The North East LHIN continues to work in partnership to strengthen Northeastern Ontario’s health care system and enable system integrations that ensure better patient outcomes.

A unique feature of LHINs is their ability to enable organizations, health professionals and consumers to work together to solve problems and improve local health care services. Through LHIN’s legislation, Local Health System Integration Act (LHSIA), the LHINs have a number of tools to create a more integrated and well functioning health care system for health care providers and, most importantly, for the consumers they serve.

There are four types of integration as described through LHSIA:

Facilitated Integration

  • LHIN identifies an integration opportunity and brings Health Service Providers (HSPs) together
  • One or more HSPs agree to integrate, but they do not have the resources and/or expertise to fulfill integration requirements
  • HSPs request the LHIN to negotiate integration solutions between partners
  • LHIN may appoint a facilitator to work with HSPs and LHIN

Required Integration

  • LHIN requires a funded (whole or in part) HSPs to integrate one or more of its services / programs, as it deems in the best interest of the public
  • LHIN may appoint a facilitator to work between HSPs and LHIN to fulfill integration requirements

Voluntary Integration

  • HSPs identify an integration and expertise to fulfill the integration requirements
  • HSPs utilize internal resources and expertise to fulfill the integration requirements
  • HSPs may agree to appoint a facilitator to fulfill integration requirements

Directed Integration

  • Minister receives integration advice from a LHIN
  • Minister directs a LHIN funded (whole or in part) HSP to integrate one or more of its services/programs, as it deems in the best interest of the public

Voluntary Integrations

Health service providers (HSPs) are legislatively required to pursue integration opportunities.

Voluntary integrations are those initiated by health service providers and brought to the LHINs public board meeting for review. The goal is to facilitate and enable voluntary integrations that will improve quality of care and value for money. In its review of voluntary integrations, the Board applies a standard set of criteria based on voluntary integration obligations under the Local Health System Integration Act to evaluate proposals. Proposals must:

  1. Improve or, at a minimum, produce the same quality and accessibility of care
  2. Be consistent with LHIN’s and Ministry’s directions
  3. Be cost-effective.

One of the key steps in a voluntary integration involves the submission of a Notice of Intent to voluntarily integrate from two or more health service providers to the LHIN.

A Notice of Intent is required under LHSIA, which sets out the range of obligations and processes for health service providers, LHINs and the Ministry of Health and Long-Term Care regarding the integration initiative. 

The definition of integration under LHSIA includes, among other things, co-ordination of services between different organizations; establishment of partnerships in providing services or in operating; transferring, merging or amalgamating services or operations, or the ceasing to operate or provide services.

Upon receipt of a Notice of Intent, a LHIN has 60 days to carry out their due diligence, which involves a review of the Notice of Intent and a staff recommendation to the LHIN Board to not stop the proposed integration or a recommendation to issue a proposed decision to stop the integration.

In addition, proposals are reviewed for transparency, fairness, accountability and risk mitigation. The LHIN also evaluates the actions taken by the health service providers to engage the community and affected stakeholders, and any human resources implications and mitigation strategies.

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