DAY 1 Thurs. October 20 , 2011  Location:  Public Health Ontario Laboratory, Toronto 81 Resources Road, Etobicoke, Ontario  M9P 3T1 PLEASE NOTE THAT AN ARCHIVED RECORDING OF THE DAY'S PRESENTATIONS IS AVAILABLE FOR VIEWING ON THE OTN WEB SITE THIS IS AVAILABLE ONLY TO alPHa MEMBERS - PLEASE E-MAIL info@alphaweb.org TO OBTAIN LOG - IN CREDENTIALS
7:30 - 8:30: REGISTRATION AND BREAKFAST (Auditorium Foyer / Auditorium)
8:30 – 8:45 Welcome	Paul Roumeliotis  Paul Roumeliotis, President, alPHa; Vivek Goel, President & CEO, Public Health Ontario (PHO); Donald Low, Medical Director of the PHO Laboratories (PHOL); and Mike Mendaglio, Chief Laboratory Operations Officer, PHO each provided words of welcome to assembled delegates     Don Low
8:45 - 9:15 Partners for Health: alPHa and PHO	Vivek Goel Dr. Goel provided a brief history of the Ontario Agency for Health Protection and Promotion, now publicly known as Public Health Ontario. From its origins on the back of a cocktail napkin to a source of top-notch scientific and technical advice for the public health system, near-term plans include enhancements to library services, training and collaborative projects in order to establish a true province-wide system of S, Research and Knowledge Exchange. An online platform for information sharing and collaborative work is also on its way.
9:15 – 9:45 Overview of Public Health Laboratory System Regional structure in Ontario; private vs. public; what goes to PH Labs in Ontario; national Labs	Mike Mendaglio  Mike Mendaglio gave a brief history of the ONtario Public Health Laboratories and summarized the services provided. Testing methods range from classical light-microscope observation to high-tech, robotics-assisted diagnostics. He also noted that the laboratory system is undergoing renewal, with innovative new procedures in genetics (e.g. extracting DNA from old specimens to free up storage space and Web-based DNA optical mapping), and a new focus on customer service
9:45 – 10:15 BREAK
10:15 – 11:45 Panel: Laboratory Team Members and their Roles	(l-r): Fran Jamieson, George Broukhanski, Laura Burton Influenza testing (Laura Burton, Acting Manager of immunodiagnostics and Special Procedures, PHOLT): This presentation gave an overview on influenza outbreak characteristics, testing volumes and methods, capacity to test influenza strain susceptibility to antivirals and an algorithm that is used to ensure cost-effectiveness. C. difficile (George Broukhanski, Molecular Specialist, PHOLT): Delegates learned about the significance of C. difficile as a hospital-acquired infection, notification thresholds and how testing and identifying different types informs outbreak response measures. Tuberculosis (Fran Jamieson, Associate Medical Director and Medical Microbiologist, PHOL): This presentation covered information about the extent of testing for TB in the lab (47,000 specimens per year with a positivity rate of 2-3%), the methods used to get around challenges in isolating the organism, and the ability to idenify any of the strains found in the world and how that assists in identifying appropriate control measures. A Web-based surveillance tool (OUT-TB) also assists in contact tracing.
11:45 – 12:45 LUNCH
12:45 – 1:45  / 1:45 - 2:45 Public Health Surveillance Presentations and Guided Laboratory tours	Samir Patel  Lyme diagnostics (Samir Patel, Clinical Microbiologist, PHOLT) - This presentation included a description of the history, life-cycle, presentation and diagnosis of Lyme disease, which is a combination of accepted testing methods and patient history. The controversy about "chronic Lyme disease" diagnoses was also covered, with a note that such a diagnosis is usually made based on non-specific symptoms and laboratory confirmation methods that aren't scientifically validated.   Sandra Zittermann E. coli O104 laboratory response (Sandra Zittermann, Research Technician, PHOLT) -  this presentation addressed E coli 0104 as an emerging pathogen among the various entero-hemorrhagic strains. The confirmation assays for this infectious agent are cumbersome, costly or both, but the Public Health Ontario lab was able to isolate it from samples acquired during this year's outbreak in Germany.  This was characterized as an example of how information from the field can assist clinical work. Jason Garay Anne-Luise Winter  Surveillance and epidemiology (Jason Garay, Manager of Surveillance Services, PHO, and Anne-Luise Winter, Senior Epidemiologist, PHO)  - This was an overview of the surveillance services that were transferred from the Ministry of Health and Long-Term Care to Public Health Ontario as part of the recent redistribution of roles and responsibilities. These are to include support for the field during outbreaks; issuing Public Health Alerts; access to data, scientific advice and systems implementation; and a planned return of the Public Health and Epidemiology Report Ontario (PHERO) in the near future.
