Local Health Integration Networks (LHINs)

In 2005, the provincial government began restructuring the provincial health care system into 14 regions, called Local Health Integration Networks (LHINs).

As of April 1, 2007, LHINs are responsible for planning, coordinating, funding and monitoring their local health system. Many health service providers will be funded through the LHINs. This includes hospitals, most psychiatric facilities, long-term care homes, Community Care Access Centres, community service providers and community mental health and addiction agencies.

Public health, family physicians and Family Health Teams, ambulance services, laboratories, and provincial networks and programs (such as Telehealth and Cancer Care Ontario) are not under the direction of LHINs.

The Ministry of Health and Long-Term Care expects each LHIN to develop an annual Integrated Health Service Plan (IHSP). The IHSPs are expected to include strategies to better coordinate health care in their LHIN region and use health resources more efficiently. The LHINs are required to engage the community when developing plans and setting priorities. Based on the IHSP, the ministry will provide funding to each LHIN. The LHINs will then make decisions regarding the allocation of funds to health service providers in their region. The first annual IHSPs were released in December 2006 and are available on the LHIN websites.

• Local Health Integration Networks website
  • Find your LHIN by postal code
• Locate the CMHA branches in your LHIN
• Local Health Integration Networks: Building a True System
  Ministry of Health and Long-Term Care information on LHINs

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Key Issues for the Mental Health Field

1. Protected funding for mental health

A review of the effects of regionalized systems on mental health and addiction services in other jurisdictions found that as authority for decisions about funding is devolved from a central governing structure to regional decision-making bodies, there is greater likelihood of mental health having difficulty competing for resources within regional funding envelopes. A strategy which has been used in other jurisdictions is to protect or "ring-fence" monies intended to provide mental health and addiction services, at least until regionalized system planning is mature. (See Macfarlane, D., and Durbin, J., "Mental Health and Addiction Services in Regionalized Health Governance Structures: A Review," March 2005, at www.ontario.cmha.ca.)

2. Community engagement that is meaningful, and includes consumers and families, as well as service providers

LHINs are expected to "engage" the community. The inclusion of consumers and families in planning and delivery of services is a best practice in mental health. It is essential that consumers and families not only be "engaged" but that they have the power to influence services.

3. Integration based on clear goals

Both the LHINs and health service providers within each LHIN are required to identify opportunities to integrate services and use health resources more efficiently. LHINs have the power to direct integration by providing or changing funding to a health service provider, facilitating and negotiating integration plans with service providers, and/or ordering integration.

The important starting point for initiating planning for integration is to ask what is the intended goal for integration? A range of integration approaches are possible in order to attempt to achieve these goals. (See the CMHA, Ontario backgrounder "Planning for Integration," June 2006, at www.ontario.cmha.ca.)

A review of system integration demonstrates that one size does not fit all, and models of coordination and integration need to meet the unique characteristics of the community. (See Durbin, J., et al., "Strategies for Mental Health System Integration: A Review," Final Report, Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, August 2001, at www.camh.net.)

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Related Resources

More Information about Local Health Integration Networks

The LHIN Exchange

The LHIN Exchange is a website designed to enable mental health and addiction stakeholders in Ontario to share news about developments in their Local Health Integration Network (LHIN) with others across the province.

Local Health System Integration Act

The act sets out the powers and functions of the Local Health Integration Networks (LHINs), requires both health service providers and LHINs to identify opportunities for integration of services , and makes health service providers accountable to the LHINs and LHINs accountable to the Minister of Health through accountability agreements and performance evaluations.

Structure, Powers and Accountability of Local Health Integration Networks (October 2008)

An easy-to-read guide produced for the Change Foundation on Ontario's local health integration networks (LHINs). Primarily intended to make the LHIN legislation understandable to lay people, the guide also describes developments within the LHINs since they have been in place.

Mental Health and Addiction Services in the Context of Decentralized Planning and Management of Health Care Services (November 2007)

A presentation to the Partnership Policy Forum by Carrie Hayward, Director, LHIN Liaison Branch, MOHLTC.

A Focus on Addictions and Mental Health (June 2007)

A review of LHIN integrated health service plans. The purpose of this review was to assess the extent to which these plans address addiction and mental health issues.

Backgrounder: Planning for Integration (June 2006)

CMHA, Ontario provides information on various types of integration and their critical success factors, and the related concept of continuity of care, to assist communities in planning for service integration within LHINs.

Transformation: Changing the Mental Health Care Map in Ontario

The Fall 2005 issue of Network magazine focuses on how the government's health care transformation agenda will affect the community-based mental health system in Ontario.

Ontario Health Reform

CMHA, Ontario is monitoring changes in the health care system and their impact on people with mental illness and the mental health system.

Evaluation and Planning

Report of the Manitoba Regional Health Authority External Review Committee, February 2008

A report from an independent review committee published ten years after the creation of regional health authorities (RHAs) in Manitoba. Discusses the achievement of intended objectives, as well as the further systemic change that is needed to produce more improvements.