“Auditors found that food safety inspectors are identifying hundreds of establishments with serious violations, including food that has not been refrigerated properly or food that has been handled by sick workers. However, many of these food-serving establishments faced no enforcement actions whatsoever,” DiNapoli said. “According to federal authorities, one in six Americans contracts a foodborne illness every year from eating establishments. Failing to hold those with serious violations accountable could be a recipe for disaster.”
The state Department of Health (DOH) is responsible for overseeing New York’s more than 96,000 food service establishments and for ensuring they adhere to the state sanitary code. DOH’s oversight is carried out at the local level through four regional offices responsible for 36 county health departments, New York City’s health department and DOH’s own district offices.
The 21 counties without full-service health departments rely on DOH’s district offices for inspections. These departments are responsible for permitting and inspecting establishments to ensure compliance with the sanitary code and investigating complaints and reports of foodborne illness.
The departments are required to notify DOH when they initiate an investigation of a foodborne illness outbreak or when an unusual prevalence of foodborne illness is identified. Each health department is required to investigate all complaints and reports of such illness. The departments must also maintain a surveillance system to record complaints and identify possible outbreaks.
DOH reported that, between Jan. 1, 2014 and Sept. 18, 2017, health departments completed over 417,000 inspections representing 96,761 establishments. These inspections resulted in more than 1.2 million violations of the sanitary code, including over 200,000 critical violations (16.7 percent) and over 38,000 imminent health hazards (3.2 percent).
DiNapoli’s auditors reviewed 984 violations categorized as Category I (the most serious) found by the departments. Of those, 717 (73 percent) resulted in no enforcement action, and for 590 of the 717 (82 percent), inspectors also did not provide justification for the lack of enforcement actions, which they are required to do.
Auditors did site visits as part of the audit and observed food that was stored at the wrong temperature, which could lead to bacteria growth, food stored on floors and possible cross-contamination issues that could put those with allergies at risk.
Additionally, auditors found error-prone reporting and problems transmitting data from health departments have resulted in data inaccuracies that render the data unreliable, hindering DOH’s ability to monitor inspection activities and ensure code compliance.
Auditors also found regional offices inconsistently utilize the reporting functions within DOH’s Environmental Health Information and Permitting System (EHIPS), the database that houses inspection data, further limiting its usefulness as a monitoring tool.
Because not all health departments complete all inspections recommended by DOH (with many attributing their shortfalls to a lack of resources, particularly staffing), effective data analysis could help them target their limited resources to areas of greatest need or at highest risk.
DiNapoli’s auditors did find that health departments reviewed have effective systems for both investigating and following up on foodborne illness outbreaks and for protecting the public from further contamination. However, a lack of guidance from DOH for defining what constitutes an accurate, complete, and timely investigation has created inconsistencies in complaint investigations across health departments.
DiNapoli recommended DOH:
- Implement procedures to incorporate periodic data analysis and consistent use of EHIPS reporting mechanisms to: assess the performance of designated health department functions that need improvements; identify patterns and/or areas of concern involving non-compliance with the code; and provide information to regional offices and designated health departments to assist them in the most effective allocation of staff resources.
- Ensure that health departments take enforcement action for Category I violations, or document justification for not doing so, especially for establishments that demonstrate a pattern of repeated violations.
- Take steps to improve the accuracy and completeness of EHIPS data.
- Develop procedures that provide a basic framework for complaint investigations to improve consistency and standardize the information recorded for investigations.
- DOH generally agreed with the audit’s findings. The department’s full response is included in the complete audit.