The Klickitat County Health Department began operation January 1, 1998, after becoming independent from Southwest Washington Health District. After operations began, the health department elected The Klickitat County Board of Health, which historically consisted of the Klickitat County Board of Commissioners, a representative from the city of Goldendale, and a representative from the city of Bingen/White Salmon. Currently, the Board of Health is the County Board of Commissioners.
Policy development for all health department programs is provided by the Board of Health. Quarterly meetings are advertised in the local newspapers and are held at the commissioner's chambers in the Klickitat County Court House in Goldendale. The Board of Health sets policies for environmental health and personal health services. The mission of the Klickitat County Health Department is to preserve, promote and protect the health of all people residing in or visiting Klickitat County.