By Iowa law, each County must have a Board of Health. Law also allows cities of greater than 25,000 population to have a City Board of Health if it wishes. The Board of Supervisors appoints county boards for three-year terms. Although the Board of Health may operate under numerous State laws, the primary Iowa Code responsibility is Chapter 137 (Local Boards of Health). This chapter sets out the duties and responsibilities of the Board of Health.

The Board of Health is tasked with creating and maintaining regulations to ensure the health of the residents of the county. All regulations passed by the Board of Health are also affirmed by the Board of Supervisors in the County.