It is by what we ourselves have done, and not by what others have done for us, that we shall be remembered in after ages. – Francis Wayland
Originally founded on July 1, 1947, the Leeds and Grenville Health Unit was established to meet the need for integrated public health services throughout Brockville, Gananoque and surrounding municipalities. The Health Unit was initially set up in the Brockville Court House. However, a rapid growth in the area’s population over the next few years resulted in an increased need for the agency’s services, so the Health Unit soon expanded its operation into the neighbouring Victoria Building. Staff at that time consisted of 15 people: a Medical Officer of Health, eight public health nurses, three sanitary inspectors, and three office support workers.
1948 saw the introduction of the Health Unit’s first branch office, which was located in Gananoque. Two more offices were added over the next few years: one in Kemptville in 1950, and another in the town of Prescott in 1954. Two years later, Smiths Falls and Perth were welcomed to the Health Unit’s jurisdiction.
Growing to Meet the Need: 60’s and 70’s
In 1967, Lanark District also joined the Health Unit and an office was set up in Carleton Place. To more accurately reflect the geographical area served by the agency, a new name was adopted: the Leeds, Grenville and Lanark District Health Unit. This name remains to the current day.
Staff numbers started to grow, including Directors of Nursing, Environmental Hygiene and Dental, which warranted the relocation of the Brockville office from the Court House to a larger building at 70 Charles Street in 1963. Several new programs and services were added over the next decade to meet the expanding health needs of the population, including rabies surveillance, nutrition education home care, nutrition education and adult protective services.
The Health Conscious 80’s
The Health Protection and Promotion Act in 1984 brought new direction to public health in Ontario. There was increased emphasis on promoting healthy lifestyles, and in using marketing concepts for promotion activities. In keeping with the healthy lifestyles mandate, the Health Unit became a smoke-free workplace in 1985.
New programs were introduced in the 80’s that reflected the prevention/promotion directives mandated by the province. Also, in 1981, the Lanark Community Mental Health Program and Placement Coordination Services became part of the Health Unit. Immunization of school children became mandatory in 1982 and two new programs were launched in 1987: the dental department’s CINOT (Children in Need of Treatment), and an AIDS prevention and education program. In 1989, the Ministry of Health introduced its Mandatory Programs, which further expanded the scope of the Health Unit’s existing services.
The Early 1990’s
Early in 1990, Health Unit was accredited for the first time by the Ontario Council for Community Health Accreditation (OCCHA). To be accredited by OCCHA, a health unit must demonstrate that it complies with a set of provincial standards in the delivery of public health programs and services.
The Health Unit moved its head office from the cramped quarters on Charles Street to a newly constructed facility on Laurier Boulevard, in January 1991. This year also brought the introduction of the Epidemiology and Resource Services Department, which provided consulting services to all staff on epidemiology, nutrition, communications and resource services.
In 1993, a committee was formed to develop a three-year strategic plan. Throughout most of the next year, the committee worked to design a meaningful long-term plan based on ideas from staff and the community.
In 1994, the Health Unit hired two brand new positions: a Health Promotion Consultant and a Computer Support Specialist. With all the growth in staffing, in 1995, there were 233 people employed by nine departments and seven offices over the three counties of the Leeds, Grenville and Lanark. Regrettably, the boom didn’t last long. In 1996 at the end of Ontario’s Social Contract, significant cuts in funding were experienced in public health. As a result, staff numbers were cut and offices were closed in Prescott and Perth. These changes took effect on January 1, 1997.
Celebration and Change
Cutbacks of the mid 1990’s didn’t slow the evolution or delivery of public health programs. In 1996, the provincial measles campaign immunized 30,000 children in the area; the HEROES program taught injury prevention to thousands of students and their parents; and a toll-free access line to health information was introduced. The Healthy Babies/Healthy Children program, an initiative funded 100% by the Ministry of Health, was launched in October 1997. This was, and continues to be, a very successful program.
In 1997, the Health Unit celebrated 50 years of public health services by publishing a commemorative tabloid tracing its history. This year also saw significant change in the provincial funding structure of public health, with municipalities set to provide 100% funding to the Health Unit as of January 1, 1998, following the previous funding arrangement of 75% provincial and 25% municipal. In the shuffle, four programs were divested of sponsorship: Home Care, Placement Coordination Services, Adult Protective Services and Lanark Community Mental Health Program.
Ice Storm and Aftermath
The counties of Leeds and Grenville and Lanark, along with many communities throughout Eastern Ontario and Quebec, were devastated by an ice storm in January of 1998 that left homes without electric power for weeks in some areas. The Health Unit responded with information and services to the community: nurses worked in shelters, inspectors made sure food was safely prepared and stored, and a psychosocial emergency response plan was produced to help people deal with the trauma.
Despite the turbulence and challenges faced by the agency during the mid-90’s, the Health Unit continued its exemplary performance by earning the highest possible (4-year) accreditation award from OCCHA in May of 1998.
In the summer of 1999, the first Canadian case of raccoon rabies was discovered in the Prescott area. This required the activation of response plans for several agencies, including the Health Unit, the Ministry of Health, the Ministry of Natural Resources, and the Canadian Food Inspection Agency. Rabies has since been maintained under tight control. Also during this time, staff participation in partnerships and coalitions increased, with health unit staff playing key roles Ontario’s first Safe Communities Coalition, the Tri-Health Coalition (a provincially funded heart health program) and Risk Watch, which helps teachers in their classrooms to teach children different aspects of safety.
The agency’s structure was reviewed and changed by the formation of a Clinical Services Department. Eighteen new positions were approved over a three-year period.
