6. FOOD SAFETY PROGRAM UPDATE

MISE À JOUR CONCERNANT LE PROGRAMME SUR LA SALUBRITÉ DES ALIMENTS

Committee Recommendation

That Council receive this report for information.

Recommandation DU Comité

Que le Conseil prenne connaissance du présent rapport.

Documentation

1. Deputy City Manager's report, City Operations dated 29 June 2010 (ACS2010-COS-OPH-0003), follows the French version of the report.

Report to/Rapport au :

Community and Protective Services Committee

Comité des services communautaires et de protection

29 June 2010 / le 29 juin 2010

Submitted by/Soumis par : Steve Kanellakos, Deputy City Manager/Directeur municipal adjoint, City Operations/Opérations municipales

Contact Person/Personne ressource : Dr. Isra Levy, Medical Officer of Health /

Médecin en chef Public Health/Santé publique

(613) 580-2424 x 26381, Isra.Levy@ottawa.ca

City Wide/à l'échelle de la Ville

Ref N°: ACS2010-COS-OPH-0003

SUBJECT:	FOOD SAFETY PROGRAM UPDATE

OBJET :	MISE À JOUR CONCERNANT LE PROGRAMME SUR LA SALUBRITÉ DES ALIMENTS

REPORT RECOMMENDATION

That Community and Protective Services Committee recommend that Council, as the Board of Health, receive this report for information.

RECOMMANDATION DU RAPPORT

Que le Comité des services communautaires et de protection recommande au Conseil, à titre de conseil de santé, prenne connaissance du présent rapport.

EXECUTIVE SUMMARY

Over the last three years, Ottawa Public Health (OPH) has developed and implemented a strategic plan to improve the operational performance of its Food Safety Program. The plan, which was prompted by the Auditor General’s 2007 Audit of the Food Safety Program, is built on achieving service excellence by building staff capacity, improving inspection consistency and efficiency as well as increasing information exchange.

OPH has completed all recommendations of the Auditor General’s 2007 Audit of the Food Safety Program:

· OPH is on track to meet 100% of its 2010 provincial inspection targets;

· The Food Safety Program is operating at its current full staff complement;

· The first Public Health Inspector (PHI) to graduate from the newly reinstated internship program will begin permanent employment with Ottawa Public Health in 2010;

· Nearly half of program staff are bilingual;

· The online food premises inspection disclosure system, EatSafe Ottawa, is fully functional and ready for a re-launch; and

· The quality assurance process for food premises inspections has been fully implemented.

The year 2009 posed serious challenges to the program. The H1N1 pandemic response, large-scale food recalls and response to the west end flood placed significant strain on staff resources in the Food Safety Program. Despite these challenges, all complaints were fully investigated.

Extremely high-risk premises were repeatedly inspected as needed, a full transition to a field-based inspection information system was successfully implemented and all food-borne illness reports were fully monitored. All premises in Ottawa received at least one inspection in 2009. A total of 10,053 inspections were performed, representing a 20% reduction in total inspections when compared to 2008.

To date in 2010, OPH is on track to meet inspection targets for all high-, medium- and low-risk premises. If the current pace remains consistent, it is projected that the program will have a total of 14,000 inspections completed by end of year. This would be the highest total recorded by Ottawa Public Health.

BACKGROUND

The presentation of the Ottawa Public Health 2005 Annual Report in the spring of 2006 prompted an audit of Ottawa Public Health’s Food Safety Program. The audit was conducted in 2007 and approved by City Council on August 28, 2008. In response to the Auditor General’s report and recommendations, a food safety program strategy was developed in 2009 and received by Community and Protective Services Committee and City Council in April 2009. This report serves to update City Council, acting as the Board of Health, on the strategy and fulfills the Auditor General’s recommendation that Ottawa Public Health (OPH) monitor and report regularly to Council on meaningful trends or indicators of the Food Safety Program’s successes and results achieved.

