Alcohol and Drug Abuse Counselors

Legislative Activity of Note

  • Legislative and Congressional redistricting.
  • “Truth in Sentencing” Act to make mandatory sentences for certain criminal offenses.
  • “Tennessee Investment in Student Achievement (TISA) Act” to reform the school funding approach.

Highlights and Noteworthy Health-Related Legislation

  •  The Department had two successful legislative initiatives that became law relating to local county health departments and the Controlled Substance Monitoring Database, respectively
  • Healthcare Facilities will move to the Health Services and Development Agency (HSDA)/Health Facility Commission on July 1, 2022
  • Healthcare providers can continue to utilize telehealth and receive reimbursement for telehealth services.
  • The Board of Pharmacy and the Board of Nursing will now hire and fire the Executive Director of the Board.
  • A registry within the Tennessee Commission on Aging and Disability was created to combat the operation of unlicensed facilities.

Pertinent Public Chapters

*All Public Chapters are Hyperlinked to the Document on the Secretary of State’s Website*

Public Chapter 644—SB1823/HB1867—Johnson/Zachary

Re: Covid-19 Vaccine Exemptions. This public chapter requires that an employer grant certain exemptions to requirements of proof/receipt of vaccinations if the request for exemption is either (1) supported by signed/date statement by a licensed physician that the staff member has a condition recognized under generally accepted medical standards as a basis for the medical exemption or (2) the staff member attests in writing (including electronic means) that the staff member has a sincerely held religious believe that prevents the staff member from complying the requirement in accordance with guidance from Medicare and Medicaid services. This public chapter creates a civil penalty of $10,000 for violation of this statute.
Effective as of March 11, 2022.

Public Chapter 749—SB2572/HB2465—Crowe/Leatherwood

Re Naloxone Standing Order. This public chapter allows licensed healthcare workers to prescribe, directly or through standing order, naloxone or other similarly acting and equally safe drugs approved by the FDA to an organization or municipal or county entity, including but not limited to a recovery organization, hospital, school, or county jail. This public chapter also allows an individual or entity under a standing order to receive and store an opioid antagonist and provide an opioid antagonist directly or indirectly to an individual. Additionally, this public chapter authorizes a first responder acting under a standing order to receive and store an opioid antagonist and to provide an opioid antagonist to an individual at risk of experiencing a drug-related overdose or to a family member friend or other individual in a position to assist an at-risk individual. This public chapter includes “unresponsiveness, decreased level of consciousness, and respiratory depression” to be included within the definition of drug related overdose.
Effective on July 1, 2022.

Public Chapter 756—SB1789/HB2858—Briggs/Kumar

Re Conditions of Participation. This public chapter removes the requirement that a healthcare provider enrolled in Medicare or Medicaid be subject to conditions of participation to be exempt from the definition of “private business” or “governmental entity” for purposes of the Title 14/Covid-19 state laws.
Effective as of March 31, 2022.

Public Chapter 764—SB2427/HB2177—Johnson/Lamberth

Drug Paraphernalia. This public chapter excludes narcotic testing equipment used to determine wither a controlled substance contains a synthetic opioid from the definition of “drug paraphernalia” as used within the criminal code unless the narcotic testing equipment is possessed for purposes of the defendant’s commission of certain drug related offenses. This public chapter will be repealed on July 1, 2025.
Effective as of March 31, 2022.

Public Chapter 766—SB2453/HB2655—Yager/Hawk

Re Telehealth. This public chapter extends the ability for healthcare providers to receive reimbursement for healthcare services provided during a telehealth encounter. This public chapter also clarifies that a healthcare provider acting within the scope of a valid license is not prohibited from delivering services through telehealth. Lastly, this public chapter adds that the requirement of an in-person encounter between the healthcare services provider, the provider’s practice group, or the healthcare system and patient within sixteen months prior to the interactive visit is tolled for the duration of a state of emergency declared by the Governor provided that healthcare services provider or patient, or both, are located in the geographical area covered by the state of emergency.

Effective as of April 1, 2022 and applies to insurance policies or contracts issued, entered into, renewed, or amended on or after that date.

