Local Health Integration Network
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Frequently Asked Questions

1. What is the purpose of the Local Health System Integration Act, 2006?

The legislation grants us the legislative power and authority to effectively plan, coordinate, and fund local health systems to make it easier for patients to access the care they need.


2. What are Local Health Integration Networks (LHINs)? What do you do?

LHINs are not-for-profit organizations responsible for planning, integrating and funding local health services in 14 different geographic areas of the province.

LHINs are based on a principle that community-based care is best planned, coordinated and funded in an integrated manner within the local community because local people are best able to determine their health service needs and priorities.

We determine the health service priorities necessary in our own communities. We work directly with our own health providers and community members to develop an integrated health service plan for our area.


3. Are LHINs reducing health service costs?

We are improving the way health services are planned and delivered at the local level across the province so that patients in our communities get the services they need. The formation of LHINs is also leading to a more efficient and accountable health system and provides better value for investments in health services.


4. What does a LHIN-organized health system mean to patients and what are the benefits for patients?

Patients benefit from having health service decisions affecting them made by people in their own community.

We are specifically mandated to engage people and providers in our communities about your needs and priorities. We are continuing to develop ways to improve access to health services, respond to concerns you may have about those services and look for ways for service providers to improve the quality of care.

We play an important role by ensuring that patients in our communities have better access to coordinated and integrated services through proper planning, and by building on the strength of local health organizations to improve communication among providers.


5. How will LHINs make health care better in communities across Ontario?

We are responsible for managing the local health system to ensure that services are integrated and coordinated. By working in collaboration with health providers, we are easing the flow of patients across the health care system and improving access to services in their community. We are also planning and allocating resources more efficiently to ensure better access to health care across the system.

Because we are responsible for the local health system, we encourage more community input in health care decisions and thus, improve health care experiences for patients in every part of the province.


6. What authority will LHINs have to integrate services in local areas? How will you improve service delivery?

We have the authority to integrate local health services and programs. We don’t make integration decisions in isolation; we work closely with local health service providers to identify ways to reduce duplication in the health system and to improve health services in Ontario.


7. Why are you being given this authority?

Community needs are best determined at the local level. By devolving responsibility for health services to us, the ministry can now be more strategic in the health system by concentrating on setting overall strategic directions and provincial priorities for the health care system.

However, the minister is ultimately accountable for the health care system and has ensured that there are appropriate checks and balances in place to hold us accountable for the performance of the local health system and the services you receive.


8. The ministry is transferring nearly two-thirds of the ministry's $37.9 billion budget to LHINs. What’s in place to make sure that you don’t take the health system in a direction counter to the government’s strategic direction?

The legislation ensures that there is an appropriate balance between granting us the authority we need to effectively and efficiently manage the local health system while retaining the ability to hold us accountable for our performance.

The relationship between ourselves and the ministry is being governed by a Memorandum of Understanding (MOU) between each LHIN and the ministry, and an accountability agreement between each LHIN and the ministry. The accountability agreements include our performance goals and objectives, performance standards, targets and measures, and a plan for spending the money we each receive.

The legislation requires us to provide the minister with annual reports, including audited financial statements. The Auditor General will also have the authority to audit any aspect of the operations of a LHIN.


9. How can communities be sure that they are included in local decision making?

We want to hear from you for a variety of reasons, including assessing local needs and planning for local health services. Community engagement is our core function, and the foundation of our existence. Each LHIN determines the process, format, and frequency of community engagement activities based on the unique characteristics and needs of our local communities.


10. Will meetings of LHIN boards be open to the public?

Most board meetings are open to the public. However, the legislation allows the board to go in camera (closed meetings) to discuss matters, such as human resources advice and information from legal counsel.


11. Will you be able to make decisions to close hospitals?

The legislation stipulates that we do not have the authority to direct amalgamations, to direct changes to provider boards or to direct service providers to close or cease their corporate operations. We cannot order the closure of a hospital.


12. Does this mean that services will move from hospitals in smaller communities to hospitals in major centres?

We do have the flexibility to address unique local population health needs and priorities, without compromising the quality, access, or the efficiency of health services.


13. Do I have to get health services from the LHIN in which I live?

No. LHIN boundaries are for management and administrative purposes only. You can continue to use the health care system as you did previously.


14. How independent are LHINs? Do LHINs have to report back to the ministry?

The government will always be ultimately responsible for providing you with high quality, accessible health care services. We work in partnership with the ministry to ensure that unique local health care needs and priorities are addressed.

The ministry sets the principles, goals, and baseline requirements for all LHINs to ensure that you have access to a consistent set of health care services when you need them, regardless of what LHIN you are in. At the same time, we as LHINs have the flexibility to address the needs and priorities in our own communities.


15. Aren’t you an expensive and additional level of bureaucracy? Shouldn't we spend more money on increasing the numbers of doctors and nurses?

Actually, we are an important channel responsible for creating a true health care system at the local level. We can assess the health needs of our communities and respond appropriately – including providing advice about the numbers of doctors and nurses. We are changing the fragmented approach to health service delivery and creating an integrated and coordinated local health care system. We are reducing duplication, not increasing it.


16. Do you have the power to override collective agreements?

The legislation provides for the application of a special labour law to deal with labour relations issues that arise following any integration. This will give employees, and their representatives, rights as the new employer and it will establish processes for resolving any issues.


17. Are LHINs just a way to expand privatization in health care?

This legislation prohibits private payments for services that result from an integration decision, unless the payment is permitted by law. In addition, the Commitment to the Future of Medicare Act preserves the public health care system in Ontario.


18. What impact does this legislation have on French language services in the province?

Each LHIN provides services to the public in French in accordance with the French Language Service Act (FLSA). Although two of the 14 LHINs are not within designated areas, there will be no difference in French language services provided to you by these LHIN offices.

Although we don’t provide clinical services, we do plan, fund and integrate the delivery of health care services. In these roles, we assess and plan for French-language services and provide the appropriate funding and allocation of resources. In doing so, we are required to engage a French language health planning entity for our specific geographic area.