dead Bodies

68-4-101. Notice of death occurring while receiving medical attention or in institution — Action taken upon expiration of eight hours — Penalty.

  1. When any person dies in a doctor's office, or any clinic, hospital or state, county or city institution, it is unlawful for any doctor, nurse, attendant, orderly, janitor or bookkeeper, or anyone, to call an undertaker without first making an effort to contact a relative of the person, if the person has any known kin in the county where the person died, so as to give the kin or relative the right to call an undertaker or crematory of the next of kin's or relative's choice.
  2. In the event kin or relatives are not available or are not known, or should the next of kin fail or refuse to summon an undertaker or crematory or to dispose of the body in some manner within eight (8) hours after the death of the person, then the doctor, hospital, clinic or other institution may summon an undertaker to take over the body.
  3. In the event the next of kin refuses to summon an undertaker or crematory or dispose of the body in some manner immediately, then the doctor, hospital, clinic or institution may summon some undertaker to take over the body.
  4. Any doctor, nurse, attendant, orderly, janitor or bookkeeper or anyone connected with the office, hospital, clinic or institution violating subsection (a) commits a Class C misdemeanor.

Acts 1953, ch. 152, §§ 1-3 (Williams, § 5717.39); T.C.A. (orig. ed.), §§ 53-501 — 53-503; Acts 1989, ch. 591, § 113.

Cross-References. Abuse of corpse, § 39-17-312.

Anatomical gifts, title 68, ch. 30.

Death certificates, title 68, ch. 3, part 5.

Disposition of dead fetus, § 68-3-506.

Penalty for Class C misdemeanor, § 40-35-111.

Power of attorney for health care decisions, § 34-6-204.

Recipients of dead bodies to be notified of communicable diseases and AIDS, § 68-5-102.

Revocation of funeral director's or embalmer's license for unlawful disposition of bodies, § 62-5-317.

Textbooks. Tennessee Forms (Robinson, Ramsey and Harwell), No. 4-103.

Comparative Legislation. Disposition of dead bodies:

Ala.  Code § 22-19-1 et seq.

Ark.  Code § 20-17-901 et seq.

Ga. O.C.G.A. § 31-21-1 et seq.

Ky. Rev. Stat. Ann. § 72.450 et seq.

Miss.  Code Ann. § 41-39-1 et seq.

Mo. Rev. Stat. § 194.005 et seq.

N.C. Gen. Stat. § 130A-415 et seq.

Va. Code § 32.1-283 et seq.

NOTES TO DECISIONS

1. Notice to Next-of-Kin.

This section did not establish a duty on the part of the city, a city police officer, or county medical examiner to notify the next-of-kin of the death of person who was found dead in a car by the police officer. Tinsley v. Dudley, 915 S.W.2d 806, 1995 Tenn. App. LEXIS 562 (Tenn. Ct. App. 1995), appeal denied, — S.W.2d —, 1996 Tenn. LEXIS 95 (Tenn. Feb. 5, 1996).

Collateral References. 22A Am. Jur. 2d Dead Bodies § 1 et seq.

25A C.J.S. Dead Bodies § 1 et seq.

Dead Bodies 2-6.

68-4-102. Disposition of unclaimed bodies of persons dying in charitable or penal institutions or to be buried at public expense.

  1. In order to promote medical and surgical science, and to provide for the disposition of unclaimed bodies of persons who die in any charitable or penal institutions, or are delivered to a public official for the purpose of burial at public expense, the chief medical examiner appointed pursuant to § 38-7-102 shall direct the disposition of unclaimed dead bodies, except those of honorably discharged veterans, which shall be interred as directed by the commissioner of veterans services, or the commissioner's representative, superseding other provisions of §§ 68-4-102 — 68-4-109.
  2. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.

Acts 1947, ch. 163, § 1; C. Supp. 1950, § 2569.8 (Williams, § 5379.1); Acts 1955, ch. 34, § 1; 1976, ch. 806, § 1(15); T.C.A. (orig. ed.), § 53-504; Acts 1990, ch. 598, § 3; 1996, ch. 744, § 1; 2015, ch. 24, § 7.

Amendments. The 2015 amendment substituted “commissioner of veterans services” for “commissioner of veterans affairs” in (a).

Effective Dates. Acts 2015, ch. 24, § 9. July 1, 2015.

68-4-103. Persons dying in publicly-supported institutions or to be buried at public expense — Notice to relatives — Notice to chief medical examiner — Removal of body — Embalming — Infectious or contagious cases.

  1. Whenever a person dies in any hospital, infirmary, mental health institute, poorhouse, penitentiary, house of correction, workhouse, jail, or other charitable or penal institution that is supported in whole or in part at public expense, or whenever a body is delivered to a public official for the purpose of determining the cause of death or for the purpose of burial of the body or the cremated remains at public expense, it is the duty of the public official or of the custodian, superintendent or active head of such institution to immediately notify the nearest relative of the person, if any relative be known, of the person's death.
    1. After the notification pursuant to subsection (a), the custodian, superintendent or active head of the institution or public official shall then hold the body of the deceased person not less than ninety-six (96) hours, and if at the end of that time no relative claims the dead body and no provision has been made for its interment by burial of the body or the cremated remains other than at public expense, then the custodian, superintendent or active head or public official shall notify the chief medical examiner or the chief medical examiner's representative that the custodian, superintendent or active head or public official has the body, and, upon demand by the chief medical examiner or the chief medical examiner's representative, shall deliver or surrender the body to the chief medical examiner or the chief medical examiner's representative or to either of their order.
    2. Notification shall be made in any manner that the chief medical examiner shall direct and all the expense of notification and delivery or surrender of the body shall be at the expense of and shall be borne by the institution obtaining the dead body.
  2. If the chief medical examiner or the chief medical examiner's representative, upon receipt of the notification, does not, within seventy-two (72) hours, make a demand for the body, then the body or the cremated remains shall be buried as provided by law or cremated in accordance with § 68-4-113. The public official or the custodian, superintendent or active head of such institution as referred to in subsection (a) may, in such person's discretion, choose to have the body cremated prior to burial.
  3. No custodian, superintendent or head of a charitable or penal institution or public official shall charge, receive or accept money or other consideration for any body.
  4. The chief medical examiner may, by proper instructions, have the body embalmed by such person as the chief medical examiner may direct, and, to the person performing this work under the chief medical examiner's instructions the institution receiving the body shall pay a reasonable compensation.
  5. No person who has died of any contagious or infectious disease shall be held to be within §§ 68-4-102 — 68-4-109, unless proper precautions, as prescribed by the chief medical examiner, are taken to prevent the spread of contagions or infections.

Acts 1947, ch. 163, § 2; C. Supp. 1950, § 2569.9 (Williams, § 5379.2); Acts 1955, ch. 34, § 2; T.C.A. (orig. ed.), § 53-505; Acts 1984, ch. 525, § 4; 1990, ch. 598, § 4; 1996, ch. 744, § 2; 2013, ch. 287, §§ 2-4.

Amendments. The 2013 amendment, in (a), substituted “for the purpose of determining the cause of death or for the purpose of burial of the body or the cremated remains” for “for the purpose of burial” and deleted “or other” preceding “relative of the person”; inserted “by burial of the body or the cremated remains” near the middle of (b)(1); and rewrote (c) which read: “If the chief medical examiner or the chief medical examiner's representative, upon receipt of the notification, does not, within twenty-four (24) hours, make a demand for the body, then it shall be buried as provided by law.”

Effective Dates. Acts 2013, ch. 287, § 6. April 25, 2013.

Cross-References. Physician to notify health authorities and recipients of dead bodies of communicable disease or AIDS, § 68-5-102.

NOTES TO DECISIONS

1. Notice to Next-of-Kin.

This section did not establish a duty on the part of the city, a city police officer, or county medical examiner to notify the next-of-kin of the death of person who was found dead in a car by the police officer. Tinsley v. Dudley, 915 S.W.2d 806, 1995 Tenn. App. LEXIS 562 (Tenn. Ct. App. 1995), appeal denied, — S.W.2d —, 1996 Tenn. LEXIS 95 (Tenn. Feb. 5, 1996).

Collateral References.

Liability in damages for withholding corpse from relatives. 48 A.L.R.3d 240.

68-4-104. Distribution of bodies among medical, dental and anthropologic institutions — Receiving institution to pay expense.

  1. The chief medical examiner, upon receiving the bodies or notification of the availability of the bodies as provided in this chapter, shall distribute them among the medical, dental and anthropologic institutions of this state regularly chartered and in active operation as prescribed in §§ 68-4-102 — 68-4-109, and shall not give, sell or deliver any body to any other person, firm, society, association or corporation.
  2. Bodies shall be distributed by the chief medical examiner to the institution that is closest to the location of the body and that has indicated a current need for bodies for the purposes authorized by this chapter.
  3. The institution receiving any body shall bear all the expense incident to the transportation of the body from the institution where death occurred, and its delivery to the institution receiving it.

Acts 1947, ch. 163, § 3; C. Supp. 1950, § 2569.10 (Williams, § 5379.3); T.C.A. (orig. ed.), § 53-506; Acts 1984, ch. 525, § 5; 1990, ch. 598, § 5.

Cross-References. Health authorities and recipients of dead bodies to be notified of communicable diseases and AIDS, § 68-5-102.

68-4-105. Bodies to be used only for promotion of science — Surrender to relative upon demand.

  1. The institution receiving a body shall use it only within this state and for the purpose of medical and dental, surgical or anatomical study and for the promotion of science alone.
  2. If, at any time before or after such use of the body, it is claimed for burial by any relatives of the deceased person, at their expense, or in the case of a veteran's body, the commissioner of veterans services, then the institution shall surrender the body.
  3. If, at any time, the institution elects to discontinue use of the unclaimed body for the purposes prescribed in this section, the institution shall summon a funeral director to take over the body at the expense of the institution.

Acts 1947, ch. 163, § 4; C. Supp. 1950, § 2569.11 (Williams, § 5379.4); T.C.A. (orig. ed.), § 53-507; Acts 1996, ch. 744, §§ 3, 4; 2015, ch. 24, § 7.

Amendments. The 2015 amendment substituted “commissioner of veterans services” for “commissioner of veterans affairs” in (b).

Effective Dates. Acts 2015, ch. 24, § 9. July 1, 2015.

Cross-References. Recipients of dead bodies to be notified of communicable diseases and AIDS, § 68-5-102.

Collateral References.

Liability in damages for withholding corpse from relatives. 48 A.L.R.3d 240.

68-4-106. Resolution of conflict regarding the person authorized to direct disposition of remains in the event of death when military personnel in a duty status.

  1. As used in this section, “DD Form 93” means the form used by the department of defense as a record of emergency data required to be completed by military personnel, a portion of which is used by military personnel to designate the person authorized to direct disposition of their remains (PADD) in the event of death when military personnel are in a duty status as defined in 10 U.S.C. § 1481.
  2. If a member of the military has executed any of the following documents:
    1. A durable power of attorney for health care executed pursuant to title 34, chapter 6, part 2;
    2. An advance directive executed pursuant to chapter 11, part 18 of this title;
    3. A donor card or other directive executed pursuant to the Revised Uniform Anatomical Gift Act, compiled in chapter 30, part 1 of this title;
    4. A living will, executed pursuant to title 32, chapter 11;
    5. A will executed pursuant to title 32 or validly executed pursuant to any other law; or
    6. Any other document properly executed pursuant to law relating to the disposition of the person's remains; and

      such member of the military has also executed a DD Form 93, then notwithstanding the provisions of law identified in subdivisions (b)(1)-(6) or documents executed thereunder, if there is a conflict between the person designated in any document identified in subdivisions (b)(1)-(6) and the PADD in the DD Form 93, the PADD designated in the DD Form 93 shall be the person to make the decisions concerning the disposition of the remains of the member of the military executing the DD Form 93 when a member of the military is in a duty status defined in 10 U.S.C. § 1481.

Acts 2010, ch. 702, § 1.

Compiler's Notes. Former § 68-4-106 (Acts 1947, ch. 163, § 5; C. Supp. 1950, § 2569.12 (Williams, § 5379.5); T.C.A. (orig. ed.), § 53-508), concerning surety bonds to ensure compliance with the provisions of this chapter, was repealed by Acts 1984, ch. 525, § 3.

68-4-107. Penalty for violations of §§ 68-4-102 — 68-4-109.

Any person, firm, board, corporation or association who violates any provision of §§ 68-4-10268-4-109 commits a Class B misdemeanor.

Acts 1947, ch. 163, § 6; C. Supp. 1950, § 2569.13 (Williams, § 5379.6); T.C.A. (orig. ed.), § 53-509; Acts 1989, ch. 591, § 112.

Cross-References. Penalty for Class B misdemeanor, § 40-35-111.

68-4-108. Expenses to be borne by medical, dental and anthropologic institutions.

No expense that may be incurred in the execution of any part of §§ 68-4-10268-4-109 shall be a charge upon the state or any county or municipality, or any officer or agent thereof, but all such expenses, whether for compensation, salary, transportation or otherwise shall be borne by the medical, dental and anthropologic institutions as provided in this chapter.

Acts 1947, ch. 163, § 7; C. Supp. 1950, § 2569.14 (Williams, § 5379.7); T.C.A. (orig. ed.), § 53-510; Acts 1990, ch. 598, § 6.

68-4-109. Immunity from civil suit.

The chief medical examiner or the chief medical examiner's representative, any medical school, dental school, anthropologic school, or other person or organization that in good faith complies with §§ 68-4-10268-4-109 shall be granted immunity from civil suit for damages in performing the authorized services.

Acts 1947, ch. 163, § 8; C. Supp. 1950, § 2569.15 (Williams, § 5379.8); T.C.A. (orig. ed.), § 53-511; Acts 1990, ch. 598, § 7.

68-4-110. Regulations governing disinterment.

  1. The department of health is empowered to prepare suitable regulations governing the disinterment of dead bodies for the protection of public health.
  2. The department of health may not require permits for the disinterment of a wrongfully buried decedent if the disinterment is pursuant to § 46-1-112 and the cemetery operator follows all procedures as set out in that section.

Acts 1879, ch. 43, § 1; Shan., § 3117; Code 1932, § 5825; Acts 1939, ch. 32, § 1; C. Supp. 1950, § 5825; T.C.A. (orig. ed.), § 53-512; Acts 2009, ch. 356, § 2.

Cross-References. Disinterment and reinterment, § 68-3-508.

68-4-111. Autopsy by consent of persons having custody of body.

  1. A physician holding an unlimited license to practice medicine under the laws of Tennessee is deemed to have been legally authorized to perform an autopsy upon the body of a deceased person, when the autopsy has been consented to by the person assuming custody of the body for the purposes of burial, such as the surviving spouse, the father, the mother, a child, a guardian, next of kin, or in the absence of any of the foregoing, such governmental agencies as charged by law with the responsibility for burial. If two (2) or more such persons assume custody of the body, the consent of one (1) of them shall be deemed sufficient legal authorization for the performance of the autopsy.
  2. Nothing contained in this section shall be construed as repealing, amending or in any way affecting § 38-1-104, which prescribes the procedure by which district attorneys general may petition for an autopsy, nor § 38-5-107, which prescribes the procedure by which coroners may summon as a witness a surgeon or physician to make examination of a dead body, including the performing of an autopsy.

Acts 1955, ch. 221, §§ 1, 2; T.C.A., § 53-513.

Cross-References. Post mortem examinations, title 38, ch. 7.

Law Reviews.

Criminal Law — Right to Autopsy in Murder Prosecutions, 24 Tenn. L. Rev. 385.

68-4-112. Rigid containers not mandatory for remains of certain children.

A rigid receptacle or rigid container shall not be a mandatory requirement for the burial, entombment, or other final disposition of the remains of a person who was not more than twelve (12) years of age at the time of death.

Acts 1981, ch. 59, § 1; T.C.A., § 53-514.

68-4-113. Cremation of unclaimed dead body.

Notwithstanding any law to the contrary, the coroner, medical investigator or county medical examiner may direct the cremation of an unclaimed dead body; provided, that:

  1. Proper notice is given in accordance with § 68-4-103; and
  2. The body is held for the time period provided in § 68-4-103.

Acts 2013, ch. 287, § 1.

Effective Dates. Acts 2013, ch. 287, § 6. April 25, 2013.

Chapter 5
Prevention of Diseases

Part 1
General Provisions

68-5-101. Notice to be given of communicable diseases in a household.

Whenever any case of communicable disease exists, except it shall not embrace any venereal disease, such as gonorrhea or syphilis, or is even suspected to exist in any household, it is the duty of the head of the household, or any other person in the household possessing knowledge of the facts, immediately to notify the municipal or county health authorities of the town or county in which the disease or diseases exist or may be supposed to exist.

Acts 1905, ch. 519, § 1; Shan., § 3112; mod. Code 1932, § 5789; T.C.A. (orig. ed.), § 53-604.

