Summary In October 2004, the Honourable George Smitherman, Minister of Health and Long-Term Care, released the first of a series of bulletins to provide the public and stakeholders with additional information on the creation of Local Health Integration Networks (LHINs). [...] The hospitals of Ontario and the OHA are strong supporters of increased integration of the health care system and believe that efforts to improve integration should build on current system strengths and successes. [...] Integrated programs to support the care of the frail elderly in the community and reduce the rate of institutionalization and dependence on hospitals. [...] The government, however, would continue to be accountable for adequate system funding and for providing an appropriate policy, legislative and regulatory environment to support population health and wellness, and the delivery of health and health care services. [...] The Working Group strongly endorses the government’s What are the reporting relationships commitment to maintain the independent nature of local between health care providers and the voluntary governance, including the voluntary role of government and LHINs?