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Annual Report 2023

The Simcoe Muskoka District Health Unit is a champion of health for all. We work with individuals and families, agencies and communities in Simcoe Muskoka to promote and protect health, and to prevent disease and injury of the people we serve. We do this by providing a variety of public health programs and services, as well as working in collaboration with community partners on policies and initiatives that protect and promote health and well-being for all.

The health unit is governed by the Board of Health and is funded municipally and provincially. We are guided by the Ontario Public Health Standards and our own core values to work toward achieving our mission and vision. This Annual Report highlights the health unit’s work and achievements in 2023.

Our Mission

With our communities, we prevent disease and injury, and promote and protect health for all in Simcoe Muskoka.

Our Vision

Healthy People. Healthy Places.

Our Values

RESPECT

We believe that respect for all people is embedded within our relationships with each other, and is reflected in our work.

COLLABORATION

We believe that by working with others we can achieve the best health outcomes for all.

ACCOUNTABILITY

We believe in being transparent and responsible to the public and our stakeholders by using ethical and sustainable organizational practices.

EQUITY

We believe that all people are entitled to achieve their full health potential.

EXCELLENCE

We believe in providing the highest quality programs and services to achieve our vision.

POSITIVE WORKPLACE

We believe in a work environment where our employees are valued, communicate openly, and have work-life balance.

Healthy People. Healthy Places.

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Ann-Marie Kungl, Board of Health Chair

In 2023, the Simcoe Muskoka Health Unit’s (SMDHU) recovery from the COVID-19 pandemic was underway and the resumption of programs and services that support the health and well-being of residents and visitors to our communities was ongoing. Public health remains a cornerstone of the health system that provides cost-effective services, such as food safety and water quality inspections to prevent illness. Additionally, it provides support for parents and families to promote healthy growth and development, tobacco control to prevent lung cancer and chronic obstructive pulmonary disease, healthy nutrition education to prevent diabetes and cardiovascular disease, mental health promotion for school-aged children, immunization against vaccine-preventable diseases, and preparations for future public health emergencies.

Being prepared for the future continues to be a priority and the Board of Health approved the 2023-2024 Strategic Plan, which is being extended for the next two years. The plan prioritizes leveraging the lessons learned from our pandemic experiences while remaining flexible to changes in our local, regional, and provincial contexts. As a Board that represents the interests of our residents and communities, we continue to advocate for sufficient, predictable and timely resources to ensure the health unit can continue to provide residents and visitors of Simcoe Muskoka with a full range of essential public health programs and services that both help prevent illness and support health.

On behalf of the Board of Health, it is a privilege to acknowledge the dedication and commitment that SMDHU’s staff demonstrated throughout the pandemic to our communities. In responding to a global health emergency, health unit staff rose to the challenge, and it is important that their work and the lessons learned from their experiences be recognized and reflected upon. In 2023, the Board of Health and senior management wished to recognize staff for their tireless dedication throughout the three years of the COVID-19 response and held an in-person event to bring everyone together with a focus on gratitude and recognition of the tremendous work staff accomplished across all departments throughout the pandemic.

We have a strong and dedicated Board of Directors, and the SMDHU has been fortunate to have benefitted from a long history of devoted public health champions that have served our communities well leading into and out of the pandemic. We are ever grateful for to those past and present, who advocate on the important role of public health in our local and provincial health system.

On behalf of the Board of Health, I extend sincere appreciation to Dr. Gardner and the SMDHU senior management team and staff for their unwavering commitment to the safety and well-being of our friends, families and neighbours across Simcoe Muskoka. We value the contributions of the collective team in their work to provide critical public health programs and outreach to some of our most vulnerable. Thank you for choosing this calling and for your service to others.

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Dr. Charles Gardner, Medical Officer of Health

For the Simcoe Muskoka District Health Unit (SMDHU), 2023 was a year to reflect, recover and resume programs that had been put on hold during the pandemic. As core programs were brought back online, the health unit developed the 2023-2024 Strategic Plan that reflected the progress made on the goals and objectives of the Recovery Framework and acknowledged resumption of our programs and services, including four key priority areas: Programs, People, Partnerships, and Future.

