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Bill 10, adopted in February 2015, substantially changed certain provisions of Quebec’s Health and Social Service Act (S 4.2). In particular, it radically altered the way in which Quebec’s public health and social services system is administered. It had far-reaching effects on the status of the institutions that deliver health and social services, merging almost all institutions into 22 Centres Intégrés that now deliver all of the regionally based services. The only exceptions are seven highly specialized hospitals (five in Montreal, two in Quebec City), one institution that already resembled a Centre Intégré (in region 10), and five institutions that deliver services to the Cree, Inuit and Naskapi communities (located respectively in regions 18, 17 and 09).