Ontario’s Checkup

The LHINs and Matthew Little are doing big things for Ontario’s health

Matthew Little fills in the gaps. As the CFO of Local Health Integration Network (LHIN) Erie St. Clair, he frequently collaborates with his organization’s 13 other branches when they need help integrating systems or, as it happened at LHIN Waterloo in November 2013, someone goes on maternity leave. “I’ve become known as the resource guy,” says Little, who was initially drawn to the LHINs after getting a taste of what the nonprofit sector had to offer while working for the Ontario Teachers’ Insurance Plan. “I saw how accounting was a little bit different,” he says, “how decisions were made for the betterment of the stakeholders versus the betterment of the bottom dollar.” Since 2007, he has helped the LHINs build their teams and develop an emerging vision of what health care means to the people of southwestern Ontario.

The 21st century has seen a rise in support for local food, locally sourced materials, and local business, as communities have grown increasingly weary of outside control while becoming more environmentally conscious. The movement finally hit the health-care sector in Ontario in 2005, when the Ministry of Health and Long-Term Care divided the province into 14 regions, dubbed Local Health Integration Networks (LHINs). The idea was that it made more sense for people living locally to plan, fund, and integrate health services in their communities, and in April 2007, the local LHINs took full responsibility for the task.

“We’re bringing local engagement to the people that we’re going to actually serve,” says Matthew Little, the CFO of the Erie St. Clair LHIN. “Often, when it comes to government programs, they’re planned centrally and by people who may not know what their constituents really need.” Out of Canada’s millions of people, the LHINs represents the 13 million in Ontario, and the Erie St. Clair LHIN represents 640,000. “It’s always in the interest of meeting our vision: better care, better experiences, better value,” Little says. “By zeroing in, we can do more with what we have.”

Little has been with the LHINs for eight years, having started as a controller and business-support manager. In those early days, the organizations were still figuring out how they should be set up, so each of the 14 branches had its own controller and business manager who would report to a central CEO. As the LHINs have developed more policies and recruited more individuals, they have gone from a staff of 16 to a staff of 36, and Little became a director of finance along the way before eventually occupying a CFO position in 2012.

Today, he’s responsible for almost anything operational: human resources, IT, finance, procurement, privacy, admin, and facilities. And, on a larger scale, he’s responsible for strategic-planning activities, funding allocation, compliance, and the management of many contracts with LHIN providers and vendors. Little has overseen these tasks for two LHIN branches over the course of the past four years, but he’s transitioning to working solely on Erie St. Clair. “I truly believe in my role,” Little says. “I provide the level head within the LHINs as a member of the executive team.” With their regional focus, the LHINs frequently learn of new issues simply by listening to the general public; their executive team, which includes Little, works with staff to respond.


Population of Erie St. Clair, ON

$700 million

LHIN Erie St. Clair’s budget for fiscal year 2008

$1.1 billion+

LHIN Erie St. Clair’s budget for fiscal year 2014

Less than 0.5%

Amount spent on administration (99.5% of LHIN dollars go out the door to other agencies)


Staff members in the organization, with 9 governing board members

As a CFO, Little’s role is mostly related to support and compliance, and his largest contribution to date entailed changing his organization’s finance system from SAP to Great Plains three years ago. “That helped me further become a key resource for all the LHINs when it comes to system-setup change and its management,” Little says. The change has led to increased efficiency for the organization, and it has aided the LHINs’ positive contributions in each of their communities, including the implementation of an aging-at-home policy and the improvement of wait times at LHIN health-service providers.

The LHINs were also able to add 53 more beds into their system between 2013 and 2014, and the increase has helped them handle short-stay patients and patient loads in general. They also directed more attention to local mental-health needs with expanded addiction and withdrawal programs and the introduction of behavioural support systems in their long-term-care homes.

Moving forward, Little’s team is working on expanding its chronic-disease prevention and management programs. The aim: to reduce the costs of the top one to five percent of health-care users. “If you break it down,” Little says, “the top 5 percent of our users in health care spend about 80 percent of our dollars.” That translates to roughly 1,200 patients out of 13 million costing the organization more than $800 million, so it’s important that it continues to improve how it cares for them.

“The LHINs were created to be that local voice,” Little says. “Now it’s grown to become a system of people working together to make health care a bit better every day and for all patients.”