Cross-References. Sexually transmitted diseases, title 68, ch. 10.

Comparative Legislation. Prevention of disease:

Ala.  Code § 22-10-1 et seq.

Ark.  Code § 20-7-110.

Ga. O.C.G.A. § 31-12-1 et seq.

Ky. Rev. Stat. Ann. § 214.010 et seq.

Miss.  Code Ann. § 41-23-1 et seq.

N.C.  Gen. Stat. § 130A-134 et seq.

Va. Code § 32.1-35 et seq.

Cited: State ex rel. Kennedy v. Head, 182 Tenn. 249, 185 S.W.2d 530, 1945 Tenn. LEXIS 215 (1945).

Collateral References. 39 Am. Jur. 2d Health § 19 et seq.

52 Am. Jur. 2d Marriage § 35.

39A C.J.S. Health and Environment §§ 28 et seq., 46.

Propriety of prophylactic availability programs. 52 A.L.R.5th 477.

Health and Environment 22 et seq.

68-5-102. Required notifications regarding diagnosed communicable and other disease and related deaths.

Whenever any physician, surgeon or practitioner of medicine knows or suspects that any person whom the physician, surgeon or practitioner of medicine has been called to visit, or who has been brought to the physician, surgeon or practitioner of medicine for examination, or any other suspicious information received relative thereto, is infected, or even so suspected, with any communicable disease, except venereal disease, such physician, surgeon or practitioner of medicine shall immediately notify the health authorities of the town or county in which the diseased person or persons are found. In the event of the death of such person, the physician, surgeon or practitioner of medicine shall also notify, or cause to be notified, at the time of delivery, the person to whom the body is delivered of the known or suspected communicable, contagious or infectious disease, including acquired immune deficiency syndrome (AIDS), so that the necessary and proper precautions can be taken in the handling, preparation for disposition or disposition of the body.

Acts 1905, ch. 519, § 2; Shan., § 3113; Code 1932, § 5790; T.C.A. (orig. ed.), § 53-605; Acts 1986, ch. 559, § 1.

Cross-References. Blood-collecting facilities to test for AIDS, § 68-32-102.

Distribution of bodies among medical and dental institutions, §§ 68-4-104, 68-4-105.

Donees under Uniform Anatomical Gift Act, § 68-30-104.

Prohibition on AIDS victims donating blood, § 68-32-104.

Sexually transmitted diseases, title 68, ch. 10.

Law Reviews.

Medical Jurisprudence — Privileged Communications Between Physician and Patient — State Regulation and Right to Privacy, 39 Tenn. L. Rev. 515.

Attorney General Opinions. Duty of health providers to provide notice of communicable diseases, OAG 98-0137 (8/6/98).

68-5-103. City or county health authorities to carry out rules and regulations of department.

It is the duty of all municipal or county health authorities, without delay, upon receiving the notice pursuant to § 68-5-102 immediately to proceed to carry out such rules and regulations as the department of health may prescribe, having for their object the prevention and restrictions of such disease or diseases.

Acts 1905, ch. 519, § 3; Shan., § 3114; impl. am. Acts 1923, ch. 7, § 46; Code 1932, § 5791; T.C.A. (orig. ed.), § 53-606.

Collateral References.

Contagious disease, general delegation of power to guard against spread of. 8 A.L.R. 836.

68-5-104. Quarantine — Penalty for escape.

    1. It is the duty of the local health authorities, on receipt of a report of a case, or suspected case, of disease declared to be communicable, contagious, or one which has been declared by the commissioner of health to be subject to isolation or quarantine, to confirm or establish the diagnosis, to determine the source or cause of the disease and to take such steps as may be necessary to isolate or quarantine the case or premise upon which the case, cause or source may be found, as may be required by the rules and regulations of the state department of health.
    2. The commissioner is authorized and directed to promulgate and publish such rules and regulations as may be necessary to prevent the spread of contagious or communicable diseases in order to protect the public health and welfare.
  1. Any person isolated or quarantined in accordance with any statute or rule or regulation promulgated and published in accordance with statutes relating to isolation or quarantine, who willfully escapes from such isolation or quarantine, commits a Class B misdemeanor.
  2. Whenever any one of the local health authorities, either municipal or county as the case may be, isolates, quarantines or placards any person or house for communicable diseases, it is the duty of the health official to deliver or cause to be delivered to the head of the household a copy of this law or such portion of this law as may pertain to the particular case under consideration.

Acts 1905, ch. 519, §§ 3, 12; Shan., §§ 3114a1, 3114a2, 3114a11; Code 1932, §§ 5792, 5793, 5802; Acts 1957, ch. 14, §§ 1, 2; T.C.A. (orig. ed.), §§ 53-607, 53-608, 53-617; Acts 1989, ch. 591, § 112.

Cross-References. Isolation or quarantine of persons infected with sexually transmitted diseases, § 68-10-106.

Penalty for Class B misdemeanor, § 40-35-111.

Quarantine, §§ 68-1-20168-1-203.

Quarantine of HIV, § 39-13-108.

Quarantine, tuberculosis, title 68, ch. 9, part 2.

NOTES TO DECISIONS

1. Applies to Venereal Disease.

By § 68-5-101 venereal diseases are excepted from communicable diseases dealt with under this chapter, but by § 68-10-101 (see now § 68-10-112), venereal diseases are expressly declared to be communicable diseases subject to quarantine. Hence, in the application of the pari materia rule, this provision for punishment may well be extended to those quarantined for venereal diseases who escape before recovery. State ex rel. Kennedy v. Head, 182 Tenn. 249, 185 S.W.2d 530, 1945 Tenn. LEXIS 215 (1945).

Collateral References.

Demurrage as affected by quarantine. 44 A.L.R. 841.

General delegation of power to guard against spread of contagious disease as including power to quarantine. 8 A.L.R. 837.

Typhoid carrier, quarantine of. 22 A.L.R. 845.

Venereal diseases, constitutionality, construction and application of statutes or ordinances concerning quarantine for. 127 A.L.R. 424.

68-5-105. Establishment of clinics for vaccinations.

  1. It is the duty of each county board of health to establish one (1) or more clinics in each county for the purpose of providing vaccinations or inoculations, or both, to prevent the introduction and spread of communicable diseases in the county. Each county board of health shall follow the recommendations of the state department of health as to the procedures necessary to provide immunity for each disease for which an immunizing agent is available and supplied by the department. No restriction shall be applied as to the eligibility of any person to receive an immunizing agent supplied by the department, except the restrictions that may be included in the recommendations of the department.
  2. If any county board of health fails or refuses to carry out this section, the department is authorized to make provision for these services, and the cost of these services shall be paid from the joint budget of the local full time public health service cooperating with the department. In the event no local full-time public health service exists, the cost of these vaccination or inoculation services shall be paid from any grant-in-aid funds available to the county under § 68-2-901.
  3. It is the legislative intent of this section to establish through the department, on a statewide basis, a uniform minimum vaccination and immunization program. Nothing in this section shall be construed as prohibiting county boards of health established and operating in accordance with chapter 2 of this title, or their counterparts in office established under private acts, from adopting and enforcing such regulations as may be reasonable and necessary to prevent the introduction of, or to arrest the progress of, communicable diseases within their jurisdictions.
  4. Any vaccination or inoculation required for international travel that is provided by a public clinic shall be available to a person residing outside the county but within the state in which the clinic is located at the same cost as charged to individuals residing within the county where the clinic is located, when the vaccination or inoculation is unavailable at a public clinic in the person's home county. This subsection (d) shall not apply in any county having a population of not less than two hundred eighty-five thousand (285,000) nor more than two hundred eighty-six thousand (286,000), according to the 1990 federal census or any subsequent federal census.

Acts 1905, ch. 519, § 8; Shan., § 3114a7; mod. Code 1932, § 5798; Acts 1967, ch. 41, § 1; T.C.A. (orig. ed.), § 53-613; Acts 1997, ch. 519, § 1.

Compiler's Notes. For tables of U.S. decennial populations of Tennessee counties, see Volume 13 and its supplement.

Cross-References. County boards of health, §§ 68-2-601, 68-2-602.

68-5-106. Refusal of vaccination — Physician giving fraudulent certificate — Penalty.

  1. Every person who refuses to be vaccinated or prevents a person under such person's care and control from being vaccinated on application being made by the health officer or board of health or by a physician employed by the health officer or board of health for that purpose, unless in the written opinion of another physician it would not be prudent on account of sickness, commits a Class C misdemeanor.
  2. Any physician fraudulently giving a certificate of sickness or of vaccination to prevent vaccination commits a Class C misdemeanor.

Acts 1905, ch. 519, § 9; Shan., § 3114a8; Code 1932, § 5799; T.C.A. (orig. ed.), § 53-614; Acts 1989, ch. 591, § 113.

Cross-References. Childhood immunizations, conflict with religious tenets and practices of parent, § 37-10-402.

Newborn testing, exemptions for religious beliefs, § 68-5-403.

Penalty for Class C misdemeanor, § 40-35-111.

68-5-107. Reports of city and county boards to department.

It is the duty of each city or county board of health to make such reports, including special reports within their jurisdiction, as the state department of health may require, in such manner, form and times as may be set out in the rules and regulations of the department.

Acts 1905, ch. 519, § 11; Shan., § 3114a10; impl. am. Acts 1923, ch. 7, § 46; mod. Code 1932, § 5801; modified; Acts 1957, ch. 14, § 3; T.C.A. (orig. ed.), § 53-616.

68-5-108. Violations — Penalties.

  1. Any person mentioned in this part, unless the penalty is prescribed in this part, who willfully neglects or refuses to comply with any of the provisions of this part, commits a Class C misdemeanor. Upon complaint from any health authority, it is the duty of the district attorney general to prosecute the violation of this part.
  2. Any person having reason at the time to believe that such person is afflicted with any contagious disease who voluntarily goes upon any public highway or street, or to any place at which people are accustomed to collect or assemble, or who enters or goes on board any steamboat, railroad car or other public conveyance, or any person who knowingly aids or assists anyone thus to offend, commits a Class C misdemeanor.

Acts 1905, ch. 519, §§ 13, 14; Shan., §§ 3114a12, 3114a13; Code 1932, §§ 5803, 5804; T.C.A. (orig. ed.), §§ 53-618, 53-619; modified; Acts 1989, ch. 591, § 113.

Cross-References. Childhood immunizations, conflict with religious tenets and practices of parent,  § 37-10-402.

Newborn testing, exemptions for religious beliefs, § 68-5-403.

Penalty for Class C misdemeanor, § 40-35-111.

Attorney General Opinions. Duty of health providers to provide notice of communicable diseases, OAG 98-0137 (8/6/98).

68-5-109. Failure of local board to carry out provisions.

Whenever a local board or department of health, either municipal or county, willfully neglects or refuses to comply with this part, and it is apparent that an epidemic of a communicable disease is threatened to invade other municipalities or counties, it then becomes the duty of the state department of health to carry out this part in such municipality or county, as the case may be, and the necessary expense incurred by the department of health in carrying out these provisions shall be paid by the respective municipality or county, as the case may be, to the commissioner of finance and administration, and the commissioner shall place the payment to the credit of the department.

Acts 1905, ch. 519, § 15; Shan., § 3114a14; Code 1932, § 5805; impl. am. Acts 1937, ch. 33, §§ 24, 29; impl. am. Acts 1959, ch. 9, § 3; impl. am. Acts 1961, ch. 97, § 3; T.C.A. (orig. ed.), § 53-620.

68-5-110. Information on pertussis vaccine.

In accordance with the latest recommendations of the advisory committee on immunization practices of the centers for disease control and prevention, during the postpartum period and prior to discharge, each hospital shall provide parents of newborns educational information on pertussis disease and the availability of a vaccine to protect against pertussis. This educational information shall include, but is not limited to, information on the center for disease control and prevention's recommendation that parents and caregivers receive Tdap during the postpartum period to protect their newborns from the transmission of pertussis. Nothing in this section shall require any hospital to provide or pay for any vaccination against pertussis. This section also shall not constitute a requirement to be assessed during any inspection under chapter 11, part 2 of this title.

Acts 2011, ch. 56, § 1.

Cross-References. Responsibility of parents to have children immunized — Specific vaccines — Immunization registry, § 37-10-401.

68-5-111. Educational information on influenza and availability of vaccine.

  1. In accordance with the latest recommendations of the advisory committee on immunization practices of the centers for disease control and prevention, each hospital shall between the dates of August 1 through March 31 and prior to patient discharge, provide to patients or inform patients where they can find educational information on influenza disease and the availability of a vaccine to protect against the influenza virus. The educational information shall include, but is not limited to, the causes and symptoms of influenza disease, the effectiveness and known contraindications of influenza immunizations and the means by which influenza is spread. This information shall be provided to all patients aged six (6) months and older and may be provided to a parent or legal guardian of patients aged six (6) months through eighteen (18) years of age.
  2. Nothing in this section shall require any hospital to provide or pay for any vaccination against influenza.
  3. This section shall also not constitute a requirement to be assessed during any inspection under chapter 11, part 2 of this title.

Acts 2013, ch. 60, § 1.

Effective Dates. Acts 2013, ch. 60, § 2. July 1, 2013.

68-5-112. Making available information and instruction concerning the appropriate use and techniques of infant cardiopulmonary resuscitation (CPR) — Blakeleigh Rone Act.

  1. An obstetrical provider who treats a prenatal patient on at least two (2) different occasions shall make available information and instruction concerning the appropriate use and techniques of infant cardiopulmonary resuscitation (CPR) to at least one (1) future parent or caregiver.
  2. A hospital or birthing center where a baby is born shall make available information and instruction concerning the appropriate use and techniques of infant CPR to at least one (1) parent or caregiver before the newborn is discharged from the facility.
  3. A primary care provider who treats a newborn in an ambulatory care setting within twenty-eight (28) days after the date of birth shall make available information and instruction concerning the appropriate use and techniques of infant CPR to at least one (1) parent or caregiver.
  4. Nothing in this section shall require classes in certification of infant CPR. This section shall also not constitute a requirement to be assessed during any inspection under chapter 11, part 2 of this title.
  5. Any facility or practitioner acting within the scope of their licensure or practice shall be immune from any civil or administrative liability under this section and shall have an affirmative defense to any criminal liability arising from making such information available.
  6. This section shall be known and may be cited as the “Blakeleigh Rone Act.”

Acts 2013, ch. 197, § 1; 2014, ch. 594, § 1.

Amendments. The 2014 amendment rewrote the section which read: “(a)(1) Hospitals, birthing centers, health care facilities, physicians, nurse practitioners, physician assistants or other health care practitioners who provide medical care to newborns as well as obstetricians who provide routine care for prenatal patients shall make available information and instruction concerning the appropriate use and techniques of infant cardiopulmonary resuscitation (CPR) to at least one (1) parent or caregiver of a newborn infant.“(2) Nothing in this section shall require classes in certification of infant CPR.“(3) This section shall also not constitute a requirement to be assessed during any inspection under chapter 11, part 2 of this title.“(b) Any facility or practitioner acting within the scope of their licensure or practice shall be immune from any civil liability under this section and shall have an affirmative defense to any criminal liability arising from making such information available.”

Effective Dates. Acts 2013, ch. 197, § 2. July 1, 2013.

Acts 2014, ch. 594, § 2. July 1, 2014.

68-5-113. Cytomegalovirus — Information — Liability.

  1. As used in this section, “CMV” means cytomegalovirus.
  2. If a healthcare provider as defined by § 63-6-703, who assumes responsibility for the prenatal care of either pregnant women during gestation or women who may become pregnant, has determined that a patient is at risk of contracting CMV, the healthcare provider or the healthcare provider's facility shall inform that patient regarding:
    1. The incidence of CMV;
    2. The transmission of CMV to at-risk women who are pregnant or who may become pregnant;
    3. Birth defects caused by congenital CMV;
    4. Methods of diagnosing congenital CMV; and
    5. Available preventative measures.
  3. Healthcare providers covered under subsection (b) are encouraged to provide all other patients with information identifying where the patients can learn about CMV.
    1. Nothing in this section shall be construed to create or impose liability for failing to comply with the requirements of this section.
    2. Nothing in this section shall be deemed to create a duty of care or other legal obligation beyond the requirements set forth in this section.

Acts 2016, ch. 625, § 1.

Effective Dates. Acts 2016, ch. 625, §  2. July 1, 2016.

68-5-114. Chronic Disease Prevention Act.