Public Chapter 769—SB568/HB702—Johnson/Lamberth

Re Anatomical Gifts. This public chapter prohibits a healthcare provider, a hospital, an ambulatory surgical treatment center, a home care organization or any other entity responsible for matching anatomical gifts or organ donors to potential recipients from, solely on the basis of whether an individual has received or will receive a Covid-19 vaccine, (1) consider an individual ineligible for transplant or receipt of an anatomical gift, (2) deny medical or other services related to transplantation, (3) refuse to refer an individual to a transplant center or specialist, (4) refuse to place an individual on an organ or tissue waiting list, or (5) place an individual at a position on an organ or tissue waiting list lower than the position the person at which the individual would have been placed if not for the individual’s vaccine status.

Effective as of April 8, 2022.

Public Chapter 804—SB1802/HB1763—Reeves/Lamberth

Re Drug Paraphernalia. This public chapter includes pill press devices and pieces of pill press devices to the definition of drug paraphernalia for the purposes of drug offenses. Pill devices or pieces of pill press devices are not included within this definition if used by a person or entity that lawfully possesses drug products in the course of legitimate business activities, such as a pharmacy or pharmacist.

Effective on July 1, 2022 and applies to offenses committed on or after that date.

Public Chapter 807—SB1846/HB1843—Watson/Terry

Re HIPPA Compliant Provider-Based Telemedicine. This public chapter recognizes HIPPA complaint audio only conversation for the provision of certain behavioral health services and healthcare services as “provider-based telemedicine” when the use of HIPPA compliant real-time, interactive video, video telecommunications, electronic technology, or store-and-forward telemedicine services are unavailable. Additionally, this public chapter specifies requirements for a healthcare provider, office staff, or party acting on behalf of the healthcare provider submitting for reimbursement of an audio-only encounter.

Effective as of April 8, 2022.

Public Chapter 833—HB1997/SB1936—Cochran/Jackson

Re UAPA. Clarifies that the ALJ shall decide a procedural questions of law. Allows the director of the administrative procedures division of the secretary of state’s office to issue subpoenas. Allows electronic participation in hearings, by agreement of the parties. The hearing officer may allow electronic testimony if the absence of the witness would otherwise cause of delay of the hearing. Requires that a final orders be issued within 90 days. Allows that a petition for reconsideration be filed within 15 days of the entry of the final order or initial order.

Effective as of April 19, 2022.

Public Chapter 856—HB2864/SB2889—Rudd/Gardenhire

Re Public Meetings. Permits boards or agencies of state government to have electronic meetings. If an electronic meeting is being held, requires that members of the public be allowed to view and/or listen to the meeting in real time. There must also be a method of members of the public to participate in the meeting electronically, if they would otherwise be permitted to participate in person. Instructions for participate are to be included in the notice of the meeting. An electronic meeting shall be recorded and that recording must be posted on the website of the organization within 3 days. The governing body shall maintain that electronic record of the meeting for at least 3 years.

Effective on July 1, 2022.

Public Chapter 881—SB2240/HB2335—Haile/Vaughn

Re Buprenorphine. Prohibits prescribing of buprenorphine via telehealth unless the healthcare provider is employed by a licensed non-residential opioid treatment facility, a community mental health center, an FQHC, a hospital, or through TennCare.

Effective as of April 14, 2022.

Public Chapter 883—SB2285/HB1749—Bell/Ragan

Re UAPA and Judicial Review Standards. Requires that a judge over a contested case not defer to an agency’s interpretation of the statue or rule and shall interpret it de novo. Remaining ambiguity shall be resolved against the agency.

Effective as of April 14, 2022.

Public Chapter 911—HB2309/SB2464—Freeman/Reeves

Re Professional License Requirements. Mandates that a person seeking a professional license have US citizenship or be authorized under federal law to work in the US as verified by the SAVE Program (allows DACA children who are now adults to obtain professional licensure if not otherwise prevented by the license).

Effective July 1, 2022.

Public Chapter 930—HB1871/SB1982—Hulsey/Hensley

Re Covid Vaccinations and Acquired Immunity. Amends Title 14 to mandate that acquired immunity from a previous Covid-19 infection be treated the same as a Covid-19 vaccination by a governmental entity, school, or local education authority. Mandates that private businesses who require vaccinations also include recognition for acquired immunity for Covid-19.

Effective as of April 11, 2022—This was not signed by Governor.

