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Hospital Planning and Accountability
The Legal Environment : the CFMA, 2004, and the LHIN Act, 2006
The Commitment to the Future of Medicare Act, 2004, received Royal Assent and became law on June 17, 2004. This historic piece of legislation marked the beginning of an era of greater accountability in Ontario through the establishment of accountability agreements between the Minister of Health and Long-Term Care and health resource providers that provide publicly-funded health services.
Accountability in Ontario was further entrenched with the passing of the Local Health System Integration Act, 2006, in March 2006, which requires the ministry to enter into accountability agreements with LHINs, and the LHINs to enter into service accountability agreements with service providers.
On February 10, 2007, a draft regulation which would see the negotiation of service agreements between LHINs and health service providers being phased in by sector, over a three-year period, was published in the Ontario Gazette for a 60-day public consultation period.
The proposed regulation would exempt LHINs from the requirement to give notice and negotiate an agreement within 90 days for the following service providers : Community Health Centres; Community Mental Health and Addiction Services; Community Service Agencies; Community Care Access Centres (CCACs); and Long-Term Care Homes. These service providers would be exempt until March 31, 2009, except for CCACs, which would be exempt until March 31, 2010.
According to the proposed timetable, LHINs would begin to negotiate agreements for 2008/09 with the hospital sector in fiscal year 2007/08.
Other sectors would follow suit, with negotiations beginning in fiscal year 2008/09. In the interim, they would continue to operate under their existing agreements.
For more information, see the Notice of Proposed Regulation Accountability Regulation Under the Local Health System Integration Act, 2006.
Effective March 19, 2007, key provisions of the Local Health System Integration Act, 2006 (LHSIA) permitting the assignment of the Minister's rights and obligations to a Local Health Integration Network (LHIN) under all, or part, of an accountability agreement between the Minister and a health service provider were proclaimed into force. These provisions include subsections 19(3), 19(4) and 19(5).
Other key provisions will become law on April 1, 2007. These additional provisions include subsections 18(1), 18(2), 18(3) and 18(5), which set out provisions related to Minister/LHIN accountability agreements; subsections 19(1) and 19(2), which provide authority for LHINs to fund health service providers; and section 21 which permits a LHIN to direct a health service provider to undergo an audit at any time.
For more information, see the March 17th, 2007, issue of The Ontario Gazette.
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