  1. This section shall be known and may be cited as the “Chronic Disease Prevention Act.”
  2. By no later than October 1, 2019, the speaker of the senate, the speaker of the house of representatives, the commissioner of health, and the governor shall establish a task force to study methods on how best to prevent cardiovascular disease, hypertension, and diabetes in this state.
  3. The task force is composed of eleven (11) members, as follows:
    1. One (1) member of the senate health and welfare committee, to be appointed by the speaker of the senate;
    2. One (1) member of the health committee of the house of representatives, to be appointed by the speaker of the house of representatives;
    3. One (1) member of the senate finance, ways and means committee, to be appointed by the speaker of the senate;
    4. One (1) member of the house finance, ways and means committee, to be appointed by the speaker of the house of representatives;
    5. One (1) member of the senate who serves in a leadership position, to be appointed by the speaker of the senate;
    6. One (1) member of the house of representatives who serves in a leadership position, to be appointed by the speaker of the house of representatives;
    7. Three (3) persons who are subject matter experts in one (1) or more of the subjects that the task force will study, to be appointed by the governor in consultation with the commissioner of health;
    8. One (1) person who is a certified medical professional from a historically black college or university offering advanced degrees in medicine, dentistry, or public health administration based in Tennessee and having a research and development unit, to be appointed by the governor; and
    9. One (1) person who possesses experience in the subjects of health and public health and who has previous legislative experience, to be appointed by the governor.
  4. The person appointed under subdivision (c)(9) shall call the first meeting of the task force.
  5. By no later than December 15, 2020, the task force shall complete its findings and make recommendations in a report to the governor and to the speaker of the senate and the speaker of the house of representatives.
  6. The members of the task force shall serve without compensation but are entitled to reimbursement of any travel expenses incurred. All reimbursement for travel expenses must conform to the comprehensive state travel regulations as promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.
  7. The task force ceases to exist upon completion of the task force's report and recommendations.

Acts 2019, ch. 372, §§ 1-6.

Effective Dates. Acts 2019, ch. 372, § 7. May 10, 2019.

Part 2
Newborn Testing — Eyes

68-5-201. [Repealed.]

Compiler's Notes. Former § 68-5-201 (Acts 1915, ch. 52, § 1; Shan., § 6756a2; Code 1932, § 11174; modified; T.C.A. (orig. ed.), § 53-621), concerning the naming and approval of a prophylaxis or preventive to be used in treating the eyes of newly-born children, was repealed by Acts 2008, ch. 847, § 1, effective April 30, 2008.

68-5-202. Treatment specified for infant at birth — Reports of redness, swelling, inflammation or pus — Religious exemption.

  1. It is the duty of any physician, nurse or midwife who assists and is in charge at the birth of any infant, or has the care of the infant after birth, to treat the eyes of the infant with a prophylaxis to prevent ophthalmia neonatorum or infections leading to blindness. The treatment shall be given as soon as practicable after the birth of the infant and always within one (1) hour; and if any redness, swelling, inflammation, or gathering of pus appears in the eyes of the infant or upon the lid or about the eyes within two (2) weeks after birth, then any nurse, midwife or other person having care of the infant shall report the condition within six (6) hours after its discovery to a physician licensed and practicing medicine in this state.
  2. Nothing in this part shall require medical treatment under subsection (a) for the minor child of any person who files with the department of health a signed, written statement that such medical treatment conflicts with the person's religious tenets and practices, affirmed under penalties of perjury.

Acts 1915, ch. 52, §§ 2, 3; Shan., §§ 6756a3, 6756a4; Code 1932, §§ 11175, 11176; modified; T.C.A. (orig. ed.), §§ 53-622, 53-623; Acts 1989, ch. 591, § 113; 2008, ch. 847, § 2; 2016, ch. 989, § 1.

Amendments. The 2016 amendment rewrote (b) which read: “A violation of this section is a Class C misdemeanor.”

Effective Dates.  Acts 2016, ch. 989, § 2. July 1, 2016.

Cross-References. Newborn testing and metabolic defects, title 68, ch. 5, part 4.

Part 3
[Reserved]

Part 4
Newborn Testing — Metabolic Defects

68-5-401. Testing required — Public policy.

    1. The general assembly declares that, as a matter of public policy of this state and in the interest of public health, every newborn infant shall be tested for phenylketonuria, hypothyroidism, galactosemia and other metabolic/genetic defects that would result in intellectual disability or physical dysfunction as determined by the department, through rules and regulations duly promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and that the people of this state shall be extensively informed as to the nature and effects of such defects.
    2. Every provider of prenatal care will adhere to the American College of Obstetricians and Gynecologists and the Centers for Disease Control recommendations for the prevention of Perinatal Group B Streptococcal Disease.
    3. All infants born in this state shall be tested for specific genetic, metabolic, or other heritable conditions beginning six (6) months following the occurrence of all of the following:
      1. The development of a reliable test or series of tests for screening newborns for specific genetic, metabolic, or other heritable conditions using dried blood spots or other testing and quality assurance testing methodology for such specific genetic, metabolic or the heritable conditions testing;
      2. The availability of quality assurance materials for the specific genetic, metabolic, or other heritable condition tests from the federal centers for disease control and prevention;
      3. The review and approval of the proposed test by the genetics advisory committee of the department of health; and
      4. The acquisition of necessary equipment, completion of appropriate validation tests, and hiring of any necessary staff to implement the expanded screening tests by the newborn screening laboratory and newborn screening follow-up program of the state.
    4. The department of health may charge a reasonable fee and any reasonable increase in this fee, as necessary, for the test performed pursuant to this section. The amount of the fee and the procedures for collecting the fee shall be determined by the commissioner of health.
  1. If the department levies a fee or charge for the cost of testing, it shall use the same billing and collection methods normally used by independent private laboratories. Any fee shall be waived for patients who are unable to pay.

Acts 1985, ch. 333, § 1; 1991, ch. 504, § 1; 1997, ch. 312, § 1; 2011, ch. 158, § 35; 2015, ch. 436, § 2.

Compiler's Notes. Acts 2015, ch. 436, § 1 provided that the act, which added (a)(3) and (4), shall be known and may be cited as the “Mabry Kate Webb Act”.

Amendments. The 2011 amendment substituted “intellectual disability” for “mental retardation” in (a)(1).

The 2015 amendment added (a)(3) and (4).

Effective Dates. Acts 2011, ch. 158, § 46. May 5, 2011.

Acts 2015, ch. 436, §  3. May 18, 2015.

Cross-References. Definitions for this part, § 68-5-501.

Genetic testing, title 68, ch. 5, part 5.

Phenylketonuria treatment, coverage, § 56-7-2505.

Statewide early intervention program for handicapped infants, toddlers, and their families, § 49-10-702.

68-5-402. Cooperation of departments.

All state departments, including the department of human services, the department of mental health and substance abuse services, the department of intellectual and developmental disabilities, and county and municipal health departments and education departments, shall cooperate with the department in carrying out this part.

Acts 1985, ch. 333, § 1; 2000, ch. 947, § 6; 2010, ch. 1100, § 106; 2012, ch. 575, § 1.

Compiler's Notes. Acts 2010, ch. 1100, § 153 provided that the commissioner of mental health and developmental disabilities, the commissioner of mental health, the commissioner of intellectual and developmental disabilities, and the commissioner of finance and administration are authorized to promulgate rules and regulations to effectuate the purposes of the act. All such rules and regulations shall be promulgated in accordance with the provisions of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

68-5-403. Exemptions for religious beliefs.

Nothing in this part shall be construed to require the testing of or medical treatment for the minor child of any person who files with the department a signed, written statement that such tests or medical treatment conflict with the person's religious tenets and practices, affirmed under penalties of perjury.

Acts 1985, ch. 333, § 1.

Cross-References. Childhood immunizations, conflict with religious tenets and practices of parent,  § 37-10-402.

Perjury, title 39, ch. 16, part 7.

68-5-404. Failure to have child tested — Misdemeanor.

Any person violating this part or parts of this chapter or the rules promulgated pursuant thereto, relative to testing of newborn infants, commits a Class C misdemeanor.

Acts 1985, ch. 333, § 1; 1989, ch. 591, § 113.

Cross-References. Childhood immunizations, conflict with religious tenets and practices of parent,  § 37-10-402.

Newborn testing, exemptions for religious beliefs, § 68-5-403.

Penalty for Class C misdemeanor, § 40-35-111.

68-5-405. Screening for blood glucose abnormalities.

The department of health shall provide a link on the department's Internet web site to the web sites of the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists for accessing the Guidelines for Perinatal Care regarding the indications for screening infants for blood glucose abnormalities. The board of medical examiners and the board of osteopathic examination shall publish the guidelines in the annual newsletter of each respective board.

Acts 2006, ch. 831, § 1.

Cross-References. Equipment, supplies and outpatient services for diabetic patients, § 56-7-2605.

68-5-406. Retention of newborn screening specimen — When specimen and form containing identifying information shall be destroyed — Retention of specimen beyond one year.

A newborn screening specimen taken for testing pursuant to this part or part 5 of this chapter shall be kept for one (1) year to permit time for the infant's physician to request additional tests. After one (1) year, both the specimen and the form containing the identifying information shall be destroyed. If a specimen is needed for quality assessment, quality control, or test calibration, that specimen may be retained for longer than one (1) year; provided, that the form containing the identifying information has been separated from the sample and destroyed, to ensure that the source of the sample cannot be identified.

Acts 2015, ch. 246, § 3.

Effective Dates. Acts 2015, ch. 246, § 5. July 1, 2015.

Part 5
Genetic Testing

68-5-501. Definitions for parts 4 and 5.

As used in parts 4 and 5 of this chapter, unless the context otherwise requires:

  1. “Birth defects” means those abnormalities of body structure or function present at birth that adversely affect the intellectual capacity, health or abilities of affected individuals;
  2. “Commissioner” means the commissioner of health or a designated representative;
  3. “Committee” means the genetics advisory committee;
  4. “Department” means the department of health;
  5. “Genetic and metabolic screening” means search through systematic testing of the population at risk for metabolic or genetic conditions, to enable early dietary or medical treatment and counseling so as to ameliorate or avoid adverse consequences of those disorders; and
  6. “Genetic disorders” means those conditions caused by an alteration or abnormality in the genetic material (DNA) which may adversely affect the health and functional abilities of affected individuals.

Acts 1985, ch. 333, § 1.

Cross-References. Testing newborn infants for phenylketonuria, hypothyroidism, metabolic or genetic defects resulting in mental retardation or physical dysfunction, title 68, ch. 5, part 4.

68-5-502. Establishment of genetics program.

  1. The department shall establish a statewide genetics program to ensure the availability of genetic services to citizens of the state who need them for the prevention and treatment of intellectual disability or other physical dysfunctions.
  2. The program shall include comprehensive genetic services programs, including genetic and metabolic screening programs, genetic counseling services, and other related services that will aid in the prevention and treatment of particular genetic disorders and birth defects or related conditions as determined by the department through rules and regulations duly promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, with the advice of the committee established in § 68-5-503.

Acts 1985, ch. 333, § 1; 2011, ch. 158, § 36.

68-5-503. Appointment of advisory committee — Terms — Travel.

  1. The commissioner shall appoint a committee to consult with the department in the administration of parts 4 and 5 of this chapter.
  2. The committee shall be composed of one (1) representative from each regional genetic and each regional sickle cell center established pursuant to parts 4 and 5 of this chapter; at least two (2) members at large; and the chief medical officer for the state.
  3. The chief medical officer shall serve as chair of this committee.
  4. Each member shall hold office for a term of four (4) years or until such member's successor is appointed, except for the terms of initial appointments which shall be set so as to have an equal number of terms expiring each successive year.
  5. Any member appointed to fill a vacancy for any unexpired term shall serve the remainder of that term.
  6. The committee shall meet as frequently as the commissioner deems necessary, but not less than once a year.
  7. Committee members shall be reimbursed for travel expenses in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.

Acts 1985, ch. 333, § 1.

Compiler's Notes. The genetic advisory committee, created by this section, terminates June 30, 2025. See §§ 4-29-112, 4-29-246.

68-5-504. Functions of program — Duties of department.

    1. Genetic and other testing services provided for by parts 4 and 5 of this chapter shall be provided only to:
      1. Born children;
      2. Unborn children whose testing would result in treatment;
      3. Men;
      4. Nonpregnant women; and
      5. Those pregnant women whose testing would result in treatment for themselves or their unborn children.
    2. Induced abortion shall not be regarded as treatment; therefore, procedures or services designed to search out disorders in unborn children that are not treatable shall not be provided for under parts 4 and 5 of this chapter, it being the finding of the general assembly that the use of this program to abort unborn children is against the public policy of the state of Tennessee.
  1. The department shall:
    1. Develop and administer statewide genetic and metabolic screening programs to prevent, detect and assure follow-up for birth defects and genetic disorders. The screening programs shall include testing for phenylketonuria and hypothyroidism as provided by part 4 of this chapter, testing for sickle cell disease and other hemoglobinopathies and other testing programs as the department shall deem appropriate for the preventive treatment of intellectual disability or physical dysfunction, as publicly noted through rules and regulations duly promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5;
    2. Prescribe effective tests and examinations designed to detect genetic disorders as determined by the department, prescribe the methods of obtaining samples or specimens for the required tests and examinations, and designate the person or persons required to conduct the tests and examinations;
    3. Develop standards for statewide genetic services;
    4. Assist in the development, expansion and maintenance of regional genetic centers and regional sickle cell centers, including purchase of equipment and employment of specialized personnel;
    5. Develop and implement state/regional programs of professional education and training for health care providers in the causes, prevention, detection and treatment of birth defects and genetic disorders;
    6. Support clinical diagnosis and counseling services regarding genetic disorders and birth defects;
    7. Implement public education programs to inform persons of genetic screening, genetic disorders, and birth defects and the various services available;
    8. Develop a system of consultation, communication and referral to regional genetics centers and regional sickle cell centers;
    9. Develop a reporting system to allow data to be collected and stored and to facilitate the compilation of statistical information on causes, methods of treatment and prevention of genetic disorders and birth defects. The system shall be in accordance with laws and rules of the department governing confidentiality of information;
    10. Enter into contractual agreements with other agencies to provide services under the state program; and
    11. Promulgate and enforce all rules and regulations as may be necessary to effectuate the purposes of parts 4 and 5 of this chapter.
  2. It is the specific intent of the general assembly that neither abortion nor abortion research should be funded by this program.

Acts 1985, ch. 333, § 1; 2011, ch. 158, § 37.

Cross-References. Confidentiality of public records, § 10-7-504.

68-5-505. Interstate agreements.

The commissioner shall have the authority to formalize agreements with agencies in other states to provide services as may be needed.

Acts 1985, ch. 333, § 1.

68-5-506. Creation of birth defects registry — Advisory committee — Confidentiality — Penalty for unauthorized disclosure of confidential information.

  1. The general assembly finds and declares that birth defects represent problems of public health importance about which too little is known; that these conditions impose enormous physical, emotional, social, educational and financial burdens on individuals, families, communities and the state; and that a system to obtain more information about these conditions could result in development of preventive measures to decrease their incidence in the future. Therefore, it is the intent of the general assembly in enacting this section to accomplish all of the following:
    1. To maintain an ongoing program of birth defects monitoring statewide. “Birth defect” as used in this section means any structural or biochemical abnormality, regardless of cause, diagnosed at any time before or after birth, that requires medical or surgical intervention or that interferes with normal growth or development;
    2. To provide, on at least an annual basis, information on the incidence, prevalence and trends of birth defects;
    3. To provide information to determine whether environmental hazards are associated with birth defects;
    4. To provide information as to other possible causes of birth defects;
    5. To evaluate the current prevention initiatives undertaken by the state, and to give guidance for improvement of these initiatives or for the addition of new prevention strategies; and
    6. To provide a case referral element whereby the families of children born with birth defects are provided information on public services available to them and their children.
    1. There is established a birth defects registry in the department of health.
    2. The commissioner of health shall establish an advisory committee to guide the department in establishing and maintaining the registry. The committee shall include members representing the disciplines of obstetrics and gynecology, pediatrics, genetics, epidemiology, biostatistics, hospital administration, state agency service providers, parents of children with birth defects, members of interested nonprofit organizations and members of the general public. The advisory committee shall annually evaluate the adequacy of the registry and report their findings annually to the appropriate standing committees of the general assembly.
    3. The department shall maintain a system for the collection of information necessary to accomplish the outlined purposes of this section. For purposes related to the registry, the department shall have access to any medical record that pertains to a diagnosed or suspected birth defect, including the records of the mother. Providers acting pursuant to this section shall not be liable for the release of medical records as authorized by this section. The department shall develop and disseminate information about the birth defects registry to the participating perinatal centers that will be made available to the family, that explains and describes the purpose and process of the registry and how confidentiality will be protected. The information shall be made available in pamphlet format that meets the requirements imposed by §  68-5-508. The commissioner, with guidance from the advisory committee, shall promulgate by rule a mechanism for the active verification of reports through the use of multiple sources.
    4. The registry shall collect information on birth defects, whether they occur as live births, stillbirths, or fetal deaths.
    5. The registry shall collect information on birth defects diagnosed in children up to five (5) years of age.
    6. The registry shall be implemented as a pilot project to include reporting by any of the five (5) designated perinatal centers choosing to be included in the pilot project. Perinatal centers participating in the pilot project shall report to the birth defects registry as required by the commissioner.
  2. The department, with guidance from the advisory committee, shall establish a program in the registry for referring families of children born with birth defects or the mothers of children lost to birth defects to available appropriate state resources. In order for a family of a child with a birth defect to participate in the referral program established by this subsection (c), the child's parents or legal guardian must contact the department and request to be included in the program.
  3. The staff of the registry shall use the information collected pursuant to this section and information available from other reporting systems and health providers to conduct studies to investigate the causes of birth defects, and to determine and evaluate measures designed to prevent their occurrence. The department's investigation shall not be limited to geographic, temporal, or occupational associations, but may include investigation of past exposures.
    1. All information collected and analyzed pursuant to this section shall be confidential insofar as the identity of the individual patient is concerned and shall be used solely for the purposes provided in this section; provided, that the commissioner may provide access to those scientists approved by the advisory committee who are engaged in demographic, epidemiological or other similar studies related to health, and who agree, in writing as nonstate employees, to be identified and coded while maintaining confidentiality as described in this section and to the centers for disease control (CDC) for inclusion in the National Birth Defects Registry.
    2. The department shall maintain an accurate record of all persons who are given access to the information in the registry. The record shall include:
      1. The name of the persons authorizing access;
      2. The name, title, and organizational affiliation of persons given access;
      3. The dates of access;
      4. The specific purpose for which the information is to be used; and
      5. The results of the independent research.
    3. Nothing in this section shall prohibit the publishing of statistical compilations relating to birth defects or poor reproductive outcomes that do not in any way identify individual sources of information.
      1. Any individual who willfully discloses information made confidential by this section, unless permitted to do so by subdivisions (e)(1) and (3), commits a Class A misdemeanor.
      2. Any individual who negligently discloses information made confidential by this section, unless permitted to do so by subdivisions (e)(1) and (3), commits a Class B misdemeanor.

