U. S. Food and Drug Administration
Center for Food Safety and Applied Nutrition
National Food Safety Initiative
October 23, 1998


Summary of Federal-State Meeting:
"Meeting Challenges Together"
Kansas City, Missouri
September 15-17, 1998

Meeting Summary

Dear Colleague:

On behalf of all the staff at the Food and Drug Administration, I want to thank you and offer congratulations on a most successful meeting in Kansas City. This truly was an "historic" gathering. The theme, "Meeting Challenges Together" aptly captured the spirit of collaboration and trust that was evident throughout the event, as everyone looked for constructive ways to strengthen the existing food safety system. Your dedication and hard work during those three days were an inspiration to all of us!

Attached are a summary of the meeting and an executive summary. We are also providing you with the E-mail addresses of the attendees as promised. Highlights of the meeting’s results are also listed below. In addition to this summary, we will be sending to you a computer disc in text format containing the complete texts of the items listed in the appendix to the summary. This will take about three weeks to complete the duplication process. You are encouraged to share these items freely with your colleagues. Periodic progress reports will be forthcoming.

As always, we welcome comments, suggestions and offers of help. Please direct them to Richard Barnes, Director, Division of Federal State Relations, Office of Regulatory Affairs, HFC-150, Food and Drug Administration, 5600 Fishers Lane, Room 12-07, Rockville, Maryland 20857, phone 301-827-6906, fax 301-443-2143, E-mail rbarnes@ora.fda.gov.

Now comes the hard work of developing the details of how we are going to fashion and implement fully integrated federal, state and local food safety activities on a national basis. Highlights of your recommendations and the next steps following the Kansas City meeting include:

  1. Work groups will be established to develop the ideas presented in Kansas City. They will consist of local, state and federal officials, perhaps convening in conjunction with regional meetings and by conference calls over the next 6 months. The development of next steps for implementation will be part of those deliberations.
  2. Five work groups will be established to contribute to the development of a plan for both outbreak coordination and an integrated food safety system:
  3. Education, training, technology research and development needs will be integral parts of each work group's deliberations.

  4. A coordinating body will be formed to facilitate and implement the work group recommendations. Membership will be determined after review and consideration of several suggestions from the Kansas City meeting participants.
  5. Public meetings with other constituencies, industry and consumer organizations will be scheduled over the next 6 months to seek their input.
  6. Continued efforts to involve others at all levels will be needed to make our vision a reality.

We share your enthusiasm and excitement for this bold, but necessary, effort, as we work together to fulfill our core public health mission to the American consumer.

Sincerely yours,

Joseph A. Levitt
Director
Center for Food Safety and Applied Nutrition


Attachment

Meeting Summary

Summary of Federal-State Meeting:
"Meeting Challenges Together"
Kansas City, Missouri
September 15-17, 1998

EXECUTIVE SUMMARY

On September 15 - 17, 1998, local, state and federal officials met in Kansas City, Missouri to develop recommendations and implementation plans for improving the coordination of foodborne disease outbreak investigations and responses and for an integrated food safety system encompassing all levels of government. Hosted by the Food and Drug Administration (FDA), this meeting was attended by state and local officials from agriculture and health departments as well as state laboratories, including state epidemiologists and regulatory officials representing all 50 states, Puerto Rico and the District of Columbia. Representatives from the U.S. Department of Agriculture and the Centers for Disease Control and Prevention also participated in this meeting.

The theme of the meeting, MEETING CHALLENGES TOGETHER, centered on the need for all levels of government to better utilize their resources in a coordinated fashion from farm-to-table. Attendees constructed visions of a successful food safety system in the year 2005, identified current obstacles to achieving that vision, and proposed action items for assignment to work groups after the meeting.

Local, state and federal agencies sometimes respond to foodborne illness outbreaks independently of one another. Seemingly routine local investigations can develop into statewide, national or even international emergencies in a matter of hours or days. Work groups identified obstacles and developed recommendations to address issues including the coordination of communication and media activities, the collection and analysis of data, resource issues, and laboratory analyses.

An integrated food safety inspection system is needed for improved coordination and to more effectively utilize the combined resources of local, state and federal agencies. These resources, when combined, are extensive but could be more effectively planned and applied to the challenges of regulating the food supply. The attendees recommended a coordinating body and work groups, composed of federal, state and local government members, should be established to carry forward action items and recommendations from this meeting. Issues for work groups to resolve include: roles and responsibilities; capacity and resource needs; communication; data collection and sharing; minimum uniform standards; education and training; and technology, research and development.

