Indigenous Governance in Public Health

Our work with Indigenous partners is fundamental to our mandate. Lakelands Public Health is committed to the principles of truth and reconciliation and to acting upon the 2015 Calls to Action of the Truth and Reconciliation Commission. In addition, the 2018 Ontario Public Health Standards Health Equity Guideline requires that all Boards of Health establish relationships with Indigenous partners. Lakelands Public Health has a long history with both Hiawatha and Curve Lake First Nations, as well as the urban Indigenous communities.

Section 50 Agreements

Section 50 of the Health Protection and Promotion Act enables First Nation communities to enter into formal agreements with Boards of Health, where the Board agrees to provide public health programs and services to members of the First Nation community. Lakelands Public Health is one of the only local public health agencies in Ontario who have a formal agreement to provide public health services to two of the local First Nation communities. The agreement also includes that the First Nation Councils agree to accept the responsibilities within the health unit, including contributing to cost sharing and having a member of the community sit on the Board of Health.

In 1967, an amendment was made to the Public Health Act, stating that for public health purposes, an Indian Band would be considered a township municipality and the Council of the Band would be deemed the Council of the Municipality. Where it was geographically feasible, local health services could be extended to Indian Reservations.

In 1983, the Health Protection and Promotion Act was updated which created a formal process for First Nations to engage with boards of health, giving them the same status and other “obligated municipalities” and granting them the right to appoint a First Nations member as their representative to the Board.  

Before the HPPA was updated, there were informal agreements but even with the new Act, it would still be a long time before formal agreements were created and fully implemented.

Please note: we recognize that this terminology is outdated, but it is the terminology that was used at the time. It highlights how, even when our intentions are kind, we sometimes stumble. We are continually thankful to our partners for their grace and understanding as we continue on our learning journey and building our partnerships.

The Haliburton Kawartha Pine Ridge District Health Unit has held historic Memorandums of Understanding with Alderville First Nation. While Section 50 Agreements can be developed, it is up to each First Nation to decide what is best for their community, and how they wish to interact, or not, with the health unit.

In 1968, then-Peterborough County-City Health Unit's Board of Health requested, and received, a provincial Order in Council officially recognizing the wishes of Hiawatha First Nation to receive public health services from the Board, and to participate in governance. The present public health service agreement dates from 1995, and a representative from Hiawatha First Nation has sat on the Board since 1998.

In 1968, then-Peterborough County-City Health Unit's Board of Health requested, and received, a provincial Order in Council officially recognizing the wishes of Hiawatha First Nation to receive public health services from the Board, and to participate in governance. The present public health service agreement dates from 2007, and a representative from Hiawatha First Nation has sat on the Board since 2009.

Hearing the Voices of Indigenous People

Indigenous Health Advisory Circle

In 2015, then-Peterborough Public Health established a First Nations Working Group, a sub-committee of the Board of Health, to discuss strengthening its relationship with Indigenous Peoples, coinciding with the Truth and Reconciliation Commission of Canada’s Calls to Action in 2015. The goal of this committee was “to deepen awareness, sensitivity and meaningful actions on issues that are of relevance and public health importance to Indigenous people living within the Peterborough County-City Health Unit catchment area”. Between 2016 and 2018, membership expanded to include the larger Indigenous community. After this expansion, the First Nations Committee was renamed the Indigenous Health Advisory Circle to represent broader representation and inclusion. 

Now the Indigenous Health Advisory Circle for Lakelands Public Health is comprised of representatives of Alderville, Curve Lake, and Hiawatha First Nations, members of the Urban Indigenous community, representatives from the Urban Indigenous serving organizations and other allies within the community.

Indigenous Health Events

Watch the Forum | October 30, 2023

Panelists: 

  • Candice Martin, Native People of Sudbury Development Corporation
  • Gaamominik Watts, Fleming College
  • Kevin Fitzmaurice, Trent University
  • Steven Teekens, Na-Me-Res

Watch the Forum | February 9, 2024

Panelists:

  • Phyllis Williams
  • Lesa Fox
  • Samantha Roan, Lakelands Public Health
  • Darrel Manitowabi, Northern Ontario School of Medicine

Bringing together healthcare leaders in Peterborough City and County from Trent University, Peterborough Regional Health Center, and Lakelands Public Health to learn from and with Indigenous peoples about governance, data sovereignty, and other pressing topics. 

Speakers:

  • Liz Stone
  • Lesa Fox
  • Sessions led by Samantha Roan

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