The Health Protection and Promotion Act (HPPA) and its Regulations dictate that every health unit in Ontario has a Board of Health. The Board of Health for the Leeds, Grenville and Lanark District Health Unit currently has ten members, seven of which are municipal politicians or appointees with three being provincial appointees. Two members represent the United Counties of Leeds and Grenville and one member represents each of the City of Brockville, the County of Lanark, the Town of Smiths Falls, the Town of Gananoque and the Town of Prescott. 

The roles of the Board of Health are:

• To provide those communities services and programs approved by the Board, including both those mandated by the Ministry of Health, and other non-mandated programs.
• To direct the development and implementation of the Health Unit Strategic Plan, including the mission, philosophy, organizational vision, goals and objectives.
• To ensure that the Chief Executive Officer manages the agency in an effective and efficient manner, following Provincial guidelines and Board policy.
• To provide leadership and advocacy on behalf of public health issues.
• To represent the community of Leeds, Grenville and Lanark, either as municipal appointees, or as provincial appointees.
• To set and review Health Unit policies and ensure compliance with those policies.
• To be accountable to the community and the respective funding bodies for the activities of the Health Unit.
• To select the Chief Executive Officer of the Health Unit and take part in the selection of the senior staff.
• To nominate candidates to the Minister of Health for provincial appointees to the Board of Health.
• To establish and maintain linkages with other health, environmental and social service agencies, on a district, regional and provincial basis.
• To support the provincial association (Association of Local Public Health Agencies)
• To assist in the identification of community health issues.
• To establish priorities for the public health programs.
• To participate on Board committees, task forces and Advisory committees