Other action items suggested as "Next Steps" included: establishing the coordinating body and work groups; and obtaining input from non-governmental groups including consumers, industry and academia.

 

I. INTRODUCTION

On September 15 - 17, 1998, 170 local, state and federal officials met in Kansas City, Missouri to develop recommendations and implementation plans for improving the coordination of foodborne disease outbreak investigations and response and for an integrated food safety inspection system encompassing all levels of government.

Hosted by the Food and Drug Administration (FDA), the historic meeting was attended by 110 state and local officials from agriculture and health departments as well as state laboratories, including state epidemiologists and regulatory officials from all 50 states, Puerto Rico and the District of Columbia.

The contingent of Federal participants included sixty officials from: FDA’s district and regional offices and headquarters’ Office of Regulatory Affairs (ORA), Center for Food Safety and Applied Nutrition (CFSAN), Center for Veterinary Medicine (CVM) and Office of Chief Counsel; the Centers for Disease Control and Prevention; and representatives from the U.S. Department of Agriculture, including the Food Safety and Inspection Service (FSIS).

The theme of the meeting, MEETING CHALLENGES TOGETHER, centered around the need for all levels of government to better coordinate use of their respective resources in two main areas: 1) investigating and responding to foodborne disease outbreaks and 2) integrating food safety activities from farm to table. Attendees were assigned to work groups that developed a series of recommendations that would encompass all levels of government. Each group was asked to construct a vision of a successful effort in the year 2005, identify current obstacles and gaps to achieving that vision, and propose action items for assignment to working teams after the meeting.

This report summarizes the results of the deliberations in Kansas City and the next steps recommended for successful implementation. A detailed Appendix will be made available at a later date and will include: a listing of attendee names, organization, address, and telephone numbers; individual work products of each group; and tables, schematic graphics and ancillary items that may warrant future consideration. The Appendix Table of Contents is attached.

Opening

The meeting began with presentations from federal and state officials that welcomed the participants and offered topics to consider in the workgroup sessions.

Mr. Fred Dailey, Director, Ohio State Department of Agriculture, and Mr. Gary Mitchell, Director, Kansas State Department of Health and Environment discussed the importance of educating everyone about food safety. Mr. Dailey said that trust between all levels of government is critical for these concepts to be successful. Mr. Mitchell emphasized the consumer benefit from such collaboration in that food safety is part of our core public health mission.

Dr. Catherine Woteki, Under Secretary for Food Safety, USDA, spoke on the subject of the future food safety system. She indicated that this meeting is of interest to the Strategic Planning meetings as part of the Food Safety Initiative (FSI). Two recent events - the release of the National Academy of Sciences' report "Ensuring Safe Food From Production to Consumption" and President Clinton’s Executive Order creating the President’s Council on Food Safety - have heightened awareness of food safety. Dr. Woteki said she believes the current system provided a strong foundation but we need to strengthen it still further to meet today's food safety needs.

Mr. Joseph Levitt, Director, Center for Food Safety and Applied Nutrition (CFSAN), FDA said it is time to move "From Talking the Talk to Walking the Walk" for improving our food safety system. A possible framework for such a system would require: equivalent minimum regulatory standards for everyone to apply; adequate training of inspectors; information exchange on inspection results; verification of performance; and enforcement.

Ms. Betsy Woodward, Chief, Bureau of Food and Residue Laboratories, Florida State Department of Agriculture, said we need to determine more effective ways to enhance the effectiveness of the federal, state, and local infrastructure currently in place. The Association of Food and Drug Officials (AFDO) has developed a vision as to what a national food safety system could and should be. AFDO calls the system Food Safety VINE (Vertically Integrated National Enterprise). The vision includes coordination and uniformity resulting in the better utilization of all current food safety resources. AFDO believes the time is right to develop a "blueprint" for a truly integrated national food regulatory system.

