A unique feature of the LHINs is their ability to enable organizations, health professionals and consumers to work together to solve problems and improve local health care services. Through the LHIN’s legislation, Local Health System Integration Act (LHSIA), the LHINs have a number of tools to create a more integrated and well functioning health care system for health care providers and, most importantly, for the consumers they serve. 

Voluntary Integrations

Voluntary integrations are those initiated by health service providers and brought to the LHINs public board meeting for review. The goal is to facilitate and enable voluntary integrations that will improve quality of care and value for money. In its review of voluntary integrations, the Board applies a standard set of criteria based on voluntary integration obligations under the Local Health System Integration Act to evaluate proposals. Proposals must:

  1. Improve or, at a minimum, produce the same quality and accessibility of care
  2. Be consistent with LHIN’s and Ministry’s directions
  3. Be cost-effective.

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 LHSIA, 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. 

The definition of integration under LHSIA includes, among other things, co-ordination of services between different organizations; establishment of partnerships in providing services or in operating; transferring, merging or amalgamating services or operations, or the ceasing to operate or provide services.

Upon receipt of a Notice of Intent, a LHIN has 60 days to carry out their due diligence, which involves a review of the Notice of Intent and a staff recommendation to the LHIN Board to not stop the proposed integration or a recommendation to issue a proposed decision to stop the integration.

In its review of voluntary integrations, Toronto Central LHIN applies a standard set of criteria based on obligations outlined in LHSIA, including access, effectiveness, quality, and coordination.

In addition, proposals are reviewed for transparency, fairness, accountability and risk mitigation. The LHIN also evaluates the actions taken by the health service providers to engage the community and affected stakeholders, and any human resources implications and mitigation strategies.

For any questions on integrations at the Toronto Central LHIN please contact, Nello DelRizzo, Senior Consultant at or 416-969-3318

Current Integrations

Toronto Central LHIN welcomes the public to view the business cases and provide feedback on proposed integrations that are currently under review.

Click here to view current voluntary integrations in Toronto Central LHIN.