N.Y. Public Health Law § 351
1. The board of health of each county and part-county health district or other body having the powers and duties of a board of health of a county or part-county health district or the county executive in those counties where the county charter provides that said commissioner is to be appointed by the county executive shall appoint a county health commissioner, county health director or, when authorized under the state sanitary code, public health director; except, however,