Frequently Asked Questions



1. What are Local Health Integration Networks (LHINs)? What do they do?
LHINs are not-for-profit corporations that work with local health providers and community members to determine the health service priorities of their regions. They were created in April 2006, and will take on their full role of planning and funding health services April 1st, 2007. LHINs will not provide services directly, but will instead be responsible for integrating services in each of their specific geographic areas.

Through community engagement, LHINs work with local health providers and community members to develop integrated health service plans for their local area.

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

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2. What programs/services are LHINs responsible for?
LHINs have responsibility for:

  • Public and private hospitals
  • Community Care Access Centres
  • Community Support Service Organizations
  • Mental Health and Addiction Agencies
  • Community Health Centres
  • Long-Term Care Homes

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3. What programs/services are staying with the Ministry of Health and Long-Term Care?
The government retains control for:

  • Individual practitioners
  • Family Health Teams
  • Ambulance Services
  • Laboratories
  • Provincial drug programs
  • Provincial programs
  • Independent Health Facilities
  • Public Health

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4. Why is the government organizing the health system by LHINs?
The government is transforming the health system in order to make it more patient-centered, efficient and accountable. LHINs are a key component of that plan. By improving the integration and coordination of the system, LHINs will help ensure that Ontarians receive the care they need now and in the future.

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5. Are LHINs a cost-cutting measure?
LHINs are not about cutting costs – they are about improving the delivery of vital health services. They were created to ensure a more efficient and accountable health system that provides better value for investments in health services, in order that Ontarians can continue to receive the care they need now and in the future.

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6. What does a LHIN-organized health system mean to patients and what are the benefits for patients?
Patients will benefit from having health service decisions affecting them made by people in their community, who understand the needs of the community and the people who live there.

LHINs are specifically mandated to engage people and providers in their communities about their needs and priorities. They are developing ways to improve access to health services, respond to concerns people have about those services and look for ways for service providers to improve the quality of care.
LHINs are playing an increasingly important role by ensuring that patients 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.

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7. How do LHINs make health care better in communities across Ontario?
LHINs are responsible for administrating the local health system to ensure that services are integrated and coordinated. Over time, this will ease the flow of patients across the health care system and improve access to services in communities. They are also expected to plan and allocate resources more efficiently to ensure better access to health care now and in the future.

In general, LHINs allow for more community input into local health care decisions, which improves the health care experience for patients in every part of the province.

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8. What authority do LHINs have to integrate services in their local areas?
LHINs have the authority to integrate local health services and programs, however LHINs will not make integration decisions in isolation, but will work with local health service providers to identify ways to reduce duplication in the health system and to improve health services in Ontario.

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9. Why have LHINs being given this authority?
LHINs have been tasked with planning and funding health services in their local areas in such a way as to improve service delivery for patients and obtain better value for investments in health services. The integration of certain services may be required in order for those goals to be achieved.

It is important to remember, however, that the government is ultimately accountable for the health care system and the Minister of Health and Long-Term care will ensure that there are appropriate checks and balances in place to hold LHINs accountable for the performance of the local health system and the services Ontarians receive.

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10. The Ministry of Health and Long-Term Care is handing over nearly two-thirds of the ministry's budget to LHINs. What checks and balances are in the legislation to ensure that LHINs do not overstep the wishes of government, or take the health system in a direction counter to the government's strategic direction?
The legislation governing LHINs ensures that there is an appropriate balance between granting them the authority they need to effectively and efficiently manage the local health system and retaining the ability to hold LHINs accountable for their performance.

The relationship between LHINs and the government is governed by a Memorandum of Understanding (MOU) and an accountability agreement between each LHIN and the Ministry of Health and Long-Term Care. These accountability agreements include performance goals and objectives for the LHINs, performance standards, targets and measures, and a plan for spending the money the LHINs receive.

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

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11. How can communities be sure that LHINs will include them in local decision-making?
LHINs are required by legislation to engage their communities. It is what they were created to do. Each LHIN determines the process, format, and frequency of community engagement activities based on the unique characteristics and needs of the local community.

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12. Are meetings of LHIN boards open to the public?
Most board meetings are open to the public. However, the legislation does allow the board to hold private meetings discuss matters that should remain confidential, like human resources advice and information from legal counsel.

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

Services are provided in each LHIN in response to the local characteristics and needs of the community. LHINs have the flexibility to address unique local population health needs and priorities, without compromising the quality, access, or the efficiency of health services.

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14. Do I have to get health services from the LHIN in which I live?
No. LHIN boundaries are for management and administrative purposes only. People are not restricted to receiving services within their LHIN. They can continue to choose their health services providers as they do today.