Over the course of the year, we saw COVID-19 levels decline to the extent that we could safely welcome staff back to our offices and adopted a hybrid workplace to encourage greater work-life balance for staff. Staff who were redeployed to COVID-19 response assignments were repatriated to core programs allowing health unit operated Dental, Immunization and Sexual Health clinics to return to pre-pandemic service levels. In-person programs such as our prenatal classes, breastfeeding workshops, and in-school dental hygienist visits and immunization clinics also returned to local communities.

Last year, a key focus was ensuring that children and youth who had missed receiving their publicly funded immunizations required Ontario’s Immunization of School Pupils Act due to pandemic-related disruptions were caught up on these important vaccines. The health unit also launched a campaign to help ensure that adults aged 65 years and older also got caught up on the vaccines they had missed, such as shingles, tetanus, diphtheria and pertussis.

Throughout the pandemic many staff members were redeployed and also worked, intense and long hours as they responded to the evolving demands created by COVID-19. As SMDHU began to focus on recovery, senior management and Board of Health recognized that health unit staff and management had demonstrated tireless dedication and needed to reflect on their individual and collective experience of working at the forefront of a global pandemic. All SMDHU employees were invited to an in-person professional development day to reflect on the experience and lessons of the pandemic, to allow employees to connect with colleagues from across the region, and to thank them for the sacrifices and contributions they made over three years of pandemic response.

Public health focuses on supporting the health of the people who live and visit our communities and SMDHU’s work relies on collaboration. During the pandemic, the health unit built strong relationships with community partners from the Indigenous community, health and emergency services, and education, municipal government and business sectors and we look forward to continuing to foster them. I also acknowledge SMDHU’s staff and their unparalleled commitment to ensuring critical public health work continued. I am also grateful for the strong support and leadership provided by the members of the Board of Health throughout 2023.

SMDHU Programs and Services

In 2023, the health unit focused on rebuilding capacity. At the start of the year, health unit staff continued to be redeployed to support on-going COVID-19 immunization efforts and outbreak response. However, as the year progressed the health unit resumed its mandated public health programs and services that promote and protect the health of all those who live, work and play in Simcoe Muskoka. The following sections provide an overview of the health unit’s programs and services delivered in 2023.

4,831

social media posts

4,326,648

reach/impressions

1,377

safe water inspections

8,215

food premise inspections

1,551

personal service settings and child care inspections

460

community and institutional outbreak investigations

19,468

vaccines given during public immunization clinics

36,561

vaccines given at school-based clinics

2,537

sexual health clinic appointments

1,728

doses of sexually transmitted blood borne infection medications distributed to SMDHU HCPs

Sexual Health-related Phone cCalls Received from the Community

4,038

sexual health-related phone calls received from the community

2,396

home visits by public health nurses and/or family home visitors

4,943

naloxone kits distributed by SMDHU

30,772

students, staff and parent/caregivers reached with vaping

68,000

engagements on notanexperiment.ca(Youth Vaping Website)

Infectious Diseases Program

In 2023, the Infectious Diseases Program focused on preventing community transmission of critical public health threats, including tuberculosis, MPOX, invasive Group A Streptococcal infection and hepatitis A. Staff managed outbreaks of RSV, COVID-19, and salmonellosis. Public health inspectors conducted inspections of food safety and infection prevention at personal service and child care settings, ensuring compliance with public health standards. The program also maintained an infectious diseases phone line and provided 24/7 on-call response for emergencies.

Sexual Health Program

Sexual health clinical services resumed in health unit offices and at local high schools in January 2023. 2,537 clinic appointments were offered, with 78% involving testing for sexually transmitted and blood borne infections (STBBIs). Sexual health nurses offered confidential education, counseling, and services, including birth control, pregnancy testing, and STBBI testing, with anonymous HIV testing available. They responded to 4,038 calls from community partners, clients, and health care providers via the sexual health phone line. Free STI medications were provided to 116 local healthcare providers, walk-in clinics, hospitals, and clients using the health unit’s clinics. Public health nurses also supported emergency response personnel, healthcare professionals, and corrections staff with follow-ups under the Mandatory Blood Testing Act (MBTA).

