Must a jurisdiction have a local health director? What happens if a local health director is not appointed?

For all agency types except a consolidated human services agency (CHSA), the local board of health appoints the local health director. The director of a CHSA is appointed by the county manager with the advice and consent of the board, and the CHSA director must then appoint a person with the qualifications of a health director.

The different statutes that describe the procedures for appointing a local health director all use mandatory language—the word “shall”—suggesting that the appointment of a local health director is obligatory, not discretionary. For example, the statute addressing county and district health directors states that the local board of health “shall” appoint a health director who meets particular qualifications.[1] There is also a state rule that requires each local health department to have a local health director,[2] and a state accreditation standard that requires the local board of health to assure that a qualified health director is in place to lead the agency.[3] Finally, the local health director has a number of legal powers and duties, which someone must be empowered to exercise.[4] It thus appears that the appointing entity (the board or the county manager) does not have the discretion to choose not to appoint a director.[5]

When vacancies in the health director position occur, there may be a period of time during which an individual is named as an acting or interim health director while a search is conducted. However, if a director of a county health department, a district health department, or a public health authority is not appointed within 60 days after the vacancy is created, the State Health Director may appoint a person to serve as local health director until the local board makes its appointment.[6] The CHSA statute does not include a provision authorizing the State Health Director to make an appointment if the county manager fails to appoint an agency director, or if the agency director fails to appoint a person with the qualifications of a local health director.[7] It is unclear what would happen if either of the positions were to remain vacant for an extended period of time.