Public Chapter 1024—SB1748/HB1827—Roberts/Ragan

Re UAPA and Rules. Makes permanent all rules that were filed with the Secretary of State between January 1, 2021 and in effect upon passage of the act, unless they conflict with legislation passed during this session.

Effective as of May 11, 2022.

Public Chapter 1054—HB1747/SB1877—Jernigan/Yarbro

Re Cannabanoid Oil and Quadriplegia. Adds quadriplegia to one of the qualifying ailments that can be in legal possession of cannabanoid oil.

Effective as of May 25, 2022.

Public Chapter 1061—HB2228/S2465—Ramsey/Reeves

Re Opioid Antagonists. Requires that a prescriber offer a prescription for an opioid antagonist when issuing a prescription for an opioid if the prescription is for longer than 3 days and there is a history of or suspicion of abuse. This does not apply in palliative care or veterinarian settings. Penalties are included for failure to comply.

Effective on July 1, 2022 and applies to opioid prescriptions issued after that date.

Public Chapter 1073—HB2665/SB2449—Sexton, McNally

Re Covid Visitation Policies and Limitations on Covid Treatment Exemptions. Clarifies that a prescriber can be disciplined for prescribing controlled substances and/or narcotics for treatment of Covid, if appropriate. In addition, creates a patient advocate process that hospitals must follow during times of covid concern. Allows that person to enter a facility if they agree to follow procedures but provides certain exceptions to access to locations within the hospital.

Effective as of May 25, 2022.

Public Chapter 1094—SB1891/HB1905—Hulsey/Doggett

Re Mandatory Reporting of Fatal Drug Overdoses. Requires that a fatal overdose be reported to law enforcement, including by doctors and nurses.

Effective July 1, 2022.

Public Chapter 1117—SB2448/HB2671—White/Farmer

Re: Extended Liability Protection Against Covid Claims. Extends the liability protection against claims based on Covid exposure until July 1, 2023.

Effective as of June 1, 2022.

Public Chapter 1123—SB2574/HB2535—Crowe/Alexander

Re: End-of-Life Visitation at Nursing Homes and Assisted Living Facilities. Requires that nursing homes and assisted living facilities allow for visitation during a disaster, emergency, or public health emergency for Covid-19. Provides an exemption if the visitation would violate federal or state law.

Effective July 1, 2022.

Public Chapter 1135—SB1997/HB2043—Bell/Cochran

Re Tianeptine as Controlled Substance. Classifies Tianeptine and all derivatives thereof as Schedule II controlled substances.

Effective July 1, 2022.

** Please note that these are high-level overviews of each public chapter. Speak with the Board Attorney for any specific questions or concerns. **

Public Chapter 37

This act prohibits agencies subject to sunset review from promulgating rules or adopting policies to exempt members solely by virtue of their status as members.

This act took effect March 23, 2021.

Public Chapter 62

This act was one of the Department of Mental Health and Substance Abuse Services’ legislative initiatives, relative to revising requirements on death reporting. Among other requirements, this act requires the mental health facility to notify the office of the medical examiner having jurisdiction upon discovery of a death as soon as reasonably possible, but no longer than 12 hours after the discovery of the death. The act also clarifies that licensed healthcare providers listed under additional titles in Tennessee Code Annotated (such as title 68) can practice telemedicine.

This act took effect March 29, 2021.

Public Chapter 153

This act creates a new definition of “store-and-forward telemedicine services” to include the use of asynchronous computer-based communications between the healthcare provider and the patient for the purpose of diagnoses, consultation, or treatment of a patient at a distant site where there may be no in-person exchange.

This act took effect April 13, 2021.

Public Chapter 179

This act authorizes unlicensed graduates of certain medical training programs to provide telehealth services, provided they maintain the same existing standards for telehealth that licensed providers must meet.

This act took effect April 20, 2021.

Public Chapter 197

This act requires the Department of Health and other agencies to seek federal, private, or other available funding for the development of substance use disorder recovery programs. It also requires the agencies to report by February 15th of each year to the legislature the amount of funds they’ve applied for relative to substance use disorder programs, as well as recommendations to statute changes to develop recovery programs. Lastly, the report must include any benefits realized from these programs.

This act took effect April 22, 2021.

Public Chapter 230

This act revises the definition of marijuana to clarify that it does not include a product approved as a prescription by the Food and Drug Administration (FDA).

This act took effect April 22, 2021.