Oral Health Program

The Oral Health Program expanded services after completing infrastructure improvements funded by a one-time Ontario Seniors Dental Care Program grant. Renovations at SMDHU’s dental clinics in Gravenhurst and Barrie doubled their capacity. These clinics continued to provide services through publicly funded dental programs, including Ontario Works, Healthy Smiles Ontario, the Ontario Disability Support Program, and the Ontario Seniors Dental Care Program. The program worked with community partners to resume dental screenings in schools and community-based settings for children and youth up to 17 years old, providing oral health education to increase awareness and enrollment in publicly funded dental programs.

Immunization Program

The Immunization Program continued its School Immunization Program in 2023, reviewing student immunization records and notifying families of overdue vaccinations as required by the Immunization of School Pupils Act. Over 30,000 families were contacted, leading to school suspensions for approximately 1,000 high school students. The health unit supported over 400 healthcare providers, pharmacies, hospitals, and long-term care facilities, distributing publicly funded vaccines and offering support through the Health Care Provider Immunization phone line. Immunization nurses also conducted inspections, followed up on cold chain failures, and monitored adverse events following immunization.

Indigenous partnerships and tick-borne diseases

Staff members of the Vector-Borne Disease Program collaborated with Indigenous organizations and community partners to understand their experiences with ticks and Lyme disease. This initiative aimed to enhance awareness and preventative measures against tick-borne illnesses, strengthen community relationships and inform activities to control for these environmental health risks.

Climate change and health

The Healthy Environments Program and Emergency Management Programs collaborated to create a three-part webinar series on the impacts of extreme heat and health in a changing climate. This series provided valuable information to the public, municipal and education partners, and local conservation authorities. The goal was to educate the community and help them prepare for the health challenges posed by changing climatic conditions.

Air quality and wildfire smoke alerts

The Healthy Environments Program developed and implemented an air quality/wildfire smoke alert procedure to notify local partners and vulnerable sector service providers of poor air quality events, triggering the activation of response plans thus ensuring that those most at risk from poor air quality are protected and informed promptly.

Rabies control

In 2023, the health unit’s Rabies Program conducted 1,677 rabies investigations and vaccinated 928 animals at low-cost rabies clinics. These efforts are crucial in preventing the spread of rabies and ensuring public safety.

Smoke-free and vape-free initiatives and enforcement

Recognizing the rise in youth vaping, the Smoke-Free Program implemented the ‘Not An Experiment’ program in 54 schools, reaching 15,289 students, 14,987 parents/caregivers and 497 education staff. This program aims to reduce harms from youth vaping and seeks to decrease the likelihood of transitioning to smoking cigarettes. An enforcement blitz supported by a media campaign resulted in 137 charges being laid against retailers selling tobacco or vapour products to youth. Additionally, tobacco enforcement officers completed enhanced inspections in all hospitals within health unit’s jurisdiction to monitor and support smoke-free and vape-free hospital grounds in partnership with hospital administration.

Food safety and infectious disease

The Environmental Health Department created an online submission portal for special events and developed resources about canning safety and opening new food premises. It also streamlined the communication processes for issuing blue-green algae public advisories to ensure clear and timely information dissemination. A collaboration with Public Health Ontario to develop a three-part webinar series outlining public health investigations of legionellosis was also completed.

Drinking water safety

The Safe Water Program provided public health guidance and support to regulated drinking water systems and private homeowners, ensuring ongoing access to safe drinking water. Work included proactive measures to address potential contaminants and maintain water quality standards.

Emergency preparedness planning and response

The Emergency Management Program updated and tested current emergency response plans, systems, and processes to enhance public health leadership in emergency preparedness and response. These updates align the agency’s Emergency Response Plan with key recommendations and findings from evaluations of COVID-19 responses and the Ontario Public Health Standards. The agency engaged in seven internal and regional exercises in collaboration with health system and community partners to evaluate these plans and systems.