2:45 – 3:15 BREAK
3:15 – 4:15  Environmental Issues and the Public Health Laboratory	Sandra Edelsward  Water Testing (Sandra Edelsward, Program Coordinator, Drinking Water Testing, PHOL) - This presentation was an overview of how the lab works with its various clients to determine the safety of recreational and drinking water. The Walkerton E. coli outbreak (2000) was used as a starting point for describing the "drinking water safety net" that now exists in Ontario. A word about risk perception was also offered, with an illustration of the fact that private systems are not regulated and pose the greatest risk, but owners do not take advantage of the free testing services provided by the lab. It is hoped that the "Well Water" campaign will increase voluntary well testing rates by removing barriers of convenience, cost and awareness.   Ray Copes  Environmental Issues (Ray Copes, Director, Environmental and Occupational Health, PHO) - Dr. Copes covered the environmental health functions of PHO, which are carried out by a team with a mix of skills. They respond to inquiries from the field on a wide variety of topics (EMF, incineration, wind turbines and fish pedicures* for example) through compilation of data and in-services where appropriate. This group also has a stock of specialized environmental testing equipment available for loan. Plans for anhancement include doing more with scientifically - based reports, stronger environmental surveillance / tracking of trends over time and space, and partnering with academics and the field to do original research. He also invited input on other types of expertise would be valuable on this team.   *Curiously, no one asked how one goes about giving a fish a pedicure.
Bus to Hilton Airport hotel departs Lab at  4:45 PM & 5:15 PM – meet at Guest Parking lot stairs for bus pick-up   All Lined Up
5:30 – 7:00 RECEPTION Ontario Room, Conference (upper) Level Hilton Toronto Airport Hotel (5875 Airport Rd) Includes pasta station and light refreshments *********  Please note dinner is on your own *********

DAY 2 Friday. October 21 , 2011  Location:  Hilton Toronto Airport Hotel & Suites 5875 Airport Road, Mississauga, Ontario L4V 1N1
7:30 - 8:30: REGISTRATION AND BREAKFAST (Foyer - Mississauga Room)
8:30 – 10:30 Section Meetings	Council of Ontario Medical Officers of Health Meeting: Mississauga B&C Room Boards of Health Section Meeting: Dundas Room, Conference (upper) Level
10:30 – 11:00 BREAK
11:00 - 12:30   Ministry Updates (Mississauga B&C Room)	Arlene King, Darryl Sturtevant         CMOH Presentation Dr. Arlene King joined the meeting to provide updates on the newly - established Public Health Leadership Circle; the Joint Liaison Subcommittee, which is continuing the work of redistributing roles and responsibilities between PHO and the PHD; Panorama; and the Trilateral First Nations Health Senior Officials Committee, which will address mental health, diabetes, public health and data management for First Nations Communities. She also covered the expansion of the Childhood Immunization Schedule and this year’s rollout of the  UIIP. On the latter subject, she acknowledged that immunization rates among health care workers remain too low, and although she does not agree that mandating it through legislation is the answer, other approaches for outreach must be considered.  She then took the opportunity to thank local public health for its role in responding to recent public health issues, including this summer’s Northern Ontario forest fires (assistance provided by local public health to the evacuation process), the tornado in Goderich (thanks to Huron), the MOE (Timiskaming) Cobalt-Coleman soils study, and Ottawa Public Health's response to the recently publicized infection control breach at a local endoscopy clinic. This last issue was a complex one, and sorting out roles and responsibilities for similar scenarios is on the agenda for the Public Health Leadership Council. She closed with a preview of her 2010 Annual Report, which is expected to be released later this fall and will build on the themes of 2009’s “Public Health – Everybody’s Business” report.     Darryl Sturtevant Darryl Sturtevant, Assistant Deputy Minister, Ministry of Children and Youth Services confirmed that the new Minister is Dr. Eric Hoskins, and proceeded with updates on the Best Start Child and Family Centres, Speech Language Pathology programs and the Healthy Babies, Healthy Children program On the Best Start Centres, he referred to the Pascal report recommendations, singling-out the overarching vision of integration and re-enginieering of an early-years “system”. This will be based on an articulation of what the shared outcomes are going to be, and the MCYS has committed to doing community – based research as a key first step, which already includes a look at "leaders" projects at Toronto Public Health, Middlesex-London, Sudbury and Hastings Prince Edward Counties. These are aimed at defining integration and key processes, how the community defines integration, and what are the established outcomes.     The fragmented Speech Language program in Ontario is also being looked at in context of Dr. Pascal’s vision of an integrated system. This important set of services is currently spread out over three ministries through 5 different programs. Each has a long wait list for testing and treatment, and the parameters of each often force clients to change programs mid-stream due to various elegibility criteria. Seven sites have been selected to demonstrate a more integrated model to improve service, reduce wait times, improve outcomes, and improve transitions. An advisory committee has been established to examine the outcomes of the demo sites and what the best way forward will be. Preliminary information from this process is expected to be released next year.   He then referred to the changes to the Healthy Babies, Healthy Children program that were proposed in March, indicating that they were intended as a response to the capacity issues that local public health agencies were having in carrying out its requirements. The aim was to implement streamlined screening, increase access to information (print, electronic, etc.) and standardize contact training and procedures for home visiting in order to more effectively identify high-risk families for referral and follow-up.   A HBHC advisory committee has been established to evaluate the proposed changes and the specific interventions. 24 local public health agencies are involved in addition to nurses, hospitals etc. Six work groups have been established by this committee to look at screening tool validation, training, information, family service integration and home visiting protocols.   He clarified that these changes are not intended to deny anyone assessment / follow –up irrespective of risk category, and that nothing will be implemented until the work of the advosory committee is complete (exptected sometime in 2012).
12:30 – 1:30 LUNCH
1:30 – 2:30   COMOH Meeting Continues  (Mississauga B&C Room)	COMOH Educational Session on Criminalization of HIV (non-) Disclosure