Local Health Integration Networks (LHINs) are bound by the Local Health System Integration Act, 2006 to have service accountability agreements in place with all their Health Service Providers (HSP), including municipal long term care homes. The Long Term Care Service Accountability Agreements (LSAA) are the Agreements by which LHINs will flow funding to providers of long term care services including municipalities.

The LSAA template Agreement for LTC homes was developed on behalf of all LHINs by a steering committee co-chaired by Ministry and LHIN staff, in consultation with organizations representing service providers and funders. The LSAA consultation process began in the fall of 2009 and continued through to May 2010. The Association of Municipalities of Ontario (AMO) was a member of the consultation table along with the City of Toronto, the Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS), the Ontario Long Term Care Association (OLTCA) and the Ontario Hospital Association (OHA).

The LSAA was developed under challenging circumstances that include the introduction of the new Long Term Care compliance regulations. Both the LSAA and the regulations come into effect with the proclamation of the Long Term Care Homes Act in July.
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