School Health Program

Throughout the 2022-2023 school year, public health nurses (PHNs) in the School Health Program served as liaisons between local school boards, community partners, and other SMDHU programs. They supported public health programming and mental health promotion. PHNs conducted school outreach visits, leading initiatives like Healthy Schools Certification. Nutrition staff provided consultation to promote healthy school food policies, environments, and Student Nutrition Programs, while also facilitating training for the You’re the Chef program. Collaboration with other SMDHU programs and community partners ensured a comprehensive approach to health and well-being.

Substance Use and Injury Prevention Program

As a core site for the Ontario Harm Reduction Distribution Program, SMDHU and its community partners distributed:
• 959,027 needles/syringes
• 32,984 bowl pipes
• 61,710 stem pipes

Additionally, SMDHU distributed:
• 4,147 biohazard containers and installed eight wall-mounted biohazard units through new disposal contracts
• 4,333 nasal naloxone kits and 610 injectable naloxone kits

SMDHU sent 11 community-based drug alerts to partners working with people who use drugs. The program also leads the community partnership advisory committee of the Simcoe Muskoka Drug Strategy and participates in local drug strategy committees and Community Safety and Wellbeing tables.

Healthy Growth and Development Program

In 2023, the Healthy Growth and Development Program focused on offering in-person and online breastfeeding support groups, along with clinical breastfeeding support in partnership with a local well-baby clinic. Free prenatal classes were provided online, virtually, and in-person. The program offered infant nutrition sessions and capacity-building support to clients and community partners, including CAPC, CPNP, and EarlyON programs. Car seat vouchers were issued in collaboration with Honda Canada and Canadian Tire to families in need, and the program responded to service requests from community partners for local events.

Healthy Babies Healthy Children (HBHC) Program

From 2020 to April 2022, staff from the Healthy Babies Healthy Children (HBHC) Program were redeployed to the COVID-19 response, leading to a lengthy waitlist and reduced services. In 2022/23, the program prioritized reducing the waitlist, resuming home visits, and recruiting and training new staff. Efforts were made to re-engage key partners, such as local hospitals and midwives, to restore HBHC screening and referral rates to pre-pandemic levels. HBHC continues to support families affected by the COVID-19 pandemic.

Chronic Disease Prevention Program

In 2023, the Chronic Disease Prevention (CDP) Program used a comprehensive health promotion approach to reduce the risk of chronic diseases, such as cardiovascular diseases, chronic respiratory diseases, diabetes, and certain cancers. The CDP Program worked with municipalities and community partners to support healthy public policies and programs that reduce poverty and household food insecurity. The program led the Simcoe Muskoka On The Move Steering Committee, addressing barriers and promoting active school travel. CDP also provided feedback on municipal land use plans to enhance healthy community design related to the built environment.

HealthSTATS Revamp

In December 2023, the health unit launched a new and improved HealthSTATS website. It’s now easier to use and provides valuable information on health and health behaviours of the Simcoe Muskoka population. The website’s data includes details about chronic and infectious diseases, mental health, environmental issues, and much more. The many interactive charts, graphs, and maps show community health trends that can support health projects and give residents the knowledge they need to make informed decision about their health.

Keeping the Public Informed about Diverse Health Issues

In 2023, SMDHU transitioned from COVID-19-focused communications to addressing a broader range of public health topics. Communication activities included creating awareness about online breastfeeding groups, that help new parents access support and information. The issue of food affordability was addressed through the campaign "The Real Cost of Unaffordable Food," highlighting the impact of poverty on health. During National Immunization Awareness Week in April, the importance of vaccinations for all age groups was emphasized. Additionally, SMDHU worked with local media to advocate for the Barrie Consumption and Treatment Services Site to raise awareness and support for this crucial harm reduction service that saves lives by preventing drug overdoses. These initiatives reflect the health unit’s continued commitment to keeping the public informed about diverse health issues and supporting the well-being of the community.

Financial Information

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