Voluntary Integration

Voluntary integrations are those initiated by health service providers and brought to the LHIN public Board meeting for review.
One of the key steps in a voluntary integration involves the submission of a Notice of Intent to voluntarily integrate from two or more health service providers 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 health service providers, LHINs and the Ministry of Health and Long-Term Care regarding the integration initiative. 

Upon receipt of a Notice of Intent to integrate services, a LHIN has 60 days to carry out its due diligence. This involves a review of the proposed integration by LHIN staff and the provision of a recommendation to the LHIN Board either to stop or not stop the integration.

If you are a health service provider and considering a voluntary integration, please contact Chantell Tunney, Interim Senior Director, Planning, Integration & Community Engagement, before submitting a Notice of Intent to the LHIN.

Notice of Intended Voluntary Integration

The purpose of the Notice of Intent is to gather the required information together 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

  • Represents a formal notice of the intent to voluntarily integrate

  • Summarizes the intended voluntary integration

  • Identifies the health service providers involved

  • Provides the date of the notice, name of contact for further information

  • Signed by the health service provider CEO or other binding authority

2. Approval Letter from Boards
  • Letter from the Board of Directors of each health service provider and, if applicable, any third party (non-health service provider), indicating approval of the intended voluntary integration

3. Completed LHSIA Health Service Provider Checklist

  • Outlines the additional detail health service providers are required to submit to the LHIN as part of their 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 and risks and mitigation strategies if applicable (e.g. labour / employee relations)

As part of its consideration of a voluntary integration request, the LHIN may request additional information to support its review.

Upon receipt of a Notice of Intent to integrate services, a LHIN has 60 days to carry out its due diligence. This involves a review of the proposed integration by LHIN staff and the 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 Central 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 Health Service Provider Community Engagement Guiding Principles & Checklist outlines expectations regarding HSP community engagement and provides guiding principles to assist in their engagement activities.