DISCUSSION

The objective of the Food Safety Program Strategy is to achieve service excellence by building staff capacity, improving inspection consistency and efficiency as well as increasing information exchange. This strategy provides a roadmap towards optimal food safety programming, prevention of food-borne illnesses improvement of services to the public and increased public confidence.

Staff capacity

Recruitment and retention

As a result of the 2007 audit, it was determined that OPH required an additional seven full time equivalent positions to meet the minimum goals and food premises inspection requirements of the Food Safety Program. As of March 2010, OPH has achieved a full staff complement for the Food Safety Program. The Environment, Health Protection and Outbreak Management (EHPOM) Branch now employs 45 Public Health Inspectors (PHIs), 35 of whom conduct routine food premises inspections as well as other required duties such as rabies prevention, infection control and public pool inspections. The remaining 10 PHIs are responsible for food handler education, health hazard and water safety investigations, as well as environmental health advocacy and discarded needle retrieval.

A major contributor to increasing staff capacity was the implementation of the market rate adjustment for PHI salaries. The adjustment has made PHI salaries more competitive when compared to salaries offered by other municipalities. OPH has also implemented an internship program to improve staff capacity. The internship program was approved by Council in 2009 and provides students currently enrolled in an Environmental Health Degree Program with the opportunity to earn practical field training and guarantees them employment upon successful completion of their studies. As a further recruitment incentive, OPH provides the intern with a tuition grant up to a maximum of $8,000. The City of Ottawa and the Canadian Union of Public Employees Local 503 have approved both the incentive payment and guarantee of employment as part of the collective agreement. It should be mentioned that since the staffing objective has been achieved to its current capacity, the internship program will be suspended until further staffing is required.

Language abilities of PHIs

Nearly half of PHIs are bilingual in both official languages.

In addition there are PHIs fluent in languages such as Turkish, Italian, Vietnamese, Spanish, Mandarin, Cantonese, Somali, Swahili, Punjabi, Lingala and Urdu.

Inspection consistency and efficiency

Quality assurance program

Further to the 2009 Strategic Food Safety Report, a quality assurance (QA) process within the Food Safety program was initiated. Every month, each PHI performs a food safety inspection under the review of a supervisor, resulting in every PHI being evaluated approximately 12 times per year. The outcome of each QA visit is documented and assessed to ensure that polices are applied appropriately and consistently. Following the inspection, the supervisor can share immediate feedback on results. Although staff performance is not the main focus of the QA process, the goal is for PHIs to deliver services that are consistent in approach.

This QA process promotes service excellence and strives to improve public confidence in the Food Safety Program with every inspection.

Re-inspection fees

The Auditor General recommended that OPH pursue the feasibility of implementing a re-inspection fee structure for any additional inspections beyond the provincially mandated annual inspection frequency.

Following legal consultation, it was deemed that re-inspection fees are not a viable option. According to legal analysis, the City of Ottawa has broad powers to impose fees for services such as re-inspections pursuant to section 391 of the Municipal Act, 2001. Council could impose a surcharge fee by enacting a by-law that specifies the nature of the charge and the amount payable. Although Council does possess such legislative authority, the charge would be very difficult if not impossible to enforce. As stated in the management response to the audit’s recommendation, “Under the Heath Protection and Promotion Act (HPPA), OPH is required to inspect and investigate all reports of food-borne illness and cannot refuse to perform an inspection, because the premises will not pay an inspection fee.” Currently of the 36 public health units in Ontario, there are no municipalities that impose re-inspection fees for food safety inspections.

OPH will continue to pursue other means to reduce the need for re-inspections. Program trends indicate that over time, re- inspections have remained relatively stable (Table 3). It is anticipated that the new food disclosure website, Eatsafe Ottawa, and increased attendance of the Food Handler Training Course may reduce the need for re-inspections.

Information Exchange

Food Handler Certification Course

Currently, OPH has the second highest voluntary food handler course enrolment in Ontario. Classes are available in French and English, and are also been taught in Cantonese. Moreover, the popularity of the program has resulted in courses being offered in institutional settings such as long-term care facilities and retirement homes. As illustrated in Table 1, despite the increase in course fees, program attendance increased by nearly 200 participants in 2009.