Public Chapter 242

This act authorizes records custodians to petition a court for injunctive relief from individuals making frequent public records requests with the intent of disrupting government operations, following a fifth (5th) public records request. A records custodian can only petition a court if they notify the person in writing stating the specific conduct may constitute intent to disrupt government operations, and that the person continues to do so. The individual upon a court enjoinment would not be able to make public requests at the agency for up to one (1) year.

This chapter took effect April 28th, 2021 and will sunset July 1, 2025.


Public Chapter 291

This act requires the attorney general and reporter to not approve an emergency rule if the emergency rule does not meet the statutory criteria for adoption of the rule.

This act took effect July 1, 2021.

Public Chapter 309

This act is a follow up to legislation from 2018, relative to authorizing local governments and municipalities to adopt ordinances for sober living homes. In doing so, this act enacts new provisions for alcohol and drug prevention and/or treatment facilities (ADTF’s), creates a new definition for ADTF’s that specifically excludes the department of health, and requires the department of mental health and substance abuse services to maintain a list of nationally recognized recovery residence standards organizations, or grantees of a state or federal agency, on its website. Alcohol and drug services, in this act, includes services that receive funds from the department of health or assess fees for services.

This act will take effect July 1, 2022.


Public Chapter 328

This act requires that starting December 1, 2023, state agencies submit a report of their effective rules to the chairs of the government operations committee every eight (8) years. The report is required to include a brief description of the department’s operations that each chapter affects, as well as each rule and its administrative history, which would include the original promulgated date and the dates the rule was last amended, if applicable. Additionally, the report would include a determination of each rule on whether it is adheres to current state or federal law or court rulings, should be amended or repealed, reviewed further, or continue in effect without amendment. Lastly, if there are any intentionally false statements in the report, the government operations committee would have the ability to vote to request the general assembly to remove a rule or suspend the department’s rulemaking authority for any reasonable period of time.

This act took effect July 1, 2021.

Public Chapter 357

This act authorizes an exception to existing telehealth requirements governing healthcare providers in Tennessee. In doing so, it allows individuals licensed in another state to practice telehealth in Tennessee while providing healthcare services on a volunteer basis through a free clinic.

This act took effect July 1, 2021.


Public Chapter 453

This act requires public or private entities or businesses that operate a building open to the general public to post signage regarding public restroom access in certain situations. Specifically, this applies to entities or businesses that have restroom policies allowing either biological sex to use any public restroom within their building. The act includes requirements for language, size, location, and even color for the signage.  The act excludes unisex, single occupant restrooms or family restrooms intended for use by either sex.  

This act took effect July 1, 2021.

Public Chapter 491

This act is known as the “Tennessee Opioid Abatement Act” to facilitate all opioid settlements from state and local government claims against entities involved in the making, distribution, dispensing, or sale of opioids and related activities. In doing so, the Opioid Abatement Fund is created by this act, and directs all funds from these settlements to be sent to the fund. It also creates the Opioid Abatement Council, who will oversee the fund and direct how it is spent, specifically for abatement and remediation programs.

This act took effect May 24, 2021.

Public Chapter 531

This act limits an agency’s authority to promulgate rules without a public hearing.   There are exceptions to the public hearing requirement.  These exceptions include emergency rules, rules that are nonsubstantive modifications to existing rules (like clerical updates), rules that repeal existing rule, or rules that eliminate or reduce a fee described by an existing rule.

This act took effect July 1, 2021.

Public Chapter 532

This act authorizes the joint government operations committee to stay an agency’s rule from going into effect for a period of time not to exceed ninety (90) days. If the government operations committee determines that subsequent stays are necessary, then the joint committee may issue consecutive stays, each for an additional ninety (90) day period, so long as such stays do not extend beyond the fifth legislative day of the year following the year in which the rule is filed with the secretary of state. The initial stay may be done by either the house or senate government operations committee, but subsequent stays must be by agreement by the committees of both chambers.  A stay is effective when the respective committee files written notice with the secretary of state, and the respective committee shall specify the length of effectiveness of the stay.

This act took effect May 25, 2021.

