Chronic Disease Management and Prevention

Chronic diseases are among the most common and costly health problems facing Canadians; they are also among the most preventable.

Working with our partners, we seek to identify opportunities to support provincial priorities, encourage healthy living and support best practice management of complex conditions along the continuum of care - from prevention and early detection to the end of life.


Diabetes Regional Coordinating Centres

The coordination, funding and accountability of diabetes services in the Central region is now being managed by the Central LHIN.


The operational mandate, functions and funding for delivery of the Diabetes Regional Coordination Centre Program were transferred to the LHINs in the 2012/13 fiscal year. The LHINs are responsible for the regional management, planning and coordination of Ministry-funded diabetes services and programs as aligned with the former Diabetes Regional Coordination Centre Program objectives.

Diabetes Education

In 2013, the MOHLTC transferred responsibility for most of the Diabetes Education Program (DEP) funding agreements (i.e. those for Community Health Centres and hospital based programs) to LHINs.

One of the responsibilities of the LHIN is to monitor individual DEPs to ensure consistency with LHIN Diabetes Program objectives.

A Diabetes Education Program is a program that provides fundamental knowledge on the treatment of diabetes and prediabetes.

DEPs support the first priority in Ontario’s Action Plan for Health Care: Keeping Ontario Healthy, by helping people with diabetes stay healthy, promoting healthy habits and behaviours, supporting lifestyle changes and encouraging better management of chronic conditions.

For more diabetes resources and information on diabetes education programs, click here.  

Ontario Renal Network

The Ontario Renal Network (ORN) provides overall leadership and strategic direction to organize and manage the delivery of renal services in Ontario. In 2010, regional renal programs were established in all 14 LHINs. The goals of the ORN are as follows:

  • Prevent or delay the need for dialysis
  • Broaden appropriate chronic kidney disease patient care options
  • Improve the quality of all stages of chronic kidney disease care

Renal services and dialysis planning is advised by a Regional Renal Steering Committee (RRSC) for Central LHIN, led by the Regional Director, Melanie Tremblay ( and Clinical Director, Dr. Andre Charest.

Ontario Stroke Network

In 2008, the Ministry of Health and Long-Term Care established the Ontario Stroke Network (OSN), a network of regional and district stroke centres with the ultimate vision of: Fewer Strokes. Better Outcomes. OSN is focused on system change, professional education and public awareness through the following: implementing best practices across the care continuum; conducting research and evaluation; and planning, implementation and service.

Stroke Prevention Clinics

In 2009, a collaborative approach amongst five hospitals in Central LHIN, led by Mackenzie Health (formerly York Central Hospital) as the designated District Stroke Centre, has resulted in the successful implementation of a network of stroke prevention clinics. Once timely, standardized and evidenced-based preventative care for patients with transient ischemic attack or minor stoke is achieved at the nurse-practitioner run clinics, patients are encouraged to attend local Cardiovascular Rehabilitation programming to address ongoing lifestyle behaviours and risk factors for stroke (for example, diabetes, high blood pressure, lack of exercise). The goal of this initiative is to improve access to best practice stroke prevention services in order to reduce the incidence of primary or secondary stroke.

For more information on the Stroke Prevention Clinics, contact, Judy Murray at or (905) 883-1212 x3882.  

Additional Stroke Resources 

Additional Provincial Chronic Disease Management and Prevention Priorities in Central LHIN

Central Regional Cancer Program

The Regional Cancer Program of the Central LHIN hosted by Southlake Regional Health Centre oversees the delivery and quality of cancer services for residents of North York, York Region and South Simcoe. It is one of 13 Regional Cancer Programs under the leadership of Cancer Care Ontario to ensure cancer care services are delivered according to province-wide quality standards.

Regional Cardiac Care Program

The York, Simcoe, Muskoka, Dufferin Cardiac System Planning Team works collaboratively to continuously evaluate and advance access, quality and efficiency of cardiac care. The Regional Cardiac Care Program is hosted at Southlake Regional Health Centre.  

Ontario Diabetes Strategy

Stand Up to Diabetes In 2008, the government announced an investment of $741 million over four years (2008-2012) in the Ontario Diabetes Strategy (ODS) to expand diabetes programs and improve the health and health care for Ontarians living with diabetes or at risk of developing diabetes. 

In April 2012, the Ministry confirmed continued funding for the Strategy – $152 milĀ­lion from 2012 to 2016.

Through the ODS, the government has built on existing investments in prevention and care initiatives at each level of the health care system to increase capacity, make it easier for people to get the services they need and improve the overall quality of diabetes services and care in Ontario. The two key objectives of the Strategy are to:

  • Leverage existing investments and make new investments in diabetes care to improve access to, and quality of, diabetes services and care in Ontario 
  • Build capacity in the system by enhancing prevention and improving diabetes management