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15. How independent are LHINs? Do they have to report back to the government?
The government will always have the ultimate responsibility for providing Ontarians with high quality, accessible health care services. LHINs work in partnership with the Ministry of Health and Long-Term Care to ensure that unique local health care needs and priorities are addressed.

The government continues to set the principles, goals, and baseline requirements for all LHINs to ensure that all Ontarians have access to a consistent set of health care services when and where they need them, regardless of what LHIN they reside in. At the same time, LHINs have the flexibility to address unique local population health needs and priorities.

The relationship between LHINs and the government is clearly delineated in a Memorandum of Understanding and accountability agreements.

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16. Are LHINs a move to expand privatization in health care?
No. They are a move to improve the quality and ensure the sustainability of publicly delivered health care. The legislation prohibits private payments for services that result from an integration decision, unless the payments are permitted by law. Moreover, the Commitment to the future of Medicare Act preserves the public health care system in Ontario.

This initiative is about providing better health care to the people of Ontario by doing some things differently than in the past - like involving communities in important health care decision. LHINs play an important role in ensuring that patients 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.

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17. What impact do LHINs have on French language services in the province?
None. Under the French Language Services Act, (FLSA) any head or central office of a government agency must provide services in French. The FLSA also indicates that members of the public have the right to receive services in French from the Government of Ontario in 24 designated areas. Each LHIN provides services to the public in French in accordance with the FLSA. Although 2 of the 14 LHINs are not within designated areas, there is no difference in French-language services provided to the public by these LHIN offices.

Although LHINs are not providers of clinical services, they will plan, fund and integrate the delivery of health care services. In these roles, LHINs need to assess and plan for French-language services in their areas, and provide the appropriate funding and allocation of resources. In doing so, the LHINs are required to engage a French language health planning entity for their geographic area.

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18. Do residents of Ontario continue to have access to insured health services outside of the province following the full implementation of Local Health Integration Networks?
There is no change whatsoever to access to insured health services outside of Ontario under the Local Health System Integration Act, 2006. If you are an insured resident of Ontario and you are outside the province temporarily (for example, in neighbouring Manitoba) you can use your Ontario health card to obtain insured health services. Because of arrangements that Ontario has with most other provinces and territories, the publicly-funded hospital or physician that you visit while outside Ontario will not bill you directly.

In some cases, you may have to pay for health care that you receive in another part of Canada, such as doctors' services (for example, in Quebec). In those cases, you are eligible for reimbursement from the ministry, and the OHIP rate for the service will apply. More information about OHIP coverage across Canada is available in the ministry's fact sheet.

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19. What happened with LHINs on April 1, 2007?
On April 1st, 2007, Ontario’s health care system transformed itself in a fundamental way. The 14 Local Health Integration Networks (LHINs) created by the government came fully into their power, taking on responsibility for planning, funding and integrating health services in their local areas. This represented a critical step in the evolution of a health care system that is accessible, coordinated and responsive, in addition to being accountable and sustainable.

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20. What happened to the Ministry of Health and Long-Term Care once the LHINs took over the funding of services?
The Ministry of Health and Long-Term Care is rising to a more strategic level, focusing more on providing overall direction and leadership for the province’s health care system. Essentially, the ministry’s future role will focus on providing stewardship. The ministry will be less involved when it comes to the actual delivery of health care and will instead provide overall direction and leadership for the system.

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21. How do we know LHINs were ready to take on this enormous responsibility?
The Ministry of Health and Long-Term Care conducted “readiness assessments” to identify areas where additional work needs to be done or resources should be focused so LHINs, the ministry and health care providers would have a smooth transition on and after April 1, 2007. These assessments focused on ministry and LHIN capacity, knowledge, business processes, authority and resources. If work on any critical pieces seems to be falling behind, a mitigation strategy will quickly be put into place to remedy the situation.

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22. Who is responsible for long-term care home compliance?
The Ministry of Health and Long-Term Care continues to be responsible for all long-term care (LTC) compliance and inspection functions across the health system. This includes monitoring and enforcing standards; licensing, educating and handling appeals; and providing support for long-term care home closures, re-developments and sales. The new Compliance Branch, in the Health System Accountability and Performance Division, will work with the LHINs and other branches across the ministry, as well as other provincial ministries with compliance mandates. LHINs will be responsible for signing and monitoring the service agreement for each long-term care home, including LTC home performance accountabilities and funding, starting in 2010.

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23. How has life changed for service providers?
Providers now negotiate their funding agreements with LHINs instead of with the government. They will also work to resolve issues and challenges directly with LHINs instead of with the Ministry of Health and Long-Term Care.

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24. How has life changed for patients?
Patients continue to receive the first-class health care for which Ontario is known around the world. Going forward, they may notice an improvement in the access and availability of these services, as LHINs carry out their mandate of making local health care services more responsive to the needs of local communities.

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