Table 1 – Food Handler Certificate Course

	2008	2009
Enrolment	1,268	1,435
Certificates Issued	996	1,237
Passing Rate	79%	86%

Further to Council approval of the increase in food handler certification course and certificate fees, OPH increased the per person registration fee from $25 to $40 (plus taxes) in 2009, and instituted a new fee of $10 (plus taxes) for certificate re-issue. Beginning in July 2010, the food handler course will also be subject to Ontario’s new Harmonized Sales Tax.

The fee structure change aligns more closely with fees charged by other health units in Ontario and has also improved cost recovery efforts. Despite changes to course and certificate re-issue fees, in certain circumstances, charges can be reduced or waived.

For example, food handlers on financial assistance can apply for a 75% reduction in course fees, while Ottawa Food Bank employees and volunteers are exempt from any costs.

Environmental Health Information System (EHIS)

The 2007 Audit directed OPH to upgrade its information technology and to develop an Environmental Health Information System (EHIS). In 2009, PHIs were assigned computer tablets, allowing them to use hand held technology while away from the office, provide on-site printed reports and provide immediate feedback to food premises operators. In addition, the new electronic system enables the instant upload of inspection results to a centralized database. This has greatly improved the speed and ease at which staff can access food inspection reports. In addition, last year all PHIs were trained on the Municipal Application Partnership (MAP). This application is one that is readily used by many City of Ottawa departments and enables staff to record and track requests for service on a central electronic database. MAP also allows for the transfer and delegation of work amongst PHIs, ensuring that all calls are responded to in a timely and efficient manner. The EHIS has significantly improved staff efficiency and enabled better exchange of information between PHIs and food premises operators.

Online disclosure of inspection reports

In late spring of 2009, the EatSafe Ottawa website was officially launched. The website posts food premises inspection reports online and identifies any deficiencies found at the establishment during the time of inspection. EatSafe Ottawa aims to improve public access to inspection results, raise consumer awareness, and assist residents with making informed choices. The website also acts as a provincial regulation compliance measure for food establishment operators. EatSafe Ottawa is available by accessing ottawa.ca/health.

EatSafe Ottawa has also prompted OPH to change business practices to ensure that the most current information on food establishments is available to the public. Premises that receive a “not in compliance” designation as a result of inspection, will be re-visited in three business days and the results of the re-inspection are posted online. This has the dual benefit of ensuring that deficiencies are corrected in a timely manner to protect public health, while also providing food premises operators the ability to demonstrate that they have taken the necessary steps to safeguard food safety.

Graph 1 illustrates website visits during 2009. The website experienced peaks in traffic in April and February, likely the result of corresponding communications and publicity. Throughout the rest of the year this site received modest traffic by comparison. The median rate of traffic was 4,611 page views per month, and annualized growth was 12,714 visits due to the strong performance in April 2009. It is also worth noting that there is a high page view per visit ratio in comparison to the usual traffic on the City website. This indicates that during the course of one visit, visitors are browsing the site and searching for information on multiple pages.

Graph 1 - Web site visits for EatSafe Ottawa: April 2009 to April 2010

The Food Safety Program plans on increasing awareness and access to the Eatsafe website through the launch of version 2.0 in June 2010. This newest edition will officially launch a more user-friendly website as it has gone through extensive usability tests resulting in improved search capabilities and ease of use. Additionally, a new inspection certificate has been developed and will be posted at food premises across the City. This certificate will also promote the Eatsafe website.

Challenges in 2009

The year 2009 posed numerous and diverse challenges for the Food Safety Program and its staff. Although some obstacles were anticipated, most were unforeseen circumstances:

· Reassignment of staff during the OC Transpo strike to visit vulnerable populations in high-risk buildings;

· Reduction in availability of PHIs to conduct routine inspections due to training of the new EHIS system;

· Relocation of staff to Ottawa’s west end to perform health hazard assessments in the homes of flood victims;

· Redeployment of nearly 90% of PHIs during the H1N1 pandemic response and mass vaccination campaign; and

· Participation of staff in five large-scale food recalls to ensure that affected products were removed from retail distribution.