Acts 2000, ch. 965, § 1; 2015, ch. 246, § 1.

Amendments. The 2015 amendment added the fifth sentence in (b)(3).

Effective Dates. Acts 2015, ch. 246, § 5. July 1, 2015.

Cross-References. Confidentiality of public records, § 10-7-504.

Informational pamphlets to be provided to families prior to testing, § 68-5-508.

Penalties for Class A and Class B misdemeanors, § 40-35-111.

68-5-507. Screening program for critical cyanotic congenital heart disease for newborns.

On or before January 1, 2013, the genetic advisory committee is directed to develop a screening program for critical cyanotic congenital heart disease for the panel of screens authorized for newborns under § 68-5-504 that makes use of pulse oximetry.

Acts 2012, ch. 556, § 1.

68-5-508. Informational pamphlets to be provided to family prior to testing.

The information distributed to the family pursuant to §§ 68-5-504(b)(7) and 68-5-506(b)(3) shall be provided to the family before any blood sample for testing is drawn from the newborn. The pamphlet shall disclose the exemption from testing or treatment of a child pursuant to § 68-5-403. The pamphlet shall also inform the family of the newborn screening specimen use, retention, and disposal policy.

Acts 2015, ch. 246, § 2.

Compiler's Notes. Acts 2015, ch. 246, § 4 provided that no revisions shall be made to the existing pamphlet required pursuant to § 68-5-508 until a new printing of the pamphlet occurs. Existing stock of the pamphlet may be distributed until the supply is exhausted.

Effective Dates. Acts 2015, ch. 246, § 5. July 1, 2015.

Part 6
Pregnancy Serological Tests

68-5-601. Part definitions.

As used in this part, unless the context otherwise requires:

  1. “Approved laboratory” means a publicly or privately operated laboratory approved by the department according to its rules, governing the approval and licensing of laboratories for the purposes of this part;
  2. “Commissioner” means the commissioner  of health or the commissioner's designee;
  3. “Department” means the department of health;
  4. “Forms” means the forms that are authorized, prepared and distributed by the department to carry out this part; and
  5. “Standard serological test” means a test for syphilis infection or rubella immunity approved by the department and performed by an approved laboratory.

Acts 1985, ch. 13, § 2.

Cross-References. Blood donors, testing for AIDS, § 68-32-102.

Prohibition on AIDS victims donating blood, § 68-32-104.

Sexually transmitted diseases generally, title 68, ch. 10.

Teenage pregnancy, title 37, ch. 3, part 5.

68-5-602. When required — Hepatitis B treatment — Exception.

  1. Every physician, surgeon, or other person permitted by law to attend a pregnant woman during gestation shall, in the case of each woman so attended, take or cause to be taken a sample of the blood of the woman at the time of first examination and visit or within ten (10) days after the first examination. If the first visit is at the time of delivery, or after delivery, the standard serological test required by this subsection (a) shall be performed at that time. The blood sample shall be sent to a laboratory approved by the department for testing for syphilis infection, rubella immunity, and hepatitis B surface antigen (HBsAg). In the same manner, a sample of blood shall be taken during or after the twenty-eighth week of gestation for a woman whom the attending physician determines to be at high risk of hepatitis B or syphilis according to the current standards of care. This second sample shall be sent to a laboratory approved by the department for testing for syphilis infection and HBsAg only. Additional testing for rubella immunity is not required in subsequent pregnancies once a positive result is verified or a documented history of vaccination against rubella is available. However, all pregnant women shall be tested for syphilis and hepatitis B during an early prenatal visit in each pregnancy. A positive test for syphilis and hepatitis B shall be reported to the local health department in accordance with this chapter, and regulations governing the control of communicable diseases in Tennessee.
  2. Every person attending a pregnant woman who is not permitted by law to take blood samples shall cause a sample of blood to be taken by a health provider permitted by law to take the samples at the time of first examination and visit or within ten (10) days after the first examination. These samples shall be submitted to the same approved laboratories for testing for syphilis infection and HBsAg. If no rubella immunity is documented, testing for rubella is required.
  3. Infants born to HBsAg-postive mothers shall receive, in a timely manner, the appropriate treatment as recognized by the centers for disease control.
  4. This part shall not apply to any female who files with the attending medical authority a signed, written statement that taking a sample of blood or receiving other preventive measures conflict with the female's religious tenets and practices affirmed under the penalties of perjury.

Acts 1985, ch. 13, § 2; 1997, ch. 54, § 1.

Cross-References. Penalty for perjury, title 39, ch. 16, part 7.

Physicians to notify health authorities of communicable diseases or AIDS, § 68-5-102.

68-5-603. Testing free of charge — Authorized laboratories.

  1. Upon request, the laboratory tests required by this part shall be made without charge in the laboratories of the department.
  2. This section shall not be interpreted to mean that the department's laboratories shall be the only laboratory approved to perform these tests.

Acts 1985, ch. 13, § 2.

68-5-604. Reports — Confidentiality.

  1. The laboratory report of the serological test shall be made on a form provided by the department.
  2. A detailed report of the standard serological test and showing the result of the test shall be transmitted by the laboratory to the health care provider. A copy of the laboratory specimen slip shall be concurrently submitted to the local health department having jurisdiction under the following conditions, when the local health department is not the originating health care provider:
    1. A serologic test for syphilis with a result of reactive; however, a serologic test for syphilis with a result of negative need not be sent to the local health department, unless specifically requested; and
    2. A serologic test for rubella with a result of negative; however, a serologic test for rubella with a result of positive need not be sent to the local health department, unless specifically requested.
  3. The copy submitted to the local health department shall be held in absolute confidence and not open to public inspection; provided, that it shall be produced as evidence at a trial or proceeding in a court of competent jurisdiction, involving issues in which it may be material and relevant, on order of a judge of the court; and provided further, that it may be used in the compilation of aggregate figures and reports, without disclosing the identities of the persons involved.
  4. The physician of any patient who is susceptible to rubella, as indicated by a negative result on a serological test, should counsel the patient about the test results, precautions to take, and recommend immunization after delivery.

Acts 1985, ch. 13, § 2.

Cross-References. Confidentiality of public records, § 10-7-504.

68-5-605. Use of test information.

The department is authorized to use the information derived from pregnancy serological tests for such follow-up procedures as are required by law or deemed necessary by the department for the protection of the public health.

Acts 1985, ch. 13, § 2.

68-5-606. Rules and regulations.

The department is authorized to promulgate and enforce rules and regulations to implement this part.

Acts 1985, ch. 13, § 2.

Cross-References. Rules and bylaws for control of sexually transmitted diseases, § 68-10-109.

68-5-607. Violations — Penalties — Enforcement.

    1. Any person who misrepresents any of the facts called for by the serological examination, or who in any way alters the determination of a serological examination, commits a Class C misdemeanor.
    2. It is the duty of the district attorney general to prosecute the suit when requested by the commissioner, the county health officer or local board of health.
  1. Any physician or representative of a laboratory who willfully and knowingly misrepresents, falsifies, or issues false information under this part commits a Class C misdemeanor.
  2. It is the duty of the district attorney general in whose jurisdiction an offense is committed to institute proceedings against violators of this part.
  3. It is the duty of the commissioner to give all assistance necessary for the enforcement of this part to the district attorney general representing the county in which proceedings may be instituted.

Acts 1985, ch. 13, § 2; 1989, ch. 591, § 113.

Cross-References. Culpability, title 39, ch. 11, part 3

Penalty for Class C misdemeanor, § 40-35-111.

Part 7
Tennessee HIV Pregnancy Screening Act of 1997

68-5-701. Short title.

This part shall be known and may be cited as the “Tennessee HIV Pregnancy Screening Act of 1997.”

Acts 1997, ch. 296, § 1.

Cross-References. AIDS education programs, prevention of AIDS or other sexually transmitted diseases, § 49-6-1008.

Sexually transmitted diseases, title 68, ch. 10.

Collateral References.

Damage action for HIV testing without consent of person tested. 77 A.L.R.5th 541.

Validity and propriety under circumstances of court-ordered HIV testing. 87 A.L.R.5th 631.

68-5-702. Purpose.

The purpose of this part is to require all providers of health care services who assume responsibility for the prenatal care of pregnant women during gestation, except in cases where women refuse testing, to test these women for human immunodeficiency virus (HIV) and to provide referral into appropriate medical and social services for those women who test positive.

Acts 1997, ch. 296, § 2; 2007, ch. 154, § 1.

68-5-703. Testing of pregnant women for HIV — Confidentiality — Counseling.

  1. A health care provider shall arrange for each pregnant woman under the provider's care to be tested for HIV as early as possible in the course of the pregnancy, and again during the third trimester, unless the woman has refused testing in writing and this refusal has been placed in the medical chart.
  2. A pregnant woman who presents herself for delivery and who does not have a documented negative HIV test during the last trimester of the pregnancy, unless already known to be HIV positive, shall be tested for HIV using a rapid HIV test, unless she refuses in writing. If she refuses testing, and when the time and circumstances are medically appropriate, she should be counseled regarding the consequences of exposing her unborn child to HIV.
  3. All HIV testing performed under this part shall be done in a confidential manner and the results of the testing may be disclosed only as provided by law.
  4. After receiving a positive HIV test result, the medical provider, when the time and circumstances are medically appropriate, shall:
    1. Explain the meaning and reliability of the test results and the availability of additional or confirmatory testing, if appropriate;
    2. Counsel the woman to obtain appropriate medical treatment for herself and her baby and inform her of the increased risks to her baby if she fails to obtain appropriate treatment;
    3. Make available information concerning the available medical interventions to prevent onset of illness in the mother and to prevent transmission of HIV to her children; and
    4. Arrange for additional counseling in order to assist the woman in obtaining access to a comprehensive clinical care facility that can meet her needs.

Acts 1997, ch. 296, § 3; 2007, ch. 154, § 2.

Cross-References. Confidentiality of public records, § 10-7-504.

Cited: Miller v. Dacus, 231 S.W.3d 903, 2007 Tenn. LEXIS 648 (Tenn. Aug. 17, 2007).

68-5-704. [Repealed.]

Compiler's Notes. Former § 68-5-704 (Acts 1997, ch. 296, § 4), concerning HIV screening reports to the department of health, was repealed by Acts 2007, ch. 154, § 3, effective May 14, 2007.

68-5-705. Rulemaking.

The department may promulgate rules in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this part.

Acts 1997, ch. 296, § 5.

Part 8
Tennessee Chronic Kidney Disease Screening Act of 2005

68-5-801. Short title.

This part shall be known and may be cited as the “Tennessee Chronic Kidney Disease Screening Act of 2005.”

Acts 2005, ch. 172, § 2.

68-5-802. Purpose.

The purpose of this part is to urge all providers of health care services that assume responsibility for patients with diabetes, hypertension or a family history of kidney disease to counsel these patients regarding chronic kidney disease, to test such patients for chronic kidney disease, and to ensure that consulting laboratories provide appropriate reports concerning chronic kidney disease.

Acts 2005, ch. 172, § 3.

68-5-803. Counseling and testing of patients by providers — Laboratory reports.

  1. A provider of health care services that assumes responsibility for the care of patients with diabetes, hypertension, or a family history of kidney disease, is urged to counsel each such patient regarding chronic kidney disease, and is urged to test those patients for chronic kidney disease through routine clinical laboratory assessment of kidney function, unless the patient refuses such testing.
  2. Laboratories shall report the glomerular filtration rate on any serum creatinine test ordered by a health care provider.

Acts 2005, ch. 172, § 4.

68-5-804. Rules and regulations.

The commissioner of health is authorized to promulgate rules and regulations to effectuate the purposes of this part. All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2005, ch. 172, § 5.

Part 9
Early Detection of Hearing Loss

68-5-901. Legislative findings.

The general assembly finds and declares the following:

  1. That hearing loss occurs in newborns more frequently than any other health condition for which newborn screening is currently required;
  2. That early detection of hearing loss, early intervention, and early follow-up have been demonstrated to be highly effective in encouraging development of a child's health and communication and cognitive skills; and
  3. That early screening and intervention will serve the public purposes of promoting healthy development of children and reducing public expenditures for health care, special education and related services.

Acts 2008, ch. 768, § 2.

Compiler's Notes. Acts 2008, ch. 768, § 10 provided that the title of this act is and may be cited as “Claire's Law.”

68-5-902. Part definitions.

As used in this part, unless the context otherwise requires, “hearing screening” or “hearing screening test” means a screening or test provided in accordance with current hearing screening standards established by a nationally recognized organization such as the Joint Committee on Infant Hearing Screening of the American Academy of Pediatrics.

Acts 2008, ch. 768, § 3.

Compiler's Notes. Acts 2008, ch. 768, § 10 provided that the title of this act is and may be cited as “Claire's Law.”

68-5-903. Newborn infant.

Every newborn infant shall be screened for hearing loss in order to prevent the consequences of unidentified hearing loss, unless the parent or parents of the child object on the grounds that the test would conflict with the parent or parents' religious tenets or practices.

Acts 2008, ch. 768, § 4.

Compiler's Notes. Acts 2008, ch. 768, § 10 provided that the title of this act is, and may be cited as “Claire's Law.”

68-5-904. Child born in hospital or other specified facilities.

  1. A child born in a hospital or other birthing facility shall be screened for hearing loss prior to discharge from that facility. The attending health care professional shall refer a child born in a setting other than a hospital or other birthing facility to the department of health or an appropriate hearing screening provider as listed in the latest edition of the directory of hearing screening providers in Tennessee for hearing screening. A child born on an emergency basis in a hospital that does not otherwise provide obstetrical or maternity services and that does not provide infant hearing screening tests prior to discharge of an infant from the hospital, shall refer a child born in that facility to the department of health or an appropriate hearing screening provider as listed in the latest edition of the directory of hearing screening providers in Tennessee for hearing screening. The hearing screening test shall be provided in accordance with current hearing screening standards established by a nationally recognized organization such as the Joint Committee on Infant Hearing Screening of the American Academy of Pediatrics. All screening providers or entities shall report their screening results to the department of health.
  2. Any medical or audiologic provider performing follow-up tests shall report the results of the tests to the department of health.

Acts 2008, ch. 768, § 5.

Compiler's Notes. Acts 2008, ch. 768, § 10 provided that the title of this act is and may be cited as “Claire's Law.”

68-5-905. Report and referrals.

The results of all hearing screenings performed pursuant to this part shall be reported to the department of health. The department of health shall refer any child who does not pass the hearing screening test to the Tennessee early intervention system (TEIS) of the department of education for follow-up. Children who have been identified with hearing loss or high risk conditions that place them at high risk for hearing loss as identified by standards established by a nationally recognized organization such as the Joint Committee on Infant Hearing Screening of the American Academy of Pediatrics shall be referred to the TEIS.

Acts 2008, ch. 768, § 6.

Compiler's Notes. Acts 2008, ch. 768, § 10 provided that the title of this act is and may be cited as “Claire's Law.”

68-5-906. Rules and Regulations.

The department of health, in consultation with the department of education, shall promulgate rules and regulations in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to effectuate this part.

Acts 2008, ch. 768, § 7.

Compiler's Notes. Acts 2008, ch. 768, § 10 provided that the title of this act is and may be cited as “Claire's Law.”

