The Scotland County Board of Health has the duty to protect and promote the public health and the authority to adopt rules necessary to those purposes. A board of health rule may also be called a "regulation" and is comparable in nature to a regulation adopted by a federal agency such as the U.S. Department of Health and Human Services, or a state commission such as the Commission for Public Health. The rule is valid only within the local board's jurisdiction (that is, the county or counties it serves), including within the boundaries of any municipalities in the counties served by the board.

A rule has the "force of law", meaning that it can be enforced in one or more of several methods set forth in the public health laws, potentially including a criminal charge, a civil action, or, in limited cases, the imposition of administrative penalties (fines).