Local Health Integration Network
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Ontario LHIN Legislation

Highlights of the Local Health System Integration Act, 2006

In March 2006, the government of Ontario passed historic health care legislation. The Local Health System Integration Act, 2006 changed the way our health care system is managed by creating 14 Local Health Integration Networks (LHINs). 

More than 6,000 people across the province as well as representatives of patient advocacy and community groups, unions, health care providers and health related associations all helped to shape the development of LHINs and this legislation.


Benefits of the Legislation

  • The Local Health System Integration Act, 2006 was about building a health care system around the needs of our patients and communities
  • LHINs were a long overdue evolution of health care in Ontario. LHINs have helped to break down the barriers faced by patients trying to navigate the system
  • LHINs represent an understanding that community-based care reflecting the needs of that community is best planned, coordinated and funded in an integrated manner within that community
  • LHINs will engage Ontarians in the health care discussion. Accountability and transparency are the keys to you knowing what you are getting and helping to define local health care priorities.

Health care is an investment, not an expense. This legislation is designed to better position the government to make that investment, improving health care for everyone and preserving the economic advantage that our publicly funded health care gives our industries.


Overview of the Legislation

LHIN Health Service Providers
LHINs will have responsibility for the following providers:

  • Hospitals
  • Divested psychiatric hospitals
  • Community Care Access Centres (CCACs)
  • Community support service organizations
  • Community mental health and addictions agencies
  • Community health centres
  • Long-term care homes.

In addition to continuing to fund major capital projects, the Ministry of Health and Long-Term Care has retained responsibility for the following providers:

  • Public Health
  • Physicians
  • Ambulance services (emergency and non-emergency)
  • Laboratories
  • Provincial networks and programs.

LHIN Governance 
The legislation:

  • Defines LHIN structure, powers and board composition
  • Provides LHINs with the ability to create their own by-laws
  • Ensures that LHIN board meetings are open to the public; however, the legislation allows the board to go in camera (closed meetings) to discuss matters in certain circumstances
  • Requires LHIN boards to appoint a licensed auditor to conduct an annual audit.


Community Engagement and Planning
The legislation:

  • Requires the province to develop and publish a provincial strategic plan to help guide the health care system
  • Requires each LHIN to develop an integrated health service plan (IHSP) with input from the community.
  • Sets out requirements for community engagement by LHINs and health service providers
  • Requires LHINs to engage Aboriginal and First Nations and French language health planning entities
  • Requires each LHIN to establish a Health Professionals Advisory Committee as part of its community engagement process. This committee is comprised of health care professionals, including doctors and nurses.

Funding and Accountability
The legislation:

  • Gives LHINs the authority to fund the following service providers – hospitals, Community Care Access Centres (CCACs), long-term care, mental health and addiction, community health centres and community support services
  • Requires the ministry to enter into accountability agreements with LHINs
  • Requires LHINs to enter into service accountability agreements with service providers
  • Provides authority for the minister to allow LHINs to reinvest a portion of savings back into patient care in the community if they find efficiencies within their local health system.


The legislation:

  • Recognizes that LHINs can help to integrate the local health system through:
    • the negotiation or facilitation of integration plans with service providers/others
    • the use of funding levers (incentives and disincentives)
    • requiring integration of service providers, when it is in the public interest to do so
  • Requires both LHINs and service providers to develop strategies to integrate services
  • Requires service providers to comply with LHIN decisions on integrating services
  • Specifically sets out the types of integration LHINs can require such as moving a service from one provider to another
  • Prohibits LHINs from requiring corporate changes such as amalgamation, changes to provider boards or closure of a corporate operation
  • Provides the minister with the power to integrate service providers in certain circumstances.

Labour Relations 
The legislation: 

  • Generally applies the Public Sector Labour Relations Transition Act, 1997 (PSLRTA) framework to LHIN integration decisions that affect health service providers. PSLRTA currently provides a process for resolving complex labour relations issues arising from public sector restructuring, addressing issues such as bargaining agents, seniority rights, and collective agreement transitions. 


Community Care Access Centres (CCACs)
The legislation:

  • Amends the Community Care Access Corporations Act, 2001, to permit the Lieutenant Governor in Council and the minister to re-organize CCACs and return them to non-profit boards under provisions of the Corporations Act
  • Allows a CCAC in the future to select its own board of directors as well as hire its executive director
  • Removes the requirement for CCACs to have community advisory committees while retaining the ability to establish committees of the board that they consider appropriate
  • Allows the government to broaden the CCAC mandate to permit an expanded role in the future.