Chapter 6
Sudden Cardiac Arrest Prevention Act

68-6-101. Short title.

This chapter shall be known and may be cited as the “Sudden Cardiac Arrest Prevention Act.”

Acts 2015, ch. 325, § 1.

Code Commission Notes.

Acts 2015, ch. 325, § 1 enacted this chapter as chapter 54 of title 68, but the chapter has been codified as chapter 6 by authority of the Code Commission.

Compiler's Notes. Former chapter 6, §§ 68-6-10168-6-107 (Acts 1949, ch. 26, §§ 1-7; C. Supp. 1950, §§ 4916.14-4916.20 (Williams, §§ 4916.16-4916.22); T.C.A. (orig. ed.), §§ 53-701 — 53-707), concerning cancer control, was repealed by Acts 1983, ch. 124, § 11. For new law, see title 68, ch. 1, part 10.

Effective Dates. Acts 2015, ch. 325, § 2. January 1, 2016.

68-6-102. Chapter definitions.

As used in this chapter, unless the context otherwise requires:

  1. “Community-based youth athletic activity” or “youth athletic activity” means an athletic activity organized by a city, county, business, or nonprofit organization when the majority of the participants are under eighteen (18) years of age, and are engaging in an organized athletic game or competition against another team, club, or entity or in practice or preparation for an organized game or competition against another team, club, or entity. “Community-based youth athletic activity” does not include college or university activities or an activity which is entered into for instructional purposes only, an athletic activity that is incidental to a nonathletic program, or a lesson;
  2. “Department” means the department of health;
  3. “Health care provider” means a Tennessee licensed medical doctor (M.D.) or an osteopathic physician (D.O.);
  4. “Person” means any individual or governmental entity, corporation, association, organization, nonprofit institution, or other entity or such entities' representatives; and
  5. “School youth athletic activity” means a school or a local education agency organized athletic activity when the majority of the participants are under eighteen (18) years of age, and are engaging in an organized athletic game or competition against another team, club, or entity or in practice or preparation for an organized game or competition against another team, club, or entity. “School youth athletic activity” does not include college or university activities, an activity which is entered into for instructional purposes only, or an athletic activity that is incidental to a nonathletic program, or a lesson.

Acts 2015, ch. 325, § 1.

Effective Dates. Acts 2015, ch. 325, § 2. January 1, 2016.

68-6-103. Requirements to be met by governing authorities of public and nonpublic schools for prevention of sudden cardiac arrest during school youth athletic activities.

  1. This section applies to school youth athletic activity.
    1. The governing authority of each public and nonpublic elementary school, middle school, junior high school, and high school, working through guidance approved by the department of health and communicated through the department of education, shall at a minimum:
      1. Adopt guidelines and other pertinent information and forms as approved by the department of health to inform and educate coaches, school administrators, youth athletes, and their parents or guardians of the nature, risk, and symptoms of sudden cardiac arrest, including the risks associated with continuing to play or practice after experiencing any of the following symptoms:
        1. Fainting or seizures during exercise;
        2. Unexplained shortness of breath;
        3. Chest pains;
        4. Dizziness;
        5. Racing heart rate; or
        6. Extreme fatigue;
      2. Require annual completion by all coaches, whether the coach is employed or a volunteer, and by school athletic directors of a sudden cardiac arrest education program approved by the department. In developing the program, the department may use, at no cost to the state, materials and resources created by organizations, such as Simon's Fund, for the purpose of educating coaches about sudden cardiac arrest. The department shall make the sudden cardiac arrest education course program available on its web site for any school to access free of charge;
      3. Require that, on a yearly basis, a sudden cardiac arrest information sheet be signed and returned by each coach and athletic director and, if appointed, a licensed health care professional, to the lead administrator of a nonpublic school or, for a public school, the local education agency's director of schools prior to initiating practice or competition for the year;
      4. Require that, on a yearly basis, a sudden cardiac arrest information sheet be reviewed by each youth athlete and the athlete's parent or guardian. The information sheet shall be signed and returned by the youth athlete, if the youth athlete is eighteen (18) years of age or older, otherwise by the athlete's parent or guardian, prior to the youth athlete's initiating practice or competition, to confirm that both the parent or guardian and the youth athlete have reviewed the information and understand its contents;
      5. Maintain all documentation of the completion of a sudden cardiac arrest education course program and signed sudden cardiac arrest information sheets for a period of three (3) years;
      6. Establish as policy the immediate removal of any youth athlete who passes out or faints while participating in an athletic activity or immediately following an athletic activity, or who exhibits any of the following symptoms:
        1. Unexplained shortness of breath;
        2. Chest pains;
        3. Dizziness;
        4. Racing heart rate; or
        5. Extreme fatigue; and
      7. Establish as policy that a youth athlete who has been removed from play shall not return to the practice or competition during which the youth athlete experienced symptoms consistent with sudden cardiac arrest and not return to play or participate in any supervised team activities involving physical exertion, including games, competitions, or practices, until the youth athlete is evaluated by a health care provider and receives written clearance from the health care provider for a full or graduated return to play.
    2. After a youth athlete who has experienced symptoms consistent with sudden cardiac arrest has been evaluated and received clearance for a graduated return to play from a health care provider, then a school may allow a licensed health care professional, if available, with specific knowledge of the youth athlete's condition to manage the youth athlete's graduated return to play based upon the health care provider's recommendations. The licensed health care professional, if not the youth athlete's health care provider, shall provide updates to the health care provider on the progress of the youth athlete, if requested.
    3. No licensed health care professional or other person acting in good faith within the authority prescribed under this chapter shall be liable on account of any act or omission in good faith while so engaged; provided, that “good faith,” as used in this chapter, shall not include willful misconduct, gross negligence, or reckless disregard.
  2. The local education agency, in consultation with the head of the school youth athletic activity, may establish the following minimum penalties for a coach found in violation of ignoring a youth athlete's sudden cardiac arrest symptoms or allowing the youth to return to the practice or competition during which the youth athlete experienced the symptoms without written clearance from the health care provider for a full or graduated return to play:
    1. For a first violation, suspension from coaching any school youth athletic activity for the remainder of the season;
    2. For a second violation, suspension from coaching any school youth athletic activity for the remainder of the season and the next season; and
    3. For a third violation, permanent suspension from coaching any school youth athletic activity.

Acts 2015, ch. 325, § 1.

Effective Dates. Acts 2015, ch. 325, § 2. January 1, 2016.

68-6-104. Requirements to be met by organizers of community-based youth athletic activities for prevention of sudden cardiac arrest.

  1. This section applies to community-based youth athletic activity.
    1. Any city, county, business, or nonprofit organization that organizes a community-based youth athletic activity for which an activity fee is charged, working through guidance from the department of health, shall at a minimum:
      1. Adopt guidelines and other pertinent information and forms as developed by the department of health to inform and educate the director of the youth athletic activity, coaches, youth athletes, and their parents or guardians of the nature, risk, and symptoms of sudden cardiac arrest, including the risks associated with continuing to play or practice after experiencing any of the following symptoms:
        1. Fainting or seizures during exercise;
        2. Unexplained shortness of breath;
        3. Chest pains;
        4. Dizziness;
        5. Racing heart rate; or
        6. Extreme fatigue;
      2. Require annual completion by all coaches, whether the coach is employed or a volunteer, and, if appointed, the licensed health care professional of a sudden cardiac arrest education program approved by the department. In developing the program, the department may use, at no cost to the state, materials and resources created by organizations, such as Simon's Fund, for the purpose of educating coaches about sudden cardiac arrest. The department shall make the sudden cardiac arrest education course program available on its web site for any youth athletic activity operated by a city, county, business, or nonprofit organization to access free of charge;
      3. Require that, on a yearly basis, a sudden cardiac arrest information sheet be signed and returned by each coach to the head of the youth athletic activity prior to initiating practice or competition for the year;
      4. Require that, on a yearly basis, a sudden cardiac arrest information sheet be reviewed by each youth athlete and the athlete's parent or guardian. The information sheet shall be signed and returned by the youth athlete, if the youth athlete is eighteen (18) years of age or older, otherwise by the athlete's parent or guardian, prior to the youth athlete's initiating practice or competition, to confirm that both the parent or guardian and the youth athlete have reviewed the information and understand its contents;
      5. Maintain all documentation of the completion of a sudden cardiac arrest education course program and signed sudden cardiac arrest information sheets for a period of three (3) years;
      6. Establish as policy the immediate removal of any youth athlete who passes out or faints while participating in an athletic activity or immediately following an athletic activity, or who exhibits any of the following symptoms:
        1. Unexplained shortness of breath;
        2. Chest pains;
        3. Dizziness;
        4. Racing heart rate; or
        5. Extreme fatigue; and
      7. Establish as policy that a youth athlete who has been removed from play shall not return to the practice or competition during which the youth athlete experienced symptoms consistent with sudden cardiac arrest and not return to play or participate in any supervised team activities involving physical exertion, including games, competitions, or practices, until the youth athlete is evaluated by a health care provider and receives written clearance from the health care provider for a full or graduated return to play.
    2. After a youth athlete who has experienced symptoms consistent with sudden cardiac arrest has been evaluated and received clearance for a graduated return to play from a health care provider, then the organizer of the community-based youth athletic activity may allow a licensed health care professional, if available, with specific knowledge of the youth athlete's condition to manage the youth athlete's graduated return to play based upon the health care provider's recommendations. The licensed health care professional, if not the youth athlete's health care provider, shall provide updates to the health care provider on the progress of the youth athlete, if requested.
    3. No coach, head of any athletic activity, licensed health care professional, or other person acting in good faith within the authority prescribed under this chapter shall be liable on account of any act or omission in good faith while so engaged; provided, that “good faith,” as used in this chapter, shall not include willful misconduct, gross negligence, or reckless disregard.
  2. The head of the community-based youth athletic activity may establish the following minimum penalties for a coach found in violation of ignoring a youth athlete's sudden cardiac arrest symptoms or allowing the youth to return to the practice or competition during which the youth athlete experienced the symptoms without written clearance from the health care provider for a full or graduated return to play:
    1. For a first violation, suspension from coaching any community-based youth athletic activity for the remainder of the season;
    2. For a second violation, suspension from coaching any community-based youth athletic activity for the remainder of the season and the next season; and
    3. For a third violation, permanent suspension from coaching any community-based youth athletic activity.

Acts 2015, ch. 325, § 1.

Effective Dates. Acts 2015, ch. 325, § 2. January 1, 2016.

Chapter 7
Malaria [Repealed]

68-7-101 — 68-7-110. [Repealed.]

Compiler's Notes. Former chapter 7, §§ 68-7-10168-7-110 (Acts 1945, ch. 41, §§ 2-10; C. Supp. 1950, §§ 5824.1-5824.9 (Williams, §§ 5824.2-5824.10); T.C.A. (orig. ed.), §§ 53-801 — 53-809; Acts 1975, ch. 35, § 1; T.C.A. 53-810), concerning malaria, was repealed by Acts 1984, ch. 805, § 12.

Chapter 8
Rabies

68-8-101. Short title.

This chapter shall be known and may be cited as the “Tennessee Anti-Rabies Law”.

Acts 2004, ch. 765, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

Collateral References. 4 Am. Jur. 2d Animals § 109.

3B C.J.S. Animals §§ 339, 437.

Attorney General Opinions. Wilson County domestic animal tax and Tennessee anti-rabies law.  OAG 13-40, 2013 Tenn. AG LEXIS 41 (5/23/13).

68-8-102. Chapter definitions.

As used in this chapter, unless the context otherwise requires:

  1. “Cat” means all domesticated members of the feline family;
  2. “Commissioner” means the commissioner of health or a duly authorized representative;
  3. “Compendium or rabies compendium” means the most recent issue of the national “Compendium of Animal Rabies Prevention and Control” published by the Association of State Public Health Veterinarians;
  4. “Confinement” means housed in a building, pen or by some other suitable escape-proof method or enclosure or being leashed;
  5. “Department” means the Tennessee department of health;
  6. “Dog” means all domesticated members of the canine family;
  7. “Hybrid animal” means the offspring of wild animals crossbred to domestic dogs or cats or any of their progeny for which the owner has records substantiating that their genetic heritage consists of twenty-five percent (25%) or more from wild animals. Crossbred dogs or cats with less than twenty-five percent (25%) documented genetic heritage from wild animals will be considered as domestic dogs or cats for purposes of this chapter;
  8. “Observation period” means the time following a bite incident during which the biting animal's health status must be monitored;
  9. “Owner” means any person having a right or property in a dog or cat, or who keeps or harbors a dog or cat, or who has it in such person's care or acts as its custodian, or who permits a dog or cat to remain on or about any premises;
  10. “Peace officer” means animal control officer, police, rabies control officer, sheriff, wildlife officer, or similar duly appointed law enforcement officer of the state or any political subdivision thereof, authorized by the Constitution, statutes, charter, or ordinances to enforce statutory, rule, charter or ordinance violations. It does not include employees of the department assigned to implement this chapter;
  11. “Quarantine” means a state of strictly enforced isolation from other animals or the public imposed to prevent the spread of disease;
  12. “Shelter” means animal or humane shelter, dog pound or animal pound;
  13. “Vaccination” means the injection of a rabies vaccine for animals, which meets the standards prescribed by both the United States Department of Agriculture (USDA) license granted to the vaccine for interstate sale and by the department; and
  14. “Veterinarian” means any individual licensed by the state board of veterinary medical examiners to practice veterinary medicine in this state.

Acts 2004, ch. 765, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

68-8-103. Vaccination of animals — Certificate and tags — Frequency.

  1. It is unlawful for any person to own, keep or harbor any dog or cat six (6) months of age or older that has not been vaccinated against rabies as required by this chapter, or the rules and regulations promulgated pursuant to this chapter.
  2. Dogs and cats may be vaccinated as early as three (3) months of age or at an age as specified by the vaccine's United States department of agriculture (USDA) license, but will be considered as noncompliant with this section if over six (6) months of age.
  3. Ferrets, certain livestock, hybrid animals and other animals may be vaccinated for rabies if a vaccine is legally available for that species. Routine rabies vaccination of animals other than dogs or cats is not required unless deemed necessary by the commissioner or by emergency rules of the department.
  4. All rabies vaccinations of dogs and cats as required by this chapter shall be administered only by or under the supervision of a veterinarian.
  5. Evidence of such vaccination shall consist of a certificate that contains the owner's name and address, date of vaccination, date the dog or cat should be revaccinated, description and sex of the dog or cat vaccinated, number of the vaccination tag issued when applicable, manufacturer and lot number of vaccine administered, and the name and signature of the supervising veterinarian. If the vaccination is given at an animal control facility or shelter, then the certificate shall contain the name and signature of the person administering the vaccine as well as that of the supervising veterinarian.
  6. The vaccination certificate shall be prepared in one (1) of the following manners, unless otherwise provided for by rule:
    1. Paper forms in triplicate; the original shall be given to the owner, the first copy provided to and retained by the department, and the veterinarian administering or supervising the administration of the vaccine shall retain the second copy; or
    2. Computer printout or electronic format, such that the owner, the department and the veterinarian administering the vaccine obtain a copy of the information provided for in subsection (e).
  7. The rabies certificate form and rabies tags shall be provided by the department.
  8. A licensed veterinarian may provide and use an alternative tag and certificate providing that the requirements in subsections (e) and (f) are met.
  9. Nothing in this section shall be construed to require more frequent rabies vaccinations or a greater number of rabies vaccinations than are required by the rabies compendium.

Acts 2004, ch. 765, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

68-8-104. Registration of cats and dogs — Fees — Rabies control program — Vaccination required for registration.

  1. In addition to, but not as a substitute for or in any way detracting from the vaccination requirements of this chapter, authorization is granted for the adoption of local laws or ordinances to require the registration of dogs or cats in counties or municipalities.
  2. Any local laws or ordinances implementing animal registration shall include methods for the collection of registration fees and shall require the expenditure of these funds to establish and maintain a rabies control program, also commonly known as an animal control program. In addition to various animal control activities, the rabies control program shall ensure that dogs and cats are properly vaccinated in accordance with this chapter and that biting animals or rabies suspects are observed or confined in accordance with this chapter and rules of the department.
  3. No dog or cat registration certificate shall be issued unless an unexpired certificate of rabies vaccination is exhibited.
  4. All fees collected for registration shall become part of the county or municipality rabies control fund and shall be disbursed by the appropriate trustee in a manner prescribed by the local legislative body for the sole purpose of the payment of salaries, for the establishment and operation of an animal shelter, for the establishment and operation of an animal control program, or for other expenses incidental to the enforcement of this chapter in the jurisdiction to which the registration requirement applies.
  5. Any funds remaining at the end of any fiscal year shall be carried over to the next fiscal year, and its expenditure authorized by the local legislative body only for the purpose of rabies and animal control.

