The Board of Health oversees the work of the Health Unit and ensures staff provide the programs and services required under the Ontario
Public Health Standards. These standards are set by the Ontario Ministry
of Health. On behalf of the Board of Health, the Medical Officer of Health administers the public health programs and services in agreement with the mission, vision and values of our Health Unit.

The Board of Health has representatives from the funding municipalities
(the City of Kawartha Lakes, County of Haliburton and Northumberland County) and provincial appointees.

2023 Board of Health members:

• David Marshall, Chairperson - Provincial Appointee
• Olena Hankivsky, Vice-chairperson - Northumberland County
• Cecil Ryall - County of Haliburton
• Bob Crate - Northumberland County
• John Logel - Northumberland County
• Tracy Richardson - City of Kawartha Lakes
• Mike Perry - City of Kawartha Lakes

I am delighted to present the 2023 Annual Report for the Haliburton, Kawartha, Pine Ridge District Health Unit.

The previous year was one of continued recovery and restoration with a focus on bringing a large majority of public health programs and services back online as work related to responding to COVID-19 eased. Throughout 2023 our dedicated team continued to serve the City of Kawartha Lakes, County of Haliburton and Northumberland County by addressing the risks posed by infectious diseases while fulfilling our essential duties prescribed in the Ontario Public Health Standards.

Program catch-up, resulting from closures that occurred during the COVID-19 pandemic, was a key priority throughout 2023. In the fall, we re-initiated enforcement of the Immunization of School Pupils Act to begin the process of updating the records of over 6,000 students. In addition, dental screening for early signs of tooth decay was completed in schools for over 5,000 students after multiple years of no or limited screening.  
 
Responding to emerging/re-emerging urgent public health issues was an additional priority throughout 2023. Negative impacts of the drug poisoning crisis continued to reverberate across our communities and HKPR District Health Unit teams worked to support the re-invigoration of the Haliburton, Kawartha Lakes, Northumberland Drug Strategy. The strategy brings together institutions and community-based
organizations to address the urgent need for data and evidence-informed actions and policy interventions.

Our Healthy Families team launched the Nurse Family Partnership program targeting young first-time families facing socio-economic challenges. In addition, the team focused on perinatal mental health interventions to address the post-pandemic mental health challenges
facing our communities.    

The scope of programs and services that are offered by HKPR District Health Unit is wide, varied and sometimes not visible. We work to protect our communities from infections, prevent the spread of disease, and promote healthy lifestyles to help all residents achieve their greatest potential. We advocate for those community members who experience a disproportionate burden of ill health. Reports like our Nutritious Food Basket demonstrate how not everyone has access to things that contribute to health, such as income and nutrition. 

My gratitude extends to all our employees at the HKPR District Health Unit, from front line workers, managers, and our leadership team for their continued commitment to their work despite adversity. Additionally, I would also like to acknowledge and thank the members of the Board of Health for their continued support and guidance.

Yours in health,

Dr. Natalie Bocking, MD, MIPH, CCFP, FRCPC (she/her) 
Medical Officer of Health and Chief Executive Officer

During the summer, the immunization team launched an ISPA Enforcement Program with a goal of ensuring students in all grades overdue for vaccinations, or had yet to update their immunization records, were caught up as per the Immunization of School Pupils Act R.S.O.1990. Approximately 6,000 letters were issued to overdue students which lead to approximately 1,500 updated health records and 4,500 students remaining overdue. To continue to reach those students remaining overdue, a strategic communications campaign
was launched to ensure messaging reached key audiences (school boards, students, parents/guardians) with adequate time given to avoid potential suspension.

During the fall, approximately 2,100 notices were issued to all high school and grade 3 students resulting in 500 updated health records and 1,500 students remaining overdue. The immunization team also connected with health care providers and all three school boards to ensure the ISPA enforcement program and to provide marketing resources to support. Immunization clinics were also offered in-house at the health unit for those students without a family doctor. 

Every year, the Health Unit is responsible for organizing and promoting reduced-cost rabies vaccination clinics in partnership with veterinary offices in the County of Haliburton, City of Kawartha Lakes and Northumberland County. In recent years, participating veterinarians have seen a decrease in the number of animals coming for a reduced-cost vaccination, so the Health Unit explored new methods in 2023 to increase participation, which included offering a spring session and developing new advertising methods. 

While connecting with all veterinarians in the HKPR District area, the Environmental Health team opted to allow veterinarian clinics the option to choose the date and time that accommodated their schedule and staffing. By offering a spring clinic session, the Health Unit was able to increase rabies awareness and access for pet owners with 8 clinics total in 2023, including a location in the County of Haliburton which hasn’t had a clinic in many years. Through consistent promotions, the health unit website and social media reached over 44,000 people and reduced-cost rabies vaccinations were provided to 790 animals.