Public Chapter 577

This public chapter establishes the medical cannabis commission which is administratively attached to the department of health for purposes of budgeting, audit, use of IT systems, HR support, clerical assistance and administrative support.  The commission is composed of 9 members.  The Governor appoints 3 members (1 from each grand division), the Lt. Governor appoints 3 members (1 must be a physician and 1 a pharmacist), and the Speaker of the House appoints 3 members (1 must be a physician and 1 a pharmacist).  The commission must be impaneled and hold its first meeting by October 1, 2021.  The commission is required to meet at least once every two months prior to March 2023.  The commission shall appoint an executive director.

The commission is to examine federal laws and other states’ laws regarding medical use of cannabis, including issues relating to patient qualification, patient registration, role of practitioners in recommending/prescribing, establishing guidelines for acceptable medical uses, development of a standard of care, etc.

This act took effect May 27, 2021.

**These are general summaries of legislation.  For more detailed information and all specifics/requirements, please review the links to each public chapter**

Public Chapter 611

This law requires an agency holding a public hearing as part of its rulemaking process, to make copies of the rule available in “redline form” to people attending the hearing. 

This took effect July 1, 2018.

 Public Chapter 675

This act requires the department of health to accept allegations of opioid abuse or diversion and for the department to publicize a means of reporting allegations. 

Any entity that prescribes, dispenses, OR handles opioids is required to provide information to employees about reporting suspected opioid abuse/diversion.  That notice is to either be provided individually to the employee in writing and documented by the employer OR by posting a sign in a conspicuous, non-public area of minimum height and width

Whistleblower protections are also established.  An individual who makes a report in good faith may not be terminated or suffer adverse licensure action solely based on the report.  The individual also is immune from any civil liability related to a good faith report. 

This act takes effect January 1, 2019.

 Public Chapter 744

This statute allows a licensing entity the discretion to not suspend/deny/revoke a license in cases where the licensee has defaulted or become delinquent on student loans IF a medical hardship significantly contributed to the default or delinquency.

This act takes effect January 1, 2019.

Public Chapter 745 and Public Chapter 793

These public chapters work together to create and implement the “Fresh Start Act.”  Licensing authorities are prohibited from denying an application or renewal for a license/certificate/registration due to a prior criminal conviction that does not directly relate to the applicable occupation.  Lays out the requirements on the licensing authorities as well as the exceptions to the law (ex: rebuttable presumption regarding A and B level felonies). 

These acts took effect July 1, 2018.

Public Chapter 754

This chapter prevents any board, commission, committee, etc. created by statute from promulgating rules, issuing  statements, or issuing intra-agency memoranda that infringe on an entity member’s freedom of speech. 

Freedom of speech includes, but is not limited to, a member’s freedom to express an opinion concerning any matter relating to that governmental entity, excludingmatters deemed to be confidential under TCA 10-7-504.

Violations as determined by a joint evaluation committee may result in recommendations to the general assembly concerning the entity’s sunset status, rulemaking authority and funding.

This act took effect April 18, 2018.

Public Chapter 855

Prohibits alcohol and drug treatment facilities (ADTF), healthcare providers and healthcare facilities from certain practices in regard to solicitation and marketing of alcohol and drug treatment services. 

This act took effect July 1, 2018.

Public Chapter 929

This act redefines policy and rule and requires each agency to submit a list of all policies, with certain exceptions, that have been adopted or changed in the previous year to the chairs of the government operations committees on July 1 of each year.  The submission shall include a summary of the policy and the justification for adopting a policy instead of a rule.

This act also prohibits any policy or rule by any agency that infringes upon an agency member’s freedom of speech. 

Finally, this act establishes that an agency’s appointing authority shall have the sole power to remove a member from a board, committee, etc.

This act took effect July 1, 2018 and applies to policies adopted on or after that date.

Public Chapter 954

This legislation requires the initial licensure fee for low-income persons to be waived.  Low income individuals per the
statute are defined as persons who are enrolled in a state or federal public assistance program including but not limited to TANF, Medicaid, and SNAP.  All licensing authorities are required to promulgate rules to effectuate the purposes of this act. 

This act takes effect January 1, 2019.

 Public Chapter 1021

This act allows for appeals of contested case hearings to be in the Chancery Court nearest the residence of the person contesting the agency action or at that person’s discretion, in the Chancery Court nearest the place the action arose,
or in the Chancery Court of Davidson County.  Petitions seeking review must be filed within 60 days after entry of the
agency’s final order. 

This act took effect July 1, 2018.