Acts 2004, ch. 765, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

Attorney General Opinions. T.C.A. § 68-8-104 allows counties to require the owners of animals to register or license their pets and to collect a fee, as long as the fee is dedicated for an animal control program, OAG 06-161 (10/11/06).

Wilson County domestic animal tax and Tennessee anti-rabies law.  OAG 13-40, 2013 Tenn. AG LEXIS 41 (5/23/13).

68-8-105. Exempt programs.

  1. Any county or municipality maintaining a program for the control of rabies shall be exempt from the operation of this chapter so long as such rabies program meets the minimum requirements of this chapter.
  2. This chapter shall not apply to any county that now has or hereafter may enact private laws governing the control of rabies in that county, that meet the minimum requirements of this chapter.

Acts 2004, ch. 765, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

Attorney General Opinions. Wilson County domestic animal tax and Tennessee anti-rabies law.  OAG 13-40, 2013 Tenn. AG LEXIS 41 (5/23/13).

68-8-106. Rabies tag.

  1. The person or facility administering the vaccine shall issue a rabies tag for every dog vaccinated for rabies and the identification numbers on the tag shall be recorded on the rabies certificate.
  2. Cats may be, but are not required, to be issued a rabies tag.
  3. Every dog owner shall attach a metal tag or other evidence of rabies vaccination to a collar, which shall be worn at all times by the dog vaccinated; provided, that the collar may be removed in the case of hunting dogs while in chase or returning from the chase. Nothing in this section shall be construed as permitting the use of an unvaccinated dog for any purpose.

Acts 2004, ch. 765, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

68-8-107. Seizure of dogs running at large — Notification of seized animals — Redemption by owner — Vaccination requirement.

  1. Any dog found running at large may be seized by any peace officer and placed in an animal shelter in counties or cities where an animal shelter or pound is available.
  2. If the dog or cat is wearing a rabies vaccination tag or other identification, all reasonable effort shall be made to locate and notify the owners who shall be required to appear within five (5) days and redeem the animal by paying a pound fee as set by the city or county legislative body. A failure to pay the pound fee, or have the animal vaccinated if proof of current vaccination is not produced prior to release, shall require the animal to be adopted or destroyed.
  3. If any dog or cat is not wearing a vaccination tag or other identification, the animal may be adopted or destroyed, unless legally claimed by the owner within three (3) days.
  4. No dog or cat three (3) months of age or older shall be released from a shelter without having proof of current vaccination or until it has been vaccinated and, where applicable, a tag issued.
  5. A county may allow, by local ordinance, the adoption of a dog or cat three (3) months of age or older without a vaccination as long as procedures are established to ensure that the animal is vaccinated for rabies within seventy-two (72) hours of release from the shelter.

Acts 2004, ch. 765, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

68-8-108. Transportation of dogs and cats in the state.

This chapter shall not prohibit the transportation of dogs or cats in the state; provided, that dogs or cats diagnosed with or suspected of having rabies are securely confined or kept on a leash while being transported in the state.

Acts 2004, ch. 765, § 1; 2013, ch. 58, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

Amendments. The 2013 amendment substituted “dogs or cats diagnosed with or suspected of having rabies” for “the dogs or cats” in the proviso.

Effective Dates. Acts 2013, ch. 58, § 2. March 26, 2013.

68-8-109. Observation period by confinement or quarantine — Investigation.

  1. If any animal has bitten any person, is suspected of having bitten any person or is for any reason suspected of being infected with rabies, the animal may be required to be placed under an observation period either by confinement or by quarantine for a period of time deemed necessary by the commissioner or rules of the department.
  2. The act of investigating the bite or rabies exposure and placing the animal under observation by confinement or quarantine shall be accomplished either by the department or by the animal control program, in either the county or municipality wherein either the animal owner or the person bitten resides, in consultation with the department.
  3. The confinement, quarantine or other disposition of the animal shall follow the current recommendations in the national rabies compendium unless more specific guidelines are designated by duly promulgated rules of the department or as deemed necessary by the commissioner to protect the public's health.
  4. The observation period by confinement or quarantine may occur at the animal owner's home at the discretion of the department or the animal control program.

Acts 2004, ch. 765, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

68-8-110. Offense of hiding or concealing animal in violation of this chapter.

It is an offense for any person to hide, conceal, aid, or assist in hiding or concealing any animal owned, kept or harbored in violation of § 68-8-103 or § 68-8-109. An offense under this section is punishable as a Class C misdemeanor.

Acts 2004, ch. 765, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

Cross-References. Penalty for Class C misdemeanor, § 40-35-111.

68-8-111. Liability for rabies program.

Any licensed veterinarian who provides services to vaccinate animals against rabies at a community clinic that is sponsored by a county health department or municipality in accordance with this chapter, shall not by such participation assume any responsibility or liability for the supervision of the site or location where the rabies program is conducted. Such responsibility and liability shall be borne by the sponsoring county or municipality.

Acts 2004, ch. 765, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

68-8-112. Rules and regulations.

  1. The commissioner of health shall have the authority to promulgate such rules and regulations as may be deemed necessary for the proper enforcement of this chapter.
  2. The commissioner in adopting rules may rely in whole or in part on guidance or standards contained in the rabies compendium or issued by the United States department of agriculture.
  3. The rules deemed necessary by the commissioner to effectuate this chapter are of such importance to the welfare of the citizens of this state that they may be promulgated as emergency rules.

Acts 2004, ch. 765, § 1; 2009, ch. 566, § 12.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

Acts 2009, ch. 566, § 12 provided that the Tennessee code commission is directed to change all references to public necessity rules, wherever such references appear in this code, to emergency rules, as sections are amended and volumes are replaced.

68-8-113. Violations.

Any person failing to meet any requirements or violating any of the provisions of this chapter commits a Class C misdemeanor with each violation being a separate offense.

Acts 2004, ch. 765, § 1.

Compiler's Notes. Former chapter 8, §§ 68-8-10168-8-115 (Acts 1953, ch. 252, §§ 1-14 (Williams, § 5109.20-5109.33); 1955, ch. 211, §§ 1, 2; 1957, ch. 277, §§ 1, 2; impl. am. Acts 1959, ch. 9, § 4; impl. am. Acts 1961, ch. 97, § 4; 1961, ch. 205, § 1; 1971, ch. 290, § 1-4; 1972, ch. 732, § 1; impl. am. Acts 1978, ch. 934, §§ 7, 16, 36; T.C.A. (orig. ed.) § 53-901 — 53-914; Acts 1989, ch. 591, § 113; 1995, ch. 439, § 1; 1999, ch. 387, § 1; 2002, ch. 767, § 5), concerning the Tennessee Anti-Rabies Law, were repealed by Acts 2004, ch. 765, § 1, effective July 1, 2005. For provisions concerning the Tennessee Anti-Rabies Law, effective July 1, 2005, see §§ 68-8-10168-8-113.

Cross-References. Penalty for Class C misdemeanor, § 40-35-111.

Chapter 9
Tuberculosis

Part 1
General Provisions

68-9-101. Short title.

This chapter shall be known and may be cited as the “Tuberculosis Control Act of 1971.”

Acts 1971, ch. 210, § 1; T.C.A., § 53-1020.

Comparative Legislation. Tuberculosis:

Ala.  Code § 22-11A-9 et seq.

Ark.  Code § 20-15-701 et seq.

Ga. O.C.G.A. § 31-14-1 et seq.

Ky. Rev. Stat. Ann. § 215.014 et seq.

Miss.  Code Ann. § 41-33-1 et seq.

Mo.  Rev. Stat. § 199.001 et seq.

N.C.  Gen. Stat. § 130A-134 et seq.

Va. Code § 32.1-49 et seq.

Collateral References. 39 Am. Jur. 2d Health § 22 et seq.

39A C.J.S. Health and Environment § 18 et seq.

68-9-102. Division of tuberculosis control created.

The department of health is authorized and empowered to create and maintain a division of tuberculosis control, which shall provide effective measures for the diagnosis, prevention, treatment and cure of tuberculosis.

Acts 1971, ch. 210, § 2; 1977, ch. 145, § 1; T.C.A., § 53-1021.

68-9-103. Chapter definitions.

As used in this chapter, unless the context otherwise requires:

  1. “Approved hospitals” means hospitals approved by the commissioner as having adequate facilities and staff for the diagnosis and treatment of tuberculosis;
  2. “Chest disease hospitals” means state-owned hospitals established, operated and maintained by the department for the diagnosis, treatment, prevention and cure of tuberculosis;
  3. “Commissioner” means the commissioner of health or the commissioner's duly authorized representative;
  4. “Department” means the department of health;
  5. “Division” means the division of tuberculosis control;
  6. “Physician” means any doctor of medicine or doctor of osteopathy duly licensed to practice the doctor's profession in Tennessee or the state in which the doctor resides and lawfully practices the doctor's profession;
  7. “Tuberculosis” means a disease caused by the human tubercle bacillus, whether infectious or noninfectious; and
  8. “Tuberculosis suspect” means a person with clinical, epidemiologic, x-ray, or laboratory evidence suggestive of tuberculosis.

Acts 1971, ch. 210, § 3; 1977, ch. 145, § 2; T.C.A., § 53-1022; Acts 1985, ch. 184, § 6.

68-9-104. Rules and regulations — Purposes.

The commissioner is authorized to adopt, promulgate and enforce rules and regulations to:

  1. Enable the department to carry out this chapter for the control of tuberculosis;
  2. Establish criteria for the admission of patients to approved hospitals, and for the proper hospital and out-patient care for these patients; and
  3. Establish procedures for the reporting of tuberculosis and for isolating and quarantining those persons infected with tuberculosis who have been determined by the commissioner or by a state, district, county or municipal health officer to be contagious.

Acts 1971, ch. 210, § 4; 1977, ch. 145, § 3; T.C.A., § 53-1023.

68-9-105. [Repealed.]

Compiler's Notes. Former § 68-9-105 (Acts 1971, ch. 210, § 5; 1977, ch. 145, § 4; T.C.A., § 53-1024), concerning the creation of a hospital board of trustees, was repealed by Acts 1985, ch. 184, § 6.

68-9-106. Data and records.

The department shall maintain a tuberculosis register system and conduct epidemiologic studies of the conditions existing within the state, regarding the prevalence, prevention, treatment and cure of tuberculosis. It shall compile data from the register system and the studies and keep a record of the data, to the end that the disease may be more effectually combated.

Acts 1971, ch. 210, § 11; 1977, ch. 145, § 6; T.C.A., § 53-1030.

68-9-107. Field treatment clinics.

The division has the power and is authorized to expend from the amount appropriated to it such amount as may be recommended by the commissioner and approved by the governor for the establishment and operation of field treatment clinics, which shall include, but not be limited to, the necessary medical personnel, nursing personnel, anti-tuberculosis medications, supplies and x-ray and other equipment necessary to the organization and conduct of such clinic, research, administration, and all other purposes incident thereto.

Acts 1971, ch. 210, § 12; 1977, ch. 145, § 7; T.C.A., § 53-1031.

68-9-108. Acquisition and divestiture of property.

For the execution of the powers, duties and obligations vested in the department, the department has the right to acquire by purchase, gift, bequest, lease, devise or otherwise, all necessary or proper personalty, lands and tenements, or any interest in personalty, lands and tenements as the department may determine to acquire or accept, and the department has the right to sell, give, lease or otherwise dispose of the personalty, lands and tenements, or any interest in the personalty, land and tenements, as, to the best interests of the state and for the execution of the powers and duties vested, may to the department appear necessary or proper; provided, that all property acquired by the department shall be held by the department as trustees for the state of Tennessee, for only the purposes and uses necessary or proper to the execution of the powers and duties.

Acts 1971, ch. 210, § 13; T.C.A., § 53-1032.

68-9-109. Contracts.

  1. The department is empowered to enter into, execute and perform all contracts for services or property, or both, necessary or proper to the execution of the purposes of this chapter and, to this end, may enter into any contract with any county or municipality, or both, jointly, for the use, loan or purchase of any property, real or personal, belonging to the county or municipality, and suitable for the execution of the powers conferred in this chapter, and to make any arrangement for the care, treatment, observation and supervision of eligible patients, under this chapter that may appear proper to the commissioner.
  2. Any contract authorized in this chapter shall comply with all requirements of the law in executing the contract and shall be subject to the budgetary process of the general assembly.

Acts 1971, ch. 210, § 14; 1977, ch. 145, § 17; T.C.A., §§ 53-1033, 53-1049.

68-9-110. Hospital administrative personnel.

The commissioner shall employ a hospital administrator for each of the chest disease hospitals and other capable administrative personnel as are required for the efficient and effective administration of the hospital.

Acts 1971, ch. 210, § 15; T.C.A., § 53-1034; Acts 1985, ch. 184, § 6.

68-9-111. Classification of expenditures — Hospitalization available to all.

  1. The expenditure of public funds for the control of tuberculosis and the isolation and treatment of persons ill with tuberculosis shall be considered as expenditures for the protection of the public health, and not as funds expended for welfare or relief.
  2. Hospitalization shall be available for the diagnosis and treatment of any person having or suspected of having tuberculosis.

Acts 1971, ch. 210, § 16; 1977, ch. 145, § 9; T.C.A., § 53-1035.

68-9-112. Bill collection — Free treatment.

    1. The commissioner may make such rules and regulations as may be deemed necessary to collect all or any part of the established cost of treatment from a patient, or from the person or persons legally liable for the patient's support, who may have income or estate sufficient to make reimbursement without materially affecting their economic support or obligations, or responsibilities to dependents.
    2. All funds collected pursuant to subdivision (a)(1) are to be treated as expendable receipts and are to be used for the operation of the hospitals.
    1. Any resident of Tennessee having or suspected of having tuberculosis, who is considered as acceptable for treatment by the commissioner, may be treated without cost when the person to receive care or treatment, or the person or persons legally responsible for the resident's support, is unable to pay, in whole or in part, the established cost of care and treatment.
    2. The department of human services may be requested to make field investigations.
  1. The department is empowered to enter into and execute contracts with other states or agencies for the reimbursement of the established cost for the care and treatment of persons who are acceptable for treatment by the commissioner.

Acts 1971, ch. 210, § 18; impl. am. Acts 1975, ch. 219, § 1(b); Acts 1977, ch. 145, § 10; T.C.A., § 53-1037.

68-9-113. Fiscal policies authorized to qualify for federal and other aid.

The department, with the approval of the governor, has the power and is authorized to adopt such reasonable fiscal policies governing the use and allocation of funds appropriated under provisions of this chapter as may be necessary to enable the state to procure the maximum possible financial and other aid for tuberculosis control purposes from federal and other agencies.

Acts 1971, ch. 210, § 26; T.C.A., § 53-1045.

68-9-114. Federal aid.

The state of Tennessee accepts any and all legislation enacted by the congress of the United States, whether heretofore or hereafter enacted, providing financial aid to or cooperation with the several states in the eradication, prevention or treatment of tuberculosis.

Acts 1971, ch. 210, § 27; T.C.A., § 53-1046.

68-9-115. Attorney general and reporter— Duties.

It is the duty of the attorney general and reporter, upon the request of the department, to advise the department at all times of its legal rights, duties, powers and obligations, in matters concerning this chapter, to appear in any proceedings in the courts or otherwise, concerning the department and to do all things proper to carry out the duties in this chapter imposed upon the attorney general and reporter.

Acts 1971, ch. 210, § 28; T.C.A., § 53-1047.

68-9-116. East Tennessee Chest Disease Hospital not affected.

Nothing in this chapter shall be construed to affect the continued operation and function of the East Tennessee Chest Disease Hospital or to deny to patients in the area that it serves the opportunity to be admitted to and receive treatment in that hospital, as the availability of facilities and the patient load permit.

Acts 1977, ch. 145, § 16; T.C.A., § 53-1048.

Part 2
Quarantine

68-9-201. Report of diseased persons — Immunity from liability.

  1. If any attending physician or other person knows or has good reason to suspect that a person having tuberculosis is behaving so as to expose other persons to infection, or is about to so conduct themselves, the attending physician or other person shall notify the state, district, municipal or county health officer of the name and address of the diseased person and the essential facts in the case.
  2. State, district, municipal and county health officers involved in tuberculosis control and elimination shall notify appropriate health authorities of jurisdictions in the appropriate states, territories, and municipalities when an individual with confirmed or clinically diagnosed infectious tuberculosis or currently under treatment for tuberculosis disease relocates from Tennessee into another jurisdiction, such notification being subject to approval of the state health officer or such officer's designee. Notwithstanding any law to the contrary, the commissioner of health is authorized to notify the appropriate tuberculosis infection control staff of this or another state of an individual's tuberculosis infection for the sole purpose of containing a potential threat to the public health and welfare or to assure completion of proper treatment of the diseased person. All persons who receive notification of the infectious condition of an individual under this subsection (b) shall hold the information in the strictest confidence and shall not reveal the information to others. A person making disclosure by providing patient identifying information and medical information related to the patient's tuberculosis status is immune from liability for making this disclosure of information for the purpose of preventing the further spread of disease and assuring completion of proper treatment of the diseased person.

