The Legislative Assembly provided Local Health Integration Networks (LHINs) with new powers through legislation, which received third and final reading on March 1, 2006.

Upon Royal Assent, the Local Health System Integration Act, 2006, will give the 14 LHINs in the province the power to plan, integrate and fund local health services – including hospitals, Community Care Access Centres, Community Health Centres, as well as home care, long-term care, mental health, addiction and community support services – for their specific geographic areas.

The networks will allow local communities and health care providers to work together to identify local priorities, plan health services and deliver them in a more coordinated fashion. The government will continue to set strategic directions and provincial standards for high-quality, accessible health care.

The government listened to hundreds of individuals and organizations that asked for changes to the legislation and responded with a number of amendments to improve the Local Health System Integration Act, 2006:

Some of the more notable changes to the legislation include:

• Emphasizing the government's commitment to public health care
• Listing the exceptions to the requirement for LHIN meetings to be open to the public
• Requiring advance notice of any LHIN integration decision or Minister's order
• Requiring posting of all public information on the Ministry and LHIN websites
• Further defining community engagement

A definition of "community" was added to include individuals, health service providers, employees of the health system and patients. LHINs would also be required to consult with prescribed organizations dealing with Aboriginal, First Nations and French language health issues. This will ensure that LHINs hear from a wide range of people and organizations about local needs and priorities.

The amendments to the legislation also set out possible methods for carrying out community engagement, including holding community or focus group meetings and establishing advisory committees.

The Health Results Team – System Integration would like to take this opportunity to thank the members of the Provincial Action Group for their support and expert advice throughout the design and implementation of Local Health Integration Networks (LHINs). The Action Group, which had its last meeting on February 22, was composed of provincial associations representing: home care, community support and community mental health providers; community health centres; long-term care facilities; Community Care Access Centres; hospitals; local public health agencies; French language health service providers; physicians; nurses; and, ministry regional offices.

A Think Tank on Ethics for LHINs was held on February 20, 2006 in Toronto. The full-day session was co-sponsored by LHIN CEOs and the Health Results Team – System Integration Project Team, with expert advice from the University of Toronto's Joint Centre for Bioethics.

The Think Tank was intended to share current research on ethical decision-making and priority setting in health care, and to provide advice on the development of an ethical framework for LHIN Chairs and CEOs. Representatives from each of the 14 LHINs attended the session, which provided an excellent opportunity to begin discussions on ethical issues facing LHINs, as well as on the principles and processes that will be required to support fair decision-making.

Participants included a cross-section of perspectives and expertise from academic institutions, government, service providers and regional authorities in other jurisdictions. National and international experts attended the session, including: Norman Daniels, Professor of Population Ethics and Professor of Ethics at Harvard University; Sister Elizabeth Davis, PhD Candidate with the University of Toronto; Chris Ham, Professor of Health Policy Management at the University of Birmingham in the United Kingdom; Ellen Fox, Director of the National Center for Ethics in Health Care, Veterans Health Administration; Kerry Bowman, Bioethicist, Mount Sinai Hospital; Robert Butcher, Assistant Professor and Clinical Bio-Ethicist, London Health Sciences Centre; Camille Orridge, Executive Director, Toronto Community Access Centre; Barbara Secker, Leader, Clinical Ethics, Toronto Rehabilitation Institute; Judith Shamian, President & CEO, VON Canada; Peggy Taillon, Vice President Advocacy, Community Engagement and Chief Privacy Officer, The Ottawa Hospital; Leslee Thompson, Vice President, Health System Strategies, Medtronic of Canada; and Douglas Martin and Peter Singer from the Joint Centre for Bioethics, University of Toronto.

As LHINs develop their approaches to community engagement, planning, funding and accountability, they have been seeking input from stakeholders about issues faced by community-based organizations that cross LHIN boundaries. As a first step in ongoing discussions with stakeholders, on March 3, LHIN CEOs and the Ministry of Health and Long-Term Care Health Results Team – System Integration hosted a workshop on LHIN Cross-Boundary Issues. Approximately 30 representatives from community-based organizations and associations across Ontario attended the day-long event, which included presentations and small group discussions to begin identifying cross-boundary issues and strategies for addressing them.

Please look for the LHIN Bulletin mid-month, every month. Also, LHIN-related updates and reports will be posted on this site at the beginning of every month, if necessary.

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