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The introduction of 14 Local Health Integration Networks (LHINs) was a key component of the provincial government’s plan to transform the delivery of health care in Ontario. On April 1, 2007, LHINs assumed full responsibility for planning, funding and integrating health services in their geographic areas, pursuant to the terms of the Local Health System Integration Act, 2006 (LHSIA).

LHSIA was created to support the achievement of an integrated health system that will improve the health of Ontarians through (i) better access to high quality health services; (ii) coordinated health care in local health systems and across the province; and (iii) effective and efficient management of the health system at the local level. LHSIA provides the LHINs with a number of tools to achieve integration in the system. One of these tools is funding. LHSIA requires that the accountability for the funding provided by the Ministry of Health and Long-Term Care (MOHLTC) to the LHINs be closely aligned with the accountability for the funding provided by LHINs to health service providers.

Each of the 14 LHINs and the Ministry of Health and Long-Term Care finalized and signed Accountability Agreements. The MOHLTC-LHIN Accountability Agreement (MLAA) sets out obligations on the part of both the Ministry and LHINs in fulfilling their mandates to plan, integrate, and fund local health care services for a three-year period. It also sets out the system performance objectives that the LHIN must achieve.
In accordance with the requirements of the Commitment to the Future of Medicare Act, 2004, each LHIN is required to enter into service accountability agreements (SAAs) with the health service providers (HSPs) they fund.

Long-Term Care Home Service Accountability Agreement (L-SAA)
The L-SAA outlines the responsibilities of local health service providers and the LHIN, set activity and financial targets, lay out expectations for ongoing development and service delivery and provide benchmarks so that providers and the LHIN can measure performance year over year. The L-SAA focuses on accountability and performance and is an integral component to the ongoing effort to improve health system performance and provide high-quality, resident-centered care.
To view the service accountability agreement between a City of Toronto long-term care home and its respective LHIN, please click on the applicable home below:

• Bendale Acres - Central East LHIN (PDF - 8.9 MB)
• Carefree Lodge - Central LHIN (PDF - 2.3 MB)
• Castleview-Wychwood Towers - Toronto Central LHIN (PDF - 3 MB)
• Cummer Lodge - Central LHIN (PDF - 2.3 MB)
• Fudger House - Toronto Central LHIN (PDF - 3 MB)
• Kipling Acres - Central West LHIN (PDF - 760 KB)
• Lakeshore Lodge - Toronto Central LHIN (PDF - 3 MB)
• Seven Oaks - Central East LHIN (PDF - 8.9 MB)
• True Davidson Acres - Toronto Central LHIN (PDF - 3 MB)
• Wesburn Manor - Mississauga-Halton LHIN(PDF - 3 MB)

Multi-Sector Service Accountability Agreements (M-SAA)
The M-SAA is a multi-year agreement that supports a collaborative relationship between the LHIN and the health service provider to improve the health of Ontarians through better access to high quality health services, to co-ordinate health care in local health systems and to manage the health system at the local level effectively and efficiently.
Stated as a matter of record for public viewing, the following is a copy of the M-SAA between City of Toronto Long-Term Care Homes and Services effective April 1, 2011.

Central LHIN
Mississauga Halton LHIN
Toronto Central LHIN