Acts 1971, ch. 210, § 19; T.C.A., § 53-1038; Acts 2000, ch. 786, § 1.

Cross-References. Quarantine generally, title 68, ch. 1, part 2.

68-9-202. Examination and quarantine of suspects.

The commissioner and all state, district, county or municipal health officers or their authorized deputies within their respective jurisdictions, are authorized, directed and empowered, when in their judgment it is necessary to protect the public health, to make or have examinations made by a duly licensed and practicing physician of this state to be selected by the health officer, of persons reasonably suspected because of known clinical or epidemiological evidence of having infectious tuberculosis, and to require persons found to have infectious tuberculosis to comply with all provisions of this chapter for protection of the public from exposure to tuberculosis, and also, when in the judgment of the commissioner or state, district, municipal or county health officers, it is necessary to protect the public health, the officers are directed and empowered to isolate or quarantine persons who, because of known clinical or epidemiological evidence, are suspected of having infectious tuberculosis; provided, that any person so suspected may have present at the time of examination a physician of the person's own choosing to participate in the examination.

Acts 1971, ch. 210, § 20; 1977, ch. 145, § 11; T.C.A., § 53-1039.

Collateral References.

Demurrage as affected by quarantine. 44 A.L.R. 841.

General delegation of power to guard against spread of contagious disease as including power to quarantine. 8 A.L.R. 837.

68-9-203. Quarantine conditions.

In establishing isolation or quarantine, the commissioner or state, district, municipal or county health officer having jurisdiction shall designate and define the length of time, site and any other conditions required of the person to be isolated or quarantined.

Acts 1971, ch. 210, § 21; 1977, ch. 145, § 12; T.C.A., § 53-1040.

68-9-204. Quarantine — Commencement — Termination — Standards.

  1. No one but the commissioner, a state, municipal, district or county health officer or such person's duly authorized representative shall establish and terminate isolation or quarantine of persons with infectious tuberculosis.
  2. Isolation or quarantine may be established when clinical signs of the disease are shown to be present with the aid of such laboratory examination for diagnosis as the health officer may deem necessary, or isolation or quarantine may be established when tuberculosis is shown to be present in a communicable stage.
  3. The release of a person from isolation or quarantine for tuberculosis shall be made when, in the judgment of the commissioner or the health officer, the disease is no longer communicable.
  4. It is the duty of the commissioner to set up such clinical and laboratory criteria as may be necessary for the guidance of health officers in the performance of their duties as outlined in this section.

Acts 1971, ch. 210, § 22; 1977, ch. 145, § 13; T.C.A., § 53-1041.

68-9-205. Detention facilities.

The department may establish and maintain one (1) or more detention facilities as the commissioner deems appropriate to sufficiently confine all persons who refuse to be examined, treated, isolated or quarantined as provided for by this part.

Acts 1971, ch. 210, § 23; 1977, ch. 145, § 14; T.C.A., § 53-1042.

68-9-206. Incarceration of suspect — Procedure — Appeal — Violation of quarantine.

    1. Whenever, in the judgment of the commissioner or a state, municipal, district or county health officer, there is reasonable clinical or epidemiological evidence to suspect that any person or persons have infectious tuberculosis that may be communicable, and the person or persons refuse to be examined or comply as provided for in this chapter, the commissioner or health officer or such person's duly authorized deputy is authorized to go before a magistrate or a judge of a court of general sessions and swear out a warrant of arrest for the person or persons.
    2. However, the magistrate or judge is not bound to issue the warrant, unless and until there is a showing of reasonable cause on the basis of sound clinical and epidemiological evidence to believe the person has infectious tuberculosis.
    3. If reasonable cause is shown for the arrest and examination of the person or persons, the magistrate or judge shall direct that an examination be made of the person or persons to determine whether or not they are infectious.
    4. The examination shall be made by the health officer or by a duly licensed and practicing physician of this state to be selected by the health officer, and the accused person or persons may also have a physician of their own choosing present to participate in the examination.
    5. If the physicians are not in accordance as to their diagnosis, then the court shall reach its decision after a hearing.
    6. If after a full hearing the court is of the opinion that the person examined has infectious tuberculosis that may be communicable, the court may commit the person to the custody of the commissioner for detention as provided in § 68-9-205, the person to remain under treatment until the disease, in the opinion of the commissioner or health officer, is no longer communicable.
    7. No appeal or certiorari from the decision of the court committing the person to the place of isolation shall stay the commitment, nor shall any court have the power to supersede the order, but the person or persons shall immediately be placed in the detention facility, there to remain until released by the commissioner or the health officer as no longer communicable, or released by order of court.
    8. Any person committed under this chapter may appeal from the judgment of the magistrate or court of general sessions as now provided by law for civil cases.
    9. Whenever any person violates isolation or quarantine under this chapter by leaving quarantine or isolation except as provided in this chapter, the health officer in charge of the place of isolation or quarantine may invoke the aid of all processes of law and all state, county and municipal authorities to effect the return of the person to the quarantine or isolation.
  1. If a person, who is admitted either voluntarily or as the result of commitment by the processes authorized in this part, violates quarantine by leaving the place of quarantine designated by a health officer, or becomes unruly, boisterous, offensive or recalcitrant or violates in any manner the reasonable rules and regulations of the institution in which the person is quarantined, then the commissioner or health officer may go before the judge of the court of general sessions to ask the court to commit the person to the detention facility, as provided for in this section.

Acts 1971, ch. 210, § 24; 1977, ch. 145, § 15; T.C.A., § 53-1043.

68-9-207. Release for voluntary hospital treatment — Recommitment.

  1. If, at any time after being isolated or quarantined, any person so isolated or quarantined shall, in the opinion of the commissioner or health officer in charge of the place of isolation or quarantine, be a fit and proper person for release from the isolation or quarantine to become a voluntary patient in any hospital for the treatment of tuberculosis, then the commissioner or health officer is  authorized and empowered to release the isolated or quarantined person for admission into such a hospital.
  2. If the isolated or quarantined person so released shall ever hereafter for any reason become a proper person against whom § 68-9-206 should be again invoked, the former release of the person from isolation or quarantine under this section shall not constitute a bar against again invoking § 68-9-206 or any other provisions of this chapter against the person, but the necessity for again invoking § 68-9-206 or any other provisions of this chapter shall be deemed and constitute a new and separate violation of this chapter.

Acts 1971, ch. 210, § 25; T.C.A., § 53-1044.

Chapter 10
Sexually Transmitted Diseases

68-10-101. Chapter definitions.

As used in this chapter, unless the context otherwise requires:

  1. “Commissioner” means the commissioner of health or the commissioner's designee; or in the absence of the commissioner, the deputy commissioner;
  2. “Department” means the department of health;
  3. “Forms” means the certificates that are authorized, prepared and distributed by the department to carry out this chapter;
  4. “Sexually transmitted disease (STD)” means any disease that is transmitted primarily through sexual practices and is identified in rules and regulations of the department; and
  5. “Test” means a test approved by the department to determine possible infection with STDs.

Acts 1988, ch. 695, §§ 1, 2; T.C.A. § 68-10-112.

Code Commission Notes.

Former § 68-10-112 was transferred to this location by authority of the code commission in 2006. Former § 68-10-101 was transferred to § 68-10-112.

Cross-References. Prohibition on AIDS victims donating blood, § 68-32-104.

Testing for AIDS, contaminated blood, cause of action for AIDS infection from untested blood, § 68-32-102.

Collateral References. 39A C.J.S. Health and Environment §§ 28 et seq., 46.

68-10-102. Notice to health officer of name and address of diseased person exposing others to infection.

If any attending physician or other person knows or has good reason to suspect that a person having a STD is behaving so as to expose other persons to infection, or is about to so behave, the attending physician or other person shall notify the municipal or county health officer of the name and address of the diseased person and the essential facts in the case.

Acts 1921, ch. 106, § 2; Shan. Supp., § 3116a9; Code 1932, § 5814; Acts 1943, ch. 73, § 2; C. Supp. 1950, § 5814; T.C.A. (orig. ed.), § 53-1102.

Cross-References. Public schools, information on sexually transmitted diseases, title 68, ch. 1, part 12.

Law Reviews.

Camping Trips and Family Trees: Must Tennessee Physicians Warn Their Patients' Relatives of Genetic Risks? (Carol McCrehan Parker), 65 Tenn. L. Rev. 585 (1998).

68-10-103. Printed instructions given patients.

It is the duty of every physician or other person treating persons infected with a STD to give such persons printed instructions containing information deemed advisable by the department, such printed instructions to be furnished by the department.

Acts 1921, ch. 106, § 3; impl. am. Acts 1923, ch. 7, § 46; Shan. Supp., § 3116a10; Code 1932, § 5815; T.C.A. (orig. ed.), § 53-1103.

68-10-104. Officers to examine suspected persons and require treatment — Sources of infection to be investigated.

    1. State, district, county and municipal health officers or their authorized deputies, within their respective jurisdictions, are directed and empowered, when, in their judgment, it is necessary to protect the public health, to make an examination of a person reasonably suspected because of known clinical or epidemiological evidence of being infected with a STD of a communicable nature, and to require such person when found infected to report for treatment to a reputable physician or clinic, and continue treatment until discharged by the physician or clinic as noninfectious, or in a stage of the disease in which an infectious relapse will not occur, or to submit to treatment provided at public expense until discharged as noninfectious, or in a stage of the disease in which an infectious relapse will not occur; and also, when in the judgment of the state, municipal or county health officer, it is necessary to protect the public health, to isolate and quarantine the person infected with a STD; provided, that any person so suspected may have present at the time of examination a physician of the person's own choosing to participate in the examination.
    2. Loitering about or residing in a house of assignation or prostitution or any other place where lewdness is practiced shall be construed as sufficient to suspect a person of being infected with a STD.
  1. It is the duty of all health officers to investigate sources of infection of STDs and to cooperate with the proper officers whose duty it is to enforce laws directed against prostitution, lewdness and assignation and the spread of STDs.
  2. The following healthcare officers and providers licensed in this state may examine, diagnose, and treat minors infected with STDs without the knowledge or consent of the parents of the minors, and shall incur no civil or criminal liability in connection with the examination, diagnosis, or treatment, except for negligence:
    1. Any state, district, county, or municipal health officer; or
    2. Any physician, nurse practitioner with a certificate of fitness and an appropriate supervising physician, nurse midwife who is an advanced practice registered nurse under § 63-7-126 and who has an appropriate supervising physician, or physician assistant with an appropriate supervising physician.

Acts 1921, ch. 106, § 4; Shan. Supp., § 3116a11; Code 1932, § 5816; Acts 1943, ch. 73, § 3; C. Supp. 1950, § 5816; Acts 1969, ch. 39, § 1; T.C.A. (orig. ed.), § 53-1104; Acts 2017, ch. 266, § 1.

Amendments. The 2017 amendment, in the present introductory language of (c), substituted “The following healthcare officers and providers licensed in this state” for “Any state, district, county or municipal health officer or physician” at the beginning, and inserted commas following “diagnose” and “diagnosis”; and added (c)(1) and (c)(2).

Effective Dates. Acts 2017, ch. 266, § 2. July 1, 2017.

Textbooks. Tennessee Jurisprudence, 14 Tenn. Juris., Health, § 1.

Cited: State v. Fears, 659 S.W.2d 370, 1983 Tenn. Crim. App. LEXIS 413 (Tenn. Crim. App. 1983).

NOTES TO DECISIONS

1. Quarantine Regulations.

Person examined and found to be infected with venereal disease was properly placed in quarantine. State ex rel. Kennedy v. Head, 182 Tenn. 249, 185 S.W.2d 530, 1945 Tenn. LEXIS 215 (1945).

2. Criminal Liability.

Person confined to quarantine for venereal disease who escaped from quarantine was subject to fine on the basis of § 68-10-111. State ex rel. Kennedy v. Head, 182 Tenn. 249, 185 S.W.2d 530, 1945 Tenn. LEXIS 215 (1945).

68-10-105. Infected persons isolated or quarantined to specified area.

In establishing isolation or quarantine, the municipal or county health officer having jurisdiction shall designate and define the limits of the area within which the infected person is to be isolated or quarantined, and no person other than the attending physician or nurse shall enter or leave the area of isolation or quarantine without the permission of the health officer.

Acts 1921, ch. 106, § 5; Shan. Supp., § 3116a12; Code 1932, § 5817; T.C.A. (orig. ed.), § 53-1105.

68-10-106. Quarantine of infected persons.

    1. No one but a state, municipal, district or county health officer or such officer's duly authorized representative shall establish and terminate quarantine of persons infected with STDs.
    2. A decision to establish or terminate quarantine shall be based upon the judgment of the state, municipal, district or county health officer or such officer's duly authorized representative, considering available medical and epidemiological information concerning the STD diagnosis, modes of transmission, available treatment, and the necessity of the protection of the public health.
  1. It is the duty of the commissioner to set up the clinical and laboratory criteria necessary for the guidance of health officers in the performance of their duties as outlined in this section.

Acts 1921, ch. 106, § 6; Shan. Supp., § 3116a13; Code 1932, § 5818; Acts 1943, ch. 73, § 4; C. Supp. 1950, § 5818; T.C.A. (orig. ed.), § 53-1106; Acts 1988, ch. 695, §§ 1, 4.

68-10-107. Exposure of others by infected person.

It is a violation of this chapter for any person infected with a STD to expose another person to such infection.

Acts 1921, ch. 106, § 8; Shan. Supp., § 3116a15; Code 1932, § 5820; T.C.A. (orig. ed.), § 53-1107.

68-10-108. Places for detention of infected persons.

The county legislative bodies and the city officials, or other boards of the incorporated towns or cities, are empowered to provide suitable places for the detention of persons who may be subjected to isolation or quarantine and who should be segregated under this chapter. County legislative bodies and governing boards of incorporated cities and towns are authorized to incur, on behalf of their counties, cities and towns, the expenses necessary to the enforcement of this chapter.

Acts 1921, ch. 106, § 9; Shan. Supp., § 3116a16; Code 1932, § 5821; impl. am. Acts 1978, ch. 934, §§ 7, 36; T.C.A. (orig. ed.), § 53-1108.

68-10-109. Rules and bylaws for control of sexually transmitted diseases.

  1. The department of health is empowered and directed to make such rules and bylaws for the control of STDs, not in conflict with this chapter, including the reporting of STDs and isolating and quarantining of infected persons, as it may from time to time deem advisable.
  2. All rules and bylaws made pursuant to subsection (a) shall be of force and binding upon the state, municipal and county health officers, and all other persons affected by the rules and regulations, and shall have the force and effect of law.

Acts 1921, ch. 106, § 10; impl. am. Acts 1923, ch. 7, § 46; Shan. Supp., § 3116a17; Code 1932, § 5822; T.C.A. (orig. ed.), § 53-1109.

Cross-References. Rules and regulations regarding pregnancy serological tests, § 68-5-606.

Rules and regulations regarding transmission of HIV, § 39-13-108.

Cited: State ex rel. Kennedy v. Head, 182 Tenn. 249, 185 S.W.2d 530, 1945 Tenn. LEXIS 215 (1945).

68-10-110. Arrest and temporary commitment for treatment authorized — Hearing — Examination — Appeal.

  1. Whenever in the judgment of the municipal, county or district health officer, there is reasonable clinical or epidemiological evidence to suspect that any person or persons are infected with a STD as defined in this chapter, and the person or persons refuse to be examined as provided in § 68-10-104, the health officer or the health officer's authorized deputy may go before a magistrate or judge of a court of general sessions and swear out a warrant of arrest for the person or persons.
  2. The magistrate or judge is not bound to issue the warrant pursuant to subsection (a), unless and until there is a showing of reasonable cause on the basis of sound clinical and epidemiological evidence.
  3. If reasonable cause is shown for the arrest and examination of the person or persons, the magistrate or judge shall direct that an examination be made of the person or persons to determine whether or not they are infected.
  4. The examination shall be made by the health officer or by a duly licensed and practicing physician of this state, to be selected by the health officer. The accused person or persons may also have a physician of their own choosing present to participate in the examination.
  5. If the physicians are not in accordance as to their diagnosis, then the court shall reach its decision after a hearing.
  6. If, after a full hearing, the court is of the opinion that the person examined is infected with a STD as defined in this chapter, the court may commit the person to an isolation hospital maintained by the state or local government for the purpose of detaining and treating such persons, who shall remain under treatment until the disease, in the opinion of the health officer, is no longer communicable or no longer in a stage in which infectious relapse may occur.
  7. No appeal or certiorari from the decision of the court committing the person to the isolation hospital shall stay the commitment, nor shall any court have power to supersede such order, but the person or persons shall immediately be placed in the isolation hospital, there to remain until released by the health officer as no longer communicable or in a stage of the disease in which infectious relapse may occur, or released by order of the court.
  8. Any person committed under this chapter may appeal from the judgment of the magistrate or court of general sessions as now provided by law for civil cases.

