What is a LHIN?

Local Health Integration Networks (LHINs) are 14 not-for-profit crown corporations that were formed by the Government of Ontario in March 2006 under the Local Health System Integration Act, and which are under the Ontario Ministry of Health and Long-Term Care.

The LHINs oversee nearly two-thirds of Ontario's $37.9 billion healthcare budget. LHINs do not directly provide healthcare services, but have the mandate for planning, integrating, and funding healthcare services in their regions, including:

• Hospitals

• Community Care Access Centres

• Community Support Services

• Long-term Care

• Mental Health and Addictions Services

• Community Health Centres

Areas not covered by the LHINs, but which remain under government control are:

• Individual practitioners

• Family Health Teams

• Ambulance Services

• Laboratories

• Provincial drug programs

• Provincial programs

• Independent Health Facilities

• Public Health

Who's in Charge?

The LHINs took on responsibility for planning, funding, and integrating healthcare services in their local areas as of April 1, 2007. They are governed by boards of directors made up of nine members, who are responsible for the management and control of the LHIN, and who act as the key point of interaction with the Ministry. Most board meetings are open to the public; however, some meetings may be closed when certain matters (e.g., HR issues) are discussed. The provincial government remains ultimately responsible for providing residents with high quality, accessible healthcare services.

LHINs – Why?

According to the government, prior to the formation of LHINs, healthcare services in Ontario were fragmented, and many healthcare providers delivered care in isolation. LHINs, however, are based on the 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 needs and priorities. The government believes that the LHINs are a key component of making the healthcare system more patient-centered, efficient, accountable, and sustainable.

Each LHIN has its own three-year Integrated Health Service Plan, which is available on their website (see below), and which addresses their local healthcare service needs, goals, and priorities, which have been developed in cooperation with community partners and local healthcare providers. The LHINs are also creating volunteer Advisory Teams, Communities of Interest, Working Groups, and Health Professionals Advisory Committees.

The 14 Ontario LHINs

Note that although the LHINs are regionally based, their boundaries are for administrative and management purposes and people continue to be able to receive care both inside and outside of their LHIN.

• Erie St. Clair LHIN/Réseaux local d'intégration des services de santé d'Érié St-Clair – This LHIN is located in extreme southwestern Ontario, and includes the regions of Windsor/Essex, Sarnia/Lambton, and Chatham-Kent. Some larger communities in this LHIN include Windsor, Sarnia, and Chatham.

• South West LHIN – This LHIN is located in southwestern Ontario, covering an area from Lake Erie to the Bruce Peninsula, and encompassing the counties of Grey, Bruce, Huron, Perth, Middlesex, Oxford, Elgin, and part of Norfolk. It is home to nearly one million people, who reside in rural areas and smaller cities and towns, such as Port Elgin, Woodstock, Wiarton, Sauble Beach, and Stratford.

• Waterloo Wellington LHIN/Réseaux local d'intégration des services de santé de Waterloo Wellington – This LHIN is located in southwestern Ontario, and includes the boundaries of Waterloo Region, Wellington County, and the southern portion of Grey County. Larger communities include Kitchener-Waterloo, Guelph, and Cambridge.

• Hamilton Niagara Haldimand Brant LHIN/Réseaux local d'intégration des services de santé de Hamilton Niagara Haldimand Brant – This LHIN is in southwestern Ontario, encompassing slightly more area than the Niagara Peninsula. Larger communities include Hamilton, St. Catharines, Brantford, Niagara Falls, Welland, Grimsby, and Niagara-on-the-Lake.

• Central West LHIN/Réseaux local d'intégration des services du Centre-Ouest – This LHIN serves Dufferin County, the northern portion of Peel Region, parts of northwestern Toronto, and southwestern York Region, including the communities of Bolton, Brampton, Caledon, Malton, Orangeville, Rexdale, Shelburne, and Woodbridge.

• Mississauga Halton LHIN/Réseaux local d'intégration des services de santé de Mississauga-Halton – This LHIN serves part of western Toronto, and several neighboring communities, including the municipalities of South Etobicoke, Mississauga, Halton Hills, Oakville, and Milton. It is one of the most geographically compact LHINs, but the fourth-largest based on population, with more than 1 million residents.

• Toronto Central LHIN/Réseaux local d'intégration des services de santé du Centre-Toronto – This LHIN covers the majority of the core of the city of Toronto, with the Mississauga Halton, Central West, Central, and Central East LHINs covering the peripheral areas of the city.

• Central LHIN – This LHIN covers individuals chiefly in northern Toronto and its northern suburbs, in North York, York Region, and South Simcoe, in what is locally known as the "905" area and along the Highway 400 corridor. In addition to parts of north Toronto, communities include Richmond Hill, Markham, Vaughan, Newmarket, and Aurora.

• Central East LHIN/Réseaux local d'intégration des services de santé du Centre Est – This LHIN covers a mix of urban and rural lands, covering parts of eastern Toronto up to Algonquin Park. Larger communities include Pickering, Oshawa, Whitby, Peterborough, Lindsay, Bowmanville, and Cobourg.

• South East LHIN – This LHIN covers the southeastern Ontario counties of Hastings, Prince Edward, Lennox & Addington, Frontenac, Leeds, and Grenville, and parts of Lanark and Northumberland counties. Larger communities include the cities of Kingston, Belleville, and Brockville.

• Champlain LHIN/Réseaux local d'intégration des services de Champlain – This LHIN covers the Ottawa Valley area of Eastern Ontario. The area includes Ottawa, as well as cities and towns such as Pembroke, Cornwall, Renfrew, Arnprior, and Hawkesbury.

• North Simcoe Muskoka LHIN/Réseaux local d'intégration des services de Simcoe Nord Muskoka – This LHIN covers the "cottage country" area north of metro Toronto, including cities and towns such as Barrie, Orillia, Collingwood, and Huntsville.

• North East LHIN/Réseaux local d'intégration des services du Nord-Est – This LHIN covers the large area (approximately 400,000 square kilometers) of Northeastern Ontario, but is home to only 560,000 residents. Larger communities include Sault Ste. Marie, Sudbury, North Bay, Parry Sound, and Timmins.

• North West LHIN – This LHIN covers Northwestern Ontario from White River in the east to the Manitoba border in the west – about 47% of Ontario's land mass – encompassing the districts of Thunder Bay and Rainy River, and most of the Kenora District. In addition to the city of Thunder Bay, the LHIN is comprised of numerous smaller cities, towns, and First Nations communities spread widely throughout rural and remote areas, and representing only about 2% of the province's population.

Who's in Charge?

LHINs – Why?

The 14 Ontario LHINs

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Cynthia M Piccolo

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