Voluntary Integration

Voluntary integrations are those initiated by two or more Health Service Providers (HSPs) and brought to the LHIN for review.

One of the key steps in a voluntary integration involves the submission of a Notice of Intent to voluntarily integrate from the involved HSPs to the LHIN. A Notice of Intent is required under Local Health System Integration Act, which sets out the range of obligations and processes for HSPs, LHINs and the Ministry of Health and Long-Term Care regarding the integration initiative. 

If you are an HSP and considering a voluntary integration, please contact Lynn Singh, Director, Health System Planning and Design, before submitting a Notice of Intent to the Central LHIN.

Notice of Intended Voluntary Integration

The purpose of the Notice of Intent is to gather the required information to enable the LHIN to review and determine whether or not to stop a proposed integration. Unless otherwise stated by the LHIN, the following components comprise a Notice of Intent:

1. Letter of Intention to Voluntarily Integrate

  • Formal notice of the intent to voluntarily integrate

  • Summarizes the intended voluntary integration

  • Identifies the HSPs involved

  • Provides the date of the notice

  • Contact name for further information

  • Signed by involved HSP CEO or other binding authority

2. Approval Letter from Board of Directors
  • Letter from involved HSP Board of Directors and, if applicable, any third party (non-HSP), indicating approval of the intended voluntary integration

3. Completed LHSIA Health Service Provider Checklist

  • Outlines additional details to be submitted to the LHIN as part of the notice to voluntarily integrate

  • Checklist often requests a detailed description of the intended integration, an outline of completed or planned community engagement, and a list of potential impacts, risks and mitigation strategies if applicable (e.g. labour / employee relations)

Upon receipt of a Notice of Intent to integrate services, a LHIN has 90 days to carry out its due diligence, which may include requesting additional information to support the review. After LHIN staff complete a review, there will be a provision of a recommendation to the LHIN Board either to stop or not stop the integration.

Central LHIN Voluntary Integration Evaluation Criteria

In reviewing proposed integration activities, it is the responsibility of the affected LHIN(s) to determine whether or not the integration is in the best interest of the public. For voluntary integrations, this is summarized in the criteria of LHIN Decision-Making Criteria for Voluntary Integration Checklist. The criteria include:

  • Access/equity/coordination
  • Community engagement 
  • Quality/health status/clinical outcomes
  • Efficiency/sustainability/human resources

In addition, proposals are reviewed for transparency, fairness, accountability and risk mitigation.

Community Engagement

Community engagement falls on a continuum that reflects a range of activities and processes including information sharing, public consultation and direct engagement of stakeholders in the planning and decision-making process. The community engagement process is fundamental to enabling collaboration with partners across the health system and is an important component of the LHIN Board’s integration decision-making criteria.

The level of community involvement required during the integration process will reflect the scope and potential community impact of the proposed integration activity. The Central LHIN HSP Community Engagement Guiding Principles & Checklist outlines expectations regarding community engagement and provides guiding principles to assist in engagement activities.