Acts 1921, ch. 106, § 11; impl. am. Acts 1923, ch. 7, § 46; Shan. Supp., § 3116a18; mod. Code 1932, § 5823; Acts 1943, ch. 73, § 6; C. Supp. 1950, § 5823; T.C.A. (orig. ed.), § 53-1110.

68-10-111. Violation of chapter — Penalty.

Any health officer or any other persons who fail to perform the duties required of them in this chapter, or violate any of the provisions of this chapter, or of any rule or bylaw promulgated under its authority, commit a Class C misdemeanor. Each violation is a separate offense.

Acts 1921, ch. 106, § 12; Shan. Supp., § 3116a19; mod. Code 1932, § 5824; T.C.A. (orig. ed.), § 53-1111; Acts 1989, ch. 591, § 113.

Cross-References. Penalty for Class C misdemeanor, § 40-35-111.

Attorney General Opinions. The district attorney general is not an “appropriate state agency,” under T.C.A. § 68-10-113(3), to receive health department records regarding a person who has HIV, unless the district attorney general is prosecuting, or is considering prosecuting, an individual under T.C.A. § 39-13-108 or § 68-10-111; unless such a circumstance exists, the district attorney general must obtain a court order under T.C.A. § 68-10-113(6), to obtain access to health department records regarding a person who has HIV, OAG 01-146 (9/14/01).

Absent a consent under T.C.A. § 68-10-113(2) or a court order under T.C.A. § 68-10-113(6), a health department employee is prohibited from talking to the district attorney general about: (1) The mens rea of a criminal defendant whom the district attorney general is either prosecuting, or is considering prosecuting, for knowingly exposing someone to HIV; or (2) Factual information regarding an HIV patient which is not noted in the patient's chart, but which would go to the patient's intention to commit a crime, OAG 01-146 (9/14/01).

NOTES TO DECISIONS

1. Penalty for Violation.

Person confined to quarantine for venereal disease who escaped from quarantine was subject to fine on the basis of this section. State ex rel. Kennedy v. Head, 182 Tenn. 249, 185 S.W.2d 530, 1945 Tenn. LEXIS 215 (1945).

68-10-112. Reports of physicians and health officers.

  1. Every physician or other person who makes a diagnosis of, treats, or prescribes for a case of STD and every superintendent or manager of a clinic, hospital, laboratory or penal institution, in which there is a case of STD, shall report the case immediately to those persons or agencies designated as recipients of such reports by the commissioner.
  2. Reports shall be made on forms supplied by the department, stating the name, address, age, sex, race, stage of the disease and other information on the form as may be required for the location, treatment and control of infectious cases.
  3. Reporting of STDs, other than those designated as reportable in the regulations promulgated by the department, is not required.

Acts 1921, ch. 106, § 1; impl. am. Acts 1923, ch. 7, § 46; Shan. Supp., § 3116a8; Code 1932, § 5813; Acts 1943, ch. 73, § 1; C. Supp. 1950, § 5813; T.C.A. (orig. ed.), § 53-1101; Acts 1988, ch. 695, §§ 1, 3; T.C.A. § 68-10-101.

Code Commission Notes.

Former § 68-10-101 was transferred to this location by authority of the code commission in 2006. Former § 68-10-112 was transferred to § 68-10-101.

Cross-References. Family life curriculum, title 49, ch. 6, part 13.

Physician, health personnel or institutional report of venereal disease, venereal herpes or chlamydia in children, § 37-1-403.

Pregnancy serological tests for syphilis, title 68, ch. 5, part 6.

Prohibition on AIDS victims donating blood, § 68-32-104.

Public school nurse program, title 68, ch. 1, part 12.

Testing for AIDS, contaminated blood, cause of action for AIDS infection from untested blood, § 68-32-102.

Textbooks. Tennessee Jurisprudence, 14 Tenn. Juris., Health, § 1.

Tennessee Law of Evidence (2nd ed., Cohen, Paine and Sheppeard), § 501.10.

Law Reviews.

Camping Trips and Family Trees: Must Tennessee Physicians Warn Their Patients' Relatives of Genetic Risks? (Carol McCrehan Parker), 65 Tenn. L. Rev. 585 (1998).

Updating Tennessee's Public Records Law (Douglas Pierce), 24 Tenn. B.J. 24 (1988).

Comparative Legislation. Sexually transmitted diseases:

Ala.  Code § 22-11A-13 et seq.

Ark.  Code § 20-16-501 et seq.

Ga. O.C.G.A. § 31-17-1 et seq.

Ky. Rev. Stat. Ann. § 214.400 et seq.

Miss.  Code Ann. § 41-23-27 et seq.

N.C.  Gen. Stat. § 130A-134 et seq.

Va. Code § 32.1-55 et seq.

NOTES TO DECISIONS

1. Quarantine Regulations.

Person examined and found to be infected with venereal disease was properly placed in quarantine. State ex rel. Kennedy v. Head, 182 Tenn. 249, 185 S.W.2d 530, 1945 Tenn. LEXIS 215 (1945).

2. “Public” Construed.

Courts, grand juries, and district attorneys are not embraced in the term “public” as used in this section. State v. Fears, 659 S.W.2d 370, 1983 Tenn. Crim. App. LEXIS 413 (Tenn. Crim. App. 1983).

Collateral References. 39 Am. Jur. 2d Health § 23 et seq.

39A C.J.S. Health and Environment § 18 et seq.

Physical examination or test, health regulations requiring submission to, as violation of constitutional rights. 164 A.L.R. 967, 25 A.L.R.2d 1407.

Venereal disease, compulsory examination for. 2 A.L.R. 1332, 22 A.L.R. 1189.

Venereal diseases, constitutionality, construction and application of statutes, ordinances and regulations concerning prevention and cure of. 127 A.L.R. 421.

68-10-113. Confidentiality of records and information.

All records and information held by the department or a local health department relating to known or suspected cases of STDs shall be strictly confidential. This information shall not be released or made public upon subpoena, court order, discovery, search warrant or otherwise, except that release may be made under the following circumstances:

  1. Release is made of medical or epidemiological information for statistical purposes, in such form that no individual person can be identified;
  2. Release is made of medical or epidemiological information with the consent of all persons identified in the information released;
  3. Release is made of medical or epidemiological information to medical personnel, appropriate state agencies, or county and district courts to enforce this chapter and related regulations governing the control and treatment of STDs;
  4. Release is made of medical or epidemiological information to medical personnel in a medical emergency to the extent necessary to protect the health or life of the patient;
  5. In a case involving a minor not more than thirteen (13) years of age, only the name, age, address and STD treated shall be reported to appropriate agents as required by § 37-1-403. No other information shall be released. If the information to be disclosed is required in a court proceeding involving child abuse, the information shall be disclosed in camera; or
    1. Release is made during a legal proceeding when ordered by a trial court judge, designated by § 16-2-502, or a juvenile court judge through an order explicitly finding each of the following:
      1. The information sought is material, relevant, and reasonably calculated to be admissible evidence during the legal proceeding;
      2. The probative value of the evidence outweighs the individual's and the public's interest in maintaining its confidentiality;
      3. The merits of the litigation cannot be fairly resolved without the disclosure; and
      4. The evidence is necessary to avoid substantial injustice to the party seeking it and, either the disclosure will result in no significant harm to the person examined or treated, or it would be substantially unfair as between the requesting party and the person examined or treated not to require the disclosure.
    2. A juvenile court judge shall make the findings set forth in subdivision (6)(A) by examining the information, in camera, and shall order the information placed under seal. The judge shall only examine the records of a juvenile who is under the jurisdiction of the court.

Acts 1988, ch. 695, §§ 1, 2; 1992, ch. 887, §§ 1, 2.

Cross-References. Confidentiality of public records, § 10-7-504.

Attorney General Opinions. The district attorney general is not an “appropriate state agency,” under T.C.A. § 68-10-113(3), to receive health department records regarding a person who has HIV, unless the district attorney general is prosecuting, or is considering prosecuting, an individual under T.C.A. § 39-13-108 or § 68-10-111; unless such a circumstance exists, the district attorney general must obtain a court order under T.C.A. § 68-10-113(6), to obtain access to health department records regarding a person who has HIV, OAG 01-146 (9/14/01).

Absent a consent under T.C.A. § 68-10-113(2) or a court order under T.C.A. § 68-10-113(6), a health department employee is prohibited from talking to the district attorney general about: (1) The mens rea of a criminal defendant whom the district attorney general either is either prosecuting or is considering prosecuting; or (2) For knowingly exposing someone to HIV or factual information regarding an HIV patient which is not noted in the patient's chart, but which would go to the patient's intention to commit a crime, OAG 01-146 (9/14/01).

68-10-114. Knowledge of governmental persons regarding records.

Except as provided in § 68-10-113, no state or local department officer or employee shall be examined in a civil, criminal, special or other proceeding as to the existence or contents of pertinent records of a person examined or treated for a STD by a state or local health department, or of the existence or contents of such reports received from a private physician or private health facility.

Acts 1988, ch. 695, §§ 1, 2.

68-10-115. Immunity from liability for informing person of potential HIV infection.

A person who has a reasonable belief that a person has knowingly exposed another to HIV may inform the potential victim without incurring any liability. A person making such disclosure is immune from liability for making disclosure of the condition to the potential victim.

Acts 1993, ch. 322, § 3.

68-10-116. Exposure of officers, emergency personnel or employees of Tennessee bureau of investigation's crime laboratories to hepatitis or HIV virus — Testing of blood or body fluids.

    1. If, during the course of arresting, transporting, or processing a person charged with the commission of a criminal offense, a law enforcement officer is exposed to the blood or other body fluid of the arrested person in any manner that presents a significant risk of transmission of the hepatitis virus or the HIV/AIDS virus, then the exposed officer may request that the arrested person's blood be tested for the presence of the hepatitis virus and the HIV/AIDS virus, and such test shall be administered if requested.
    2. If, during the course of receiving, analyzing, or transporting the blood or other body fluid of any person who has been arrested and charged with a criminal offense, an employee of any of the Tennessee bureau of investigation's crime laboratories is exposed to the blood or body fluid in any manner that presents a significant risk of transmission of the hepatitis virus or the HIV/AIDS virus, then the exposed employee may request that the arrested person's blood be tested for the presence of the hepatitis virus and the HIV/AIDS virus, and such test shall be administered if requested.
    3. If, while acting in the scope of duty, a firefighter, emergency medical technician-paramedic, or emergency medical technician is exposed to the blood or other body fluid of an arrested person in any manner that presents a significant risk of transmission of the hepatitis virus or the HIV/AIDS virus, then the exposed individual may request that the arrested person's blood be tested for the presence of the hepatitis virus and the HIV/AIDS virus, and such test shall be administered if requested.
  1. Testing shall occur at a licensed health care facility, with the cost to be paid by the state, county, or municipal subdivision that employs the law enforcement officer, fire fighter, emergency medical technician-paramedic, emergency medical technician, or employee of the crime laboratory of the Tennessee bureau of investigation. Any person who, acting at the written request of a law enforcement officer, fire fighter, emergency medical technician-paramedic, emergency medical technician, or employee of the crime laboratory of the Tennessee bureau of investigation, withdraws blood from a person for the purpose of making the test, shall not incur any civil or criminal liability as a result of the withdrawing of the blood, except for any damages that may result from the negligence of the person withdrawing the blood. Neither shall the hospital or licensed health care facility incur, except for negligence, any civil or criminal liability as a result of the act of withdrawing blood from any person. The results of the testing shall be confidential; provided, that the law enforcement officer, fire fighter, emergency medical technician-paramedic, emergency medical technician, or employee of the crime laboratory of the Tennessee bureau of investigation, exposed to the blood or other body fluid shall have the right to request the results of the testing and the person providing the test results shall be immune from liability in the same manner as is provided in § 68-10-115.
  2. As used in this section, “law enforcement officer” includes an employee of any of the Tennessee bureau of investigation's crime laboratories, firefighter, emergency medical technician-paramedic, or emergency medical technician; provided, however, that nothing in this section shall grant any law enforcement authority to a person who does not otherwise have the authority.

Acts 1994, ch. 914, § 1; 2005, ch. 17, §§ 1, 2; 2011, ch. 270, § 1; 2017, ch. 345, §§ 1, 2.

Amendments. The 2017 amendment, throughout (a), substituted “may request” for “has the right to request” and substituted “hepatitis virus” for “hepatitis B virus”; in (a)(2) deleted “B” following “hepatitis” near the middle and added “, and such test shall be administered if requested” at the end of (a)(1), (a)(2) and (a)(3); and added (c).

Effective Dates. Acts 2017, ch. 345, § 3. May 9, 2017.

Cross-References. Confidentiality of public records, § 10-7-504.

Collateral References.

Validity and propriety under circumstances of court-ordered HIV testing. 87 A.L.R.5th 631.

68-10-117. Possible exposure of emergency workers to airborne or bloodborne diseases — Testing.

  1. If, in the course of performing normal, authorized professional job duties, or rendering emergency care as a good samaritan under the Good Samaritan Law, codified in § 63-6-218, a member of one of the categories of individuals listed in subsection (d) reasonably believes that the member may have been exposed to potentially life-threatening airborne or bloodborne diseases, including, but not limited to, tuberculosis, HIV or hepatitis B, the person has the right to request, in writing, that the individual who may have exposed the person be evaluated to determine the presence of such disease or diseases. The request shall be made to the designated exposure control officer of the responding agency or county medical examiner, who shall conduct the evaluation pursuant to the rules provided for in subsection (c).
  2. Any evaluation pursuant to subsection (a) shall include all medical records held by the department of health, any health care provider, or health care facility pertaining to the individual who is the subject of the evaluation. Any information provided shall be made available in accordance with the rules provided for in subsection (c) and shall be used only for the purpose of performing the evaluation and shall be otherwise confidential. Any cost related to the evaluation shall be paid by the responding agency.
  3. Any evaluation provided for in subsection (a) shall be conducted pursuant to emergency rules promulgated by the commissioner of health consistent with federal regulations for such determination of exposure experienced by emergency response workers. Any agency, individual, or facility providing any assistance or information necessary for completing the evaluation shall not incur any civil or criminal liability as a result of providing assistance or information consistent with the rules promulgated pursuant to this subsection (c).
  4. The categories of individuals who may request evaluations are paramedics, emergency response employees, fire fighters, first response workers, emergency medical technicians, and volunteers making an authorized emergency response. The evaluations may also be requested by any person rendering services as a good samaritan under the Good Samaritan Law.

Acts 1997, ch. 539, § 1; 2002, ch. 589, §§ 1-3; 2009, ch. 566, § 12.

Compiler's Notes. Acts 2009, ch. 566, § 12 provided that the Tennessee code commission is directed to change all references to public necessity rules, wherever such references appear in this code, to emergency rules, as sections are amended and volumes are replaced.

Cross-References. Confidentiality of public records, § 10-7-504.

68-10-118. AIDS Centers of Excellence established — Committee membership — Terms — Compensation and reimbursement.

  1. Subject to annual appropriations made available to the state by the United States public health service through Part B (Title II) of the Ryan White CARE Act, compiled in 42 U.S.C. § 300ff-21 et seq., the commissioner of health shall establish an AIDS Center of Excellence advisory committee to advise the department of health in the designation of AIDS Centers of Excellence, provide quality assurance monitoring for the centers, and the establishment and review of policies for continuation of the AIDS Centers of Excellence. If, in any fiscal year, federal funding for the committee is eliminated or reduced, then the committee shall cease to exist in accordance with title 4, chapter 29.
  2. The committee shall be appointed by the commissioner of health, and shall be composed of the commissioner of health or the commissioner's designee, who shall serve as chair; the director of communicable and environmental disease services within the Tennessee department of health; three (3) physicians licensed in the state of Tennessee, each representing a grand division of the state and actively involved in the delivery of HIV/AIDS care; an attorney licensed in the state of Tennessee; a nurse licensed in the state of Tennessee and actively involved in the delivery of HIV/AIDS care; a social worker licensed in the state of Tennessee and actively involved in the delivery of HIV/AIDS care; and two (2) at-large members currently living with HIV/AIDS.
  3. The members' appointments shall be staggered as follows: four (4) members to be appointed for a term of three (3) years; two (2) members for a term of four (4) years; and the remaining members for a term of two (2) years. Any member appointed to fill a vacancy for an unexpired term shall serve the remainder of that term.
  4. The committee shall meet as frequently as the commissioner deems necessary, but not less than once each year. The committee members shall receive no compensation but will be reimbursed for travel expenses incurred in carrying out their duties as members of this committee. All reimbursements for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.

Acts 2001, ch. 294, § 1.

Cross-References. AIDS education programs and prevention of AIDS or other sexually transmitted diseases, § 49-6-1008.

Grand divisions, title 4, ch. 1, part 2.

Chapter 11
Health Facilities and Resources