Recognizing the public health impacts and hazards of natural disasters, infectious disease outbreaks and emergency events, the Health Unit prioritized establishing emergency preparedness messaging, planning and information throughout 2023. An Emergency Response Plan outlines the Health Unit’s plan for organizing and deploying staff and resources in the event of an emergency to minimize health risks. In the spring and early summer, the Health Unit responded to the Canadian wildfire and air quality situation by addressing public inquiries, providing timely updates and alerts, and sharing information on health and safety.

Throughout the year, the Environmental Health team also worked to generate preparedness and public health information for residents on extreme cold, extreme heat, flood safety, and wildfires.

In the summer, the Healthy Families team and Peterborough Public Health partnered with Middlesex London Health Unit to deliver the Nurse-Family Partnership Program, an evidence-based home visiting service that ensures young expecting parents who are socially and/or economically disadvantaged can receive personal support during pregnancy and after the child is born up to two years of age. Over this time, an expecting parent receives personalized support from a public health nurse and can explore topics such as: how to have a healthy pregnancy, preparation for childbirth, nutrition, exercise, parenting, child development, future life planning and accessing community resources.

Following the public announcement of the Nurse Family Partnership program launching in August, public health nurses from our Healthy Families Team connected with 136 health care professionals and community partners to promote and provide information on the new program. An information session was offered virtually to deliver key information on the enrolment and referral process. This program is now supporting seven first-time parents and is expected to continue growing with referrals and awareness.

The Oral Health Team of two Registered Dental Hygienists, four Certified Dental Assistants, Administrative Assistants and one Health Promoter supports dental health through its screening, preventive clinic, fluoride varnish, and promotion programs. In 2023, the team screened over 5,200 children. Eligible children with urgent dental needs were assisted to access the Healthy Smiles Ontario program for financial support in getting treatment with 231 enrolled by our team. The Fluoride Varnish Program was also reinstated post COVID-19 for JK and SK students in schools with higher identified dental needs. This program has demonstrated effectiveness in reducing childhood tooth decay. Our Administrative Assistants also support eligible seniors in accessing the Ontario Seniors Dental Care Program to receive needed treatment completing 451 consultations in 2023.

The School Health Team of five Public Health Nurses, one Registered Dietitian, and the support of one Administrative Assistant takes a comprehensive school health approach to implementing the School Health Standard of the OPHS including a focus on mental health. The team conducted 61 assessments with schools, 29 events, and several in-depth programs based on identified needs. Highlights include the initiation of the Playground Activity Leaders in Schools (PALS) Program, an elementary school, student leadership program. Implementation of Not an Experiment, that aims to prevent the initiation and escalation of vaping among youth to all grade four classes in the region. 

The team is also an integral part of the School-Based Immunization Program, taking on the role of Lead Nurse at clinics this year. Our Dietitians support three community partnerships focused on the provision of School Nutrition Programs in our region providing over 1.9 million meals. Collaboration on potential implementation of the You’re the Chef Program with local schools is underway. This program is a hands-on cooking program that develops the skills and confidence for Grade 5 to 8 students to prepare healthy recipes emphasizing vegetables and fruit. 

The Communication Services Department embarked on a nine-month journey to redesign and redevelop the corporate website to improve the user experience. Program and service information is now easier to find and the website itself has been updated to reflect our updated branding efforts.

The Health Unit’s corporate branding was modernized to project a refreshed and vibrant look and feel. This rebrand was introduced during the launch of the new corporate website and is also captured within the creation of the Corporate Branding and Identity Guidelines. Other communication channels that benefited from refreshed branding included all social media templates and graphics, letterhead, business cards, PowerPoint presentations and online dashboards.

• Weekly/biweekly update reports to our Respiratory Infection dashboard
• Weekly opioid overdose data updates through the Opioid Overdose Report dashboard
• Monthly reportable disease and outbreak summary reports

The Epidemiology team and Research and Evaluation Coordinator partnered with the HKPR Harm Reduction Team and the Haliburton, Kawartha Lakes, Northumberland (HKLN) Drug Strategy to conduct a survey of people using drugs around current drug use practices and needed drug poisoning prevention strategies. As part of our commitment to quality improvement, the HKPR Customer Experience Standard and Pledge were communicated to employees. A public launch of the Pledge is planned for summer 2024.

In partnership with Trent University, Indigenous Cultural Competency training was provided to employees in August and September. A full day experiential training on Indigenous Ways of Knowing Related to Health and Wellness was held at Alderville First Nation in October.