Into the New Century
In 2000, a new logo was selected for the Health Unit. As well, a Web site Coordinator was hired and the agency’s website was officially launched in June. The new web site featured the tri-county health status report, which contain statistics describing the health of residents of Leeds, Grenville and Lanark. In April of 2000, the Health Unit became the lead agency for the district’s preschool speech and language program (Language Express).
The year 2000 witnessed the community water contamination tragedy in Walkerton, Ontario. As a result of the lessons learned from Walkerton, there have been many far-reaching changes to water safety legislation that continue to have an impact on public health units today.
Also in 2001, the Ministry of Health initiated a new campaign for all residents to receive free influenza vaccinations and West Nile virus became a public health issue that attracted much media attention. The Safe Communities Coalition of Brockville and District was awarded the designation of “Safe Community” by the World Health Organization.
SARS in 2003
The SARS outbreak of 2003 in the Greater Toronto Area had a major impact on the entire province. There were no SARS cases reported in Leeds, Grenville and Lanark; however, managing the many directives from the province, coordinating surveillance activities, and dealing with public and media reaction placed a heavy burden on the Health Unit and its partner agencies.
Moving Ahead: 2004–2009
In 2004, the Health Unit helped to establish the Every Kid in our Communities initiative to promote children’s assets. To improve access to healthy nutrition, Health Unit staff worked with the Upper Canada District School Board and its contracted catering company to establish the “Eat Smart!” program in high schools. Additional highlights include:
- Three new childhood universal vaccination programs were begun in January, for pneumococcal and meningococcal C disease, and varicella.
- With the passing of the provincial Smoke-Free Ontario Act, health units were called upon to develop enhanced tobacco surveillance, education and enforcement activities.
In 2006, the Health Unit unveiled its new five-year strategic plan: Moving Upstream, which was based on the premise of “upstream thinking” and its relationship to public health. The 2006–2010 plan is based on a continuous quality improvement framework and for the first time in the agency’s strategic planning history, identifies formal performance indicators and outcomes to guide ongoing improvement. To align with this direction, a Quality Improvement Department was created in 2007.
Programs and services continued to expand, including a newly approved HPV vaccine for grade 8 girls. The Health Protection Department had to cope with a new health threat – the north shore of the St. Lawrence River and the Thousand Islands were recognized as the first area in Ontario that was endemic for Lyme Disease. Soon after, the southern Leeds Grenville area was also declared endemic for Lyme Disease and the health unit collected and tested ticks found on domestic pets in order to determine the area affected. The Small Drinking Water Systems program was transferred to LGLDHU effective December 1, 2008. We were now responsible for approximately 800 public water systems.
In January 2009 the new Ontario Public Health Standards were launched. In response, we embarked on a complete program review of all Health Unit programs and services. Efforts continued to persuade the MOHLTC to increase our base funding and this led to a promise that the provincial funding formula would be examined as part of a provincial accountability framework.
At the end of April, 2009 the H1N1 influenza pandemic hit Ontario, including Leeds, Grenville and Lanark. All non-essential activities were gradually cut back and then stopped as the pandemic grew. The week of maximum activity in Leeds, Grenville and Lanark was the last week of October, with the epidemic subsiding by the end of the year. Once the vaccine became available at the end of October we implemented mass immunization clinics and encouraged primary care to also provide the vaccine. Together we immunized over 30% of the population before the outbreak subsided by Christmas.
2010 and Beyond
In 2009, the Health Unit purchased property and built a brand new building at 25 Johnston Street in Smiths Falls. This office currently houses approximately 55 staff and offers a full-range of programs and services to surrounding areas.
In 2011, a major restructuring was undertaken, with the introduction of a community service delivery model and the loss of 3 senior management positions. Moving Upstream 2013–2018 was developed to build on the new community service delivery model. For the first time, health goals were added to the plan, which had been largely administrative in nature. The four health goals include: Healthy Baby/Child/Youth Growth and Development; Healthy Living; Health Equity; and Healthy Environments.
The Ministry of Health and Long-term Care introduced Accountability Agreements into public health in 2011. These agreements specify performance expectations in the form of indicators, for boards of health and require public health units to demonstrate compliance with the Ontario Public Health Standards. In 2017, the Ministry developed consultation documents for review by the field for modernized standards and accountability requirements.
During this time, the Health Unit’s participation in community partnerships continued to grow, including the Healthy Communities Partnership; the Rural Recreation Association, the Healthy Kids Community Challenge. New programs and services that were introduced over this time period include:
- The NutriSTEP® Program, a nutrition assessment and program for toddlers and preschoolers.
- An Online Food Safety Disclosure System, called INSIGHT, which allows residents to search food facility inspection results.
- The Baby-Friendly Initiative, encouraging supportive environments for mothers to breastfeed, as well as free breastfeeding clinics at Health Unit sites.
- Health Equity programs, including Health Unit support into investigation into the basic income guarantee program.
- Responses to emerging health hazards, including extreme weather alerts and blue-green algae.
In October 2016, the Minister of Health and Long-Term Care released a comprehensive Strategy to Prevent Opioid Addiction and Overdose, in response to increasing use and overdoses from illicit fentanyl. From the opioid strategy, it was announced on June 12, 2017, that funding will be provided to Public Health Units to enhance harm reduction programs and services and improve local opioid response capacity and initiatives. This will build on programs and services already offered by Public Health Units and community partners. This enhancement will address areas that the steering committee has identified as priorities, including local opioid response, naloxone distribution and training, and early warning and surveillance.