Food Safety Program Trends & Statistics

All food premises in Ottawa, a total of 4,794 establishments, received an inspection in 2009. This is a milestone achievement for the Food Safety Program. In 2009, a total of 10,630 inspections were performed. Of these inspections, 4,794 were provincially-mandated compliance inspections of the various types of food premises.

High-risk premises are defined as those that serve perishable foods that involve multiple preparation steps or cater primarily to groups at risk for serious food-borne illness, including full service restaurants and long-term-care facilities. Medium-risk premises are defined as those that also serve perishable foods but with minimal preparation steps and that cater primarily to a general clientele, including fast-food outlets. A low-risk food establishment prepares and/or serves non-hazardous foods with a lesser degree of handling to a smaller volume of patrons, such as variety stores. According to the provincial requirements, all low-risk premises must be inspected once per year, medium-risk premises twice per year, and high-risk premises three times per year.

Table 2 illustrates the percentage of compliance inspections performed in 2009.

Table 2 – 2009 Compliance Inspections

	High-risk	Medium-risk	Low-risk
Compliance inspections	2009	2009	2009
% of premises with 1 inspection	18	70	100
% of premises with 2 inspections	49	30
% of premises with 3 inspections	33
% of premises with more than required inspections	22	22	26

Table 3 illustrates an annual comparison of every type of inspection, investigation and various program activities performed by the Food Safety Program. As a result of Ottawa being the nation’s capital, PHIs are also required to inspect a large number of special events. A total of 610 inspections were performed at 61 special events in 2009, including; Canada Day, Blues Fest, Tulip Festival, Jazz Fest, The Exhibition, Winterlude and the Franco Ontario Festival. In 2010 it is forecasted that both the number of special events and the total number of inspections will increase significantly.

Table 3 – Inspections, investigations and program activities

	2007	2008	2009
Total Inspections	12,163	13,201	10,630
Compliance Inspections	9,826	9,744	4,794
Re-inspections	1,953	1,922	2,166
Consumer Complaint Investigations	524	500	572
Food-borne Illness Investigations	86	77	133
Confirmed cases of food poisoning associated with Ottawa area premises	5	0	0
Special Event Inspections			610
Number of Special Events			61

Graph 2 illustrates the number of inspections performed per week in 2009. The graph uses data from the new EHIS system, which was being migrated into use during Q1. Thus, since written inspection reports were still being used during the first quarter, a true representation of inspections is not illustrated until May. The decrease in production in July and October are attributed to the re-allocation of staff for the flood and H1N1 responses. Numerous staff training sessions and an inevitable learning curve from the EHIS impacted productivity throughout remaining months, specifically in May and June.

Graph 2 - Weekly inspection count in 2009

H1N1 wave 1 & staff training

H1N1 wave 2

EHIS migration

Flood

CONCLUSION

All of the recommendations tabled by the Auditor General in 2007 were completed by Q4 2009.

OPH has already begun to see the positive operational impact of these implemented recommendations in 2010. Accordingly, the program goals for this year have been elevated and include:

· Meeting all the targeted provincial requirements for food safety inspections;

· Continuing to increase visibility and enrolment in the Food Handler Training Course;

· Expanding the quality assurance process to include more measurable results and a continued process to standardize the approach for quality improvement; and

· Supporting the development of staff to increase service excellence while building competencies within the profession.

Nonetheless, following full staff complement and the completion of the Auditor General’s recommendations, the anticipated growth in number of food premises as well as the growing demands on staff from other operational pressures demonstrates that there is an inadequate number of PHIs. When compared to similar health units across Ontario, Ottawa has the third highest number of food premises per PHI. Ottawa Public Health intends to bring forward an operational budget pressure for 2011, asking for approval of additional front-line PHIs for the Food Safety Program.