Ms. Margaret Glavin, Deputy Administrator, Food Safety and Inspection Service (FSIS)/USDA stressed FSIS’s commitment to a farm-to-table food safety strategy, and recognition of the crucial role state and local agencies play in maintaining products under USDA's jurisdiction safe for consumers. She spoke of the Agency’s role under the Federal food safety inspection laws, and outlined the Agency’s initiative to seek legislation that will enhance state meat and poultry inspection programs and develop a "seamless" Federal-State system for meat and poultry inspection.

Ms. Janice Oliver, Deputy Director for Systems and Support,CFSAN/FDA, presented draft vision statements for the Food Safety Initiative Strategic Plan and AFDO and requested comments on them:

"Consumers can be confident that food is safe, healthy, and affordable. We work within a seamless food safety system that uses farm-to-table preventive strategies and integrated research, surveillance, inspection, and enforcement. We are vigilant to new and emergent threats and consider the needs of vulnerable populations. We use science- and risk-based approaches along with public/private partnerships. Food is safe because everyone understands and accepts their responsibilities. [Draft vision statement from the Food Safety Initiative's Strategic Plan, September 1998]

"Food Safety VINE (Vertically Integrated National Enterprise) - refers to a national food safety system consisting of common ownership by local, state and federal agencies organized to prevent or reduce foodborne illness, as well as economic fraud, filth, and misbranding of food. This system utilizes all necessary and appropriate food safety funding, resources and support at all levels with oversight and guidance provided by federal agencies. [Draft vision statement as proposed by AFDO, August 1998]

 

Presentations

Dr. Jesse Greenblatt, State Epidemiologist, New Hampshire, described an E. coli O157:H7 outbreak from undercooked ground beef originating in New England states, and Dr. Jerry Gibson, State Epidemiologist, State of South Carolina, described a shell egg associated Salmonella enteritiditis outbreak.

Dr. Steve Ostroff, Associate Director Epidemiologic Science, CDC, talked about outbreak coordination activities in CDC, including use of the Rapid Assessment Team (RAT).

Ms. Ellen Morrison, Deputy Director, Division of Emergency & Investigational Operations (DEIO), and Mr. Jesse Majkowski, Director, Emergency Response Division, USDA/FSIS described a multi-state outbreak to illustrate FDA/USDA coordination.

Dr. Morris Potter, Assistant Director for Foodborne Disease, CDC, asked the participants to review and comment on the following: FDA/USDA draft "Foodborne Outbreak Response and Coordination" document; the CDC draft "Essential Surveillance and Outbreak Response Components of a State Foodborne Disease Prevention and Control Program" document; and a draft CDC/CSTE checklist, to guide local and state epidemiologists on communications during outbreak investigations.

Mr. Tom Schwarz, Director of the Division of Cooperative Programs, CFSAN/FDA, discussed the draft Voluntary National Retail Food Regulatory Program Standards and Dr. John Kvenberg, Director of the Division of HACCP Programs, CFSAN/FDA, discussed a Retail HACCP Pilot Program.

 

II. OUTBREAK COORDINATION

Introduction

Historically, the initial surveillance/detection, investigation and response to outbreaks or sporadic cases resulting from foodborne pathogens were undertaken by local health agencies. Today, because of our widespread food distribution system and enhanced surveillance techniques, seemingly routine local investigations develop into statewide, national or even international emergencies in a matter of hours or days. To address how to effectively respond to these changes, FDA, working with CDC and USDA, called representatives of state and local governments together. Our goal was to identify key problems in coordinating foodborne disease outbreak investigations across local, state and federal agencies and identify ways to address these problems. Five work groups were charged with identifying their vision of how each of five areas should look in the year 2005, what obstacles exist to getting to the vision and how to overcome the obstacles. The areas were:

  1. Coordination of communication across local, state and federal agencies.
  2. Coordination of media activities.
  3. Collection and analysis of epidemiologic, environmental and traceback data.
  4. Obtaining adequate resources for investigations.
  5. Laboratory analyses of human, food and environmental specimens.

 

VISION: Communication: In the year 2005, we will operate within a system consisting of inter-governmental trust stemming from mutual respect among key players, and roles and responsibilities will be clearly defined; a secure, universal, interactive and integrated continuous technology based communication system will be operational, with standardized training and procedures, with an integrated feedback and evaluation system, and appropriate involvement of all stakeholders.

Obstacles Identified to Achieving This Vision Were:

Action Items/Recommendations

VISION: Media activities: In 2005, media activities will have an established protocol that includes who, what, where and when to contact in agencies and the media working with state-of-the-art technology with compatibility to network with industry, media, and government agencies.

Obstacles Identified to Achieving This Vision Were:

Action Items/Recommendations

 

VISION: Data collection: In 2005, collection of epidemiologic, environmental, and traceback data will have a centrally managed, secured, automated, omni-directional database that includes a communication alert system and standardized formats.

Obstacles Identified to Achieving This Vision Were:

Action Items/Recommendations

 

VISION: Resources: In 2005, the National Food Safety System has all the necessary resources for a national computer system, an adequate number of staff trained to a universal standard, media contacts for public education, all needed equipment, contingency funds to cover the unexpected and the unknown, and periodic stakeholder meetings.

Obstacles Identified to Achieving This Vision Were:

See obstacles identified in the "Communication" section.

Action Items/Recommendations

 

VISION: Laboratory Analysis: (The laboratory analysis work group adopted the "Communication" vision.) In the year 2005, we will operate within a system consisting of inter-governmental trust stemming from mutual respect among key players, and roles and responsibilities will be clearly defined; a secure, universal, interactive and integrated continuous technology based communication system will be operational, with standardized training and procedures, with an integrated feedback and evaluation system, and appropriate involvement of all stakeholders.

Obstacles Identified to Achieving This Vision Were:

Action Items/Recommendations

 

III. INTEGRATED FOOD SAFETY NETWORK

Introduction

Food safety agencies at all levels of government generally share the same goals but employ different methods and authorities that need coordination and greater consistency. When added together, the combined resources of local, state and federal agencies are extensive but can be more effectively planned and applied to the diverse challenges of regulating over one million domestic establishments at the manufacturing, processing, distribution and retail levels. Millions of increased imported food entries into the United States and an increasing variety of farm products are adding to the pressure of effectively using current resources.

Therefore, to meet these challenges, four work groups were formed, each representing a region of the United States. Each workgroup consisted of local, state and federal officials and each was asked to:

The results of their deliberations follow.

CHARGE: VISION

The first charge to each workgroup was to develop a consensus of what, in the year 2005, an integrated national system of food safety would be for improved uniformity, efficiency and effectiveness of programs at all levels of government. The results of the work groups’ efforts were a list of attributes to define a vision such a system would possess. Deleted during this process was use of the word "vertical" to describe an integrated national food safety system.

Two of the groups actually prepared narrative vision statements. Additionally, each group designed a schematic diagram depicting a visual interpretation of an integrated food safety system. Each diagram is contained in the appendix section of this report.

The work groups contributed recommendations that the integrated national system should be characterized as integrated, from farm to table, seamless, uniform and synergistic. It would be proactive, preventive, science- and risk-based, goal oriented, flexible, responsive, measurable, and accountable. It would also have shared resources, be supportive and efficient. Roles would be defined, linked and interdependent. Participants would be equal and have mutual trust and respect. The system would employ research and development, shared data, effective communication and crisis management, strategic planning, evaluation and adjustment, minimum uniform standards, training and education, standardization and certification of personnel.

The two narrative vision statements that were developed by work groups follow:

CHARGE: Obstacles Identified to Achieving This Vision Were:

The second charge to each of the work groups was to identify obstacles to implementing an integrated food safety system. The information pr esented by each group was reviewed and consolidated to reflect all identified obstacles. The following is a compilation of those obstacles.

 

CHARGE: ACTION ITEMS/RECOMMENDATIONS

The third charge for each work group was to develop recommendations to overcome the identified obstacles. The groups did not always identify the same obstacles, but the recommendations for action were similar. Often implementation of an action item will correct or improve more than one obstacle.

 

IV. COORDINATING BODY

Mr. Gary Dykstra, Deputy Associate Commissioner for Regulatory Affairs, ORA/FDA, and Ms. Janice Oliver, Deputy Director for Systems and Support, CFSAN/FDA, asked the Work Groups to address questions regarding the need to establish a Coordinating Body:

Questions Addressed

 

V. FSI Leadership: Feedback, Commitment, Next Steps

Mr. Lou Carson, Deputy Director, Food Safety Initiative Staff, CFSAN/FDA, discussed meeting highlights and action items:

Ms. Caren Wilcox, Deputy Under Secretary for Food