Submissions to the Standing Committee on Social Policy – Review of the Local Health System Integration Act and Regulations.
Introduction: In 2006, the Ontario Government established the Local Health System Integration Act (LHSIA).
The purpose of this act is to:
… provide for an integrated health system to improve the health of Ontarians through better access to high quality health services, co-ordinated health care in local health systems and across the province and effective and efficient management of the health system at the local level by local health integration networks.
Recommendations: RNAO recommends that the Standing Committee on Social Policy consider the following enhancements to LHISA:
- Place a greater emphasis on health equity, health promotion and addressing the social determinants of health.
- Specifically mandate that LHINs engage and consult with a variety of vulnerable groups, including (but not limited to): First Nations, Francophones, low-income groups, visible minorities, new immigrants, LGBQT persons, and older persons.
- Amend the definition of Health Service Provider to include:
a. Home health care and support service organizations (funded and accountable to the LHIN); b. All of primary care (Family Health Teams, Nurse Practitioner-led Clinics, Aboriginal Health Access Centres, Patient Enrollment Models and Solo Primary Care Providers); and c. Public Health Units.
- Further amend LHISA and the Community Care Access Corporations Act to transition the planning and funding functions of CCACs to LHINs. Mandate that LHINs possess a shared interprofessional leadership model that includes one physician, one RN and one other health-care professional (who is neither a physician nor RN).
Conclusion: In conclusion, the LHISA review is occurring at a pivotal time in health system transformation. RNAO supports an enhanced legislated role for LHINs - which at eight years of maturity -- must be enabled and made fully accountable for whole system regional planning and funding. The current model of ‘chopped planning/funding’ will continue to hamper the LHINs from fostering system co-ordination and integration. Not moving in this direction will result in ongoing duplication such as it exists now between the LHINs and the CCACs, lack of integrated services, delays in access to health services for Ontarians, and higher than necessary health system administrative costs. RNAO is pleased to offer recommendations, consistent with its ECCO model, to dramatically improve the planning and funding capacity of the LHINs.