FY 2013 PERFORMANCE PLAN Food Safety Inspection Program Program Purpose Program Information PHD/CHPB Evelyn Poppell, x5600 Prevent foodborne illness in food establishments licensed and inspected by Arlington County ACPHD Environmental Health provides several different types of inspections:  Routine: unannounced, comprehensive inspection  Risk Factor Assessment: unannounced inspection to evaluate risk factors and determine compliance with regulations  Follow-up: unannounced inspection for re-inspecting items that were not in compliance at the time of a routine or risk factor assessment  Complaint investigation: unannounced in response to a complaint  Pre-opening: scheduled inspection prior to a permit being issued and an establishment beginning operation  Training: scheduled inspection with training for employees Partners: Virginia Department of Agriculture and Consumer Services, Virginia Department of Health and neighboring health districts (Fairfax and Alexandria) PM1: How much did we do? Staff 9.45 FTEs:  7.7 Environmental Health Specialists (EHS)*  1.0 Standardization Officer / Senior EHS  0.75 Supervisor* *On average in FY 2013, actual staffing was 6.3 EHS and 0.0 Supervisor due to vacancies Customers  Units of Service  People who eat food from the food establishments licensed and inspected by Arlington County Owners, operators, and employees of food establishments Risk Categories FY 2012 FY 2013 Total Number of Establishments* 1,146 1,262 Total Number of Routine and Risk Factor 2,249 2,248 Assessment Inspections Completed** *Includes establishments that are active and permitted with a current license as of first day of fiscal year; does not include mobile vendors **Includes temporary event inspections PM2: How well did we do it? 2.1 Number of food establishment inspections per Environmental Health Specialist FTE 2.2 Inspections completed for food establishments PM3: Is anyone better off? 3.1 Confirmed foodborne outbreaks determined to be associated with a licensed Arlington food establishment 3.2 Licensed Arlington food establishments with violations that proceeded to enforcement Food Safety Inspection Program | FY 2013 Page 1 FY 2013 PERFORMANCE PLAN Food Safety Inspection Program Measure 2.1 Number of food establishment inspections per Environmental Health Specialist FTE Data Number of Inspections per FTE 440 420 Number of Inspections 414 414 400 380 360 340 359 320 FDA Standard is 280 to 320 inspections per FTE 300 280 260 FY 2012 Data Summary  FY 2013 FY 2014 (proj) For FY 2013, the number of inspections per FTE was 414, which is above the voluntary FDA standard of 280 to 320 inspections. What is the story behind the curve? Recommendations  The increased number of inspections per FTE may be due to position vacancies. Although routine and risk factor assessment inspections are adjusted for staffing, other inspections, such as complaints, pre-opening, and follow-up inspections, remain at the same levels regardless of staffing, therefore increasing the workload on staff.  Fill vacant positions as quickly as possible.  Food establishment inspections are a preventive measure aimed at reducing foodborne illness among patrons. Although the number of inspections per FTE exceeds the voluntary FDA standard, there have been no confirmed foodborne outbreaks in licensed Arlington food establishments since 2010.  Monitor outcomes to determine if staffing changes are needed. Forecast  FY 2014: expect the number of inspections per FTE to remain the same Food Safety Inspection Program | FY 2013 Page 2 FY 2013 PERFORMANCE PLAN Food Safety Inspection Program Measure 2.2 Inspections completed for food establishments Data Data Summary   The number of inspections required is calculated on a calendar year as a majority of food establishments are licensed on the calendar year. For the first three quarters of CY 2013, staff is meeting the goal for establishments requiring either 1 or 4 inspections for the year. For establishments needing 2 or 3 inspections this year, performance is lagging behind the goal. What is the story behind the curve? Recommendations Modified risk-based inspection frequency protocol was implemented in February 2012. Establishments require 1, 2, 3, or 4 inspections per year based on specific risk-based factors. These requirements are higher than the state’s standard of one inspection per establishment of any kind. Stay the course Due to vacancies, risk-based prioritization has been necessary when scheduling inspections. Through September of CY 2013, the inspection targets for establishments needing 2 or 3 inspections per year were not met, although the state standard of at least one inspection was met. Recruitment efforts for staff vacancies have not yet resulted in new inspectors Managers determined that temporary staff would not be able to fulfill the requirements of this work Anticipate further vacancies in other inspection programs, which may affect staffing in this program Work to fill vacancies as quickly as possible. Food Safety Inspection Program | FY 2013 Page 3 FY 2013 PERFORMANCE PLAN Forecast Anticipate 91% of all required inspections will be completed by end of CY 2013: 100% of establishments requiring 1, 3, or 4 inspections and 75% of establishments requiring 2 inspections per year. All Arlington establishments that require one or two inspections by state code will have had these completed by the end of calendar year 2013. Anticipate same level of performance in FY 2014 Food Safety Inspection Program | FY 2013 Page 4 FY 2013 PERFORMANCE PLAN Food Safety Inspection Program Measure 3.1 Confirmed* foodborne outbreaks associated with a licensed Arlington food establishment FY 2011 52 0 Data FY 2012 89 0 FY 2013 65 0 FY 2014 (proj) 65 0 Number of complaints of foodborne illness Number of confirmed foodborne outbreaks Number of known affected individuals N/A N/A N/A N/A within the outbreaks * A foodborne outbreak can be confirmed by laboratory results or epidemiologic finding. Data Summary No confirmed foodborne outbreaks associated with a licensed Arlington food establishment have been identified in the last three fiscal years. What is the story behind the curve? Recommendations  Factors contributing to the low number of foodborne outbreaks include the presence of Environmental Health Specialists in establishments for investigations, prompt response to complaints, and work to correct patterns of violations  Stay the course  Staff bases prevention activities on the five major risk factors:  Food from unsafe sources  Poor personal hygiene  Inadequate cooking  Contaminated equipment  Improper holding temperatures  Continue to monitor food safety warnings/recalls for food from unsafe places and notify public and establishment owners  Identifying a foodborne illness outbreak is dependent on active reporting of illness from individuals and mandated reporters such as medical providers Reporting is the trigger to initiate an outbreak investigation  Notify medical providers and establishment owners about the presence of outbreaks in the community  Forecast  FY 2014: anticipate no confirmed foodborne outbreaks Food Safety Inspection Program | FY 2013 Page 5 FY 2013 PERFORMANCE PLAN Food Safety Inspection Program Measure 3.2 Licensed food establishments in the enforcement process Data Number of Actions Enforcement Actions 82 100 82 80 60 40 20 0 9 0 9 Number of Notices of Violation Number of Fact Finding Conferences Number of Notices of Intent to Revoke FY 2013 Data Summary 0 0 0 Number of Revocation Hearings 0 0 Number of Licenses Revoked FY 2014 (proj) FY 2013: 82 notices of violation and 9 fact finding conferences; none of these led to revocation 11 establishments closed for imminent health hazards (not shown in chart) What is the story behind the curve? Recommendations Enforcement is a multi-step process that may include 1) Notice of Violation, 2) Fact Finding Conference, 3) Notice of Intent to Revoke and 4) Revocation Hearing Establishments receiving notices of violation work with inspectors to remedy the problems and achieve compliance Problems generally involve repeated violations in areas that can lead to foodborne illness such as hot/cold holding, pests, cooling, and handwashing. Stay the course Common reasons for closures due to imminent health hazards include fire, power outage, sewer back-up, and pest infestations. Most establishments reopen upon remedying the hazard. Stay the course Forecast FY 2014: anticipate similar number of enforcement actions and revocations as FY 2013 Food Safety Inspection Program | FY 2013 Page 6