Voluntary Integrations

Voluntary integrations are those initiated by health service providers and brought to Toronto Central LHIN for review.  Toronto Central LHIN will continue to encourage voluntary integrations while moving to implement the recommendations from the third party review.

In reviewing voluntary integrations, Toronto Central LHIN applies a standard set of criteria to evaluate proposals. 

Proposals must:

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

The key phases of Toronto Central LHIN’s involvement in voluntary integrations are as follows:

Project Initiation Phase

In this initial phase, several meetings, conversations and discussions occur between Health Service Providers (HSP) and Toronto Central LHIN. HSPs will outline their own separate reasons for pursuing integration, and their preliminary work plan and time table.   While the HSPs may not be ready to publicly announce the integration, they have progressed to the point, at a governance and senior management level, where they have agreed that an integration of services is in their best interest and the best interest of their clients and patients.  


Health System Improvement Pre-Proposal (HSIP) Submission

Once the voluntary integration has been initiated, HSPs are encouraged to prepare and submit an HSIP to Toronto Central LHIN.  The HSIP serves two purposes; it formalizes the intent of the HSPs to work on a voluntary integration by describing in writing much of what was discussed during the initial meetings with Toronto Central LHIN.  The HSIP is also the method for the HSPs to request one-time funding to cover integration costs. 


Business Case Review / Due Diligence Framework

Prior to receiving the final version of the business case outlining the voluntary integration, HSPs are strongly encouraged to submit early drafts of their business case.  TC LHIN staff review and provide feedback on the drafts to help ensure the final version is complete and comprehensive.

Toronto Central LHIN applies a standard set of criteria including effectiveness, quality, and coordination.  Business cases are also reviewed for transparency, fairness, accountability, and risk mitigation.  The LHIN also evaluates the actions taken by health service providers to engage the community and affected stakeholder, and any human resources implications and mitigation strategies.


Posting on Toronto Central LHIN Website

When Toronto Central LHIN receives the formal Letter of Intent to integrate, and the final business case for integration, both are posted on the Toronto Central LHIN website.  A notice period of 7 to14 days is set for public comment on the proposed integration.  Any comments received by Toronto Central LHIN are immediately referred to the HSPs for response. 


Toronto Central LHIN Board Approval

The Toronto Central LHIN Integration Lead will prepare a report for the Toronto Central LHIN Board outlining the analysis of the key components of the business case.  The report will also contain a recommendation to either stop, or not stop the integration from proceeding. Toronto Central LHIN staff will also outline any comments received directly from the public.  The staff report is presented at a Toronto Central LHIN Board meeting within a 60-day period of LHIN review beginning when the formal Letter of Intent to Integrate is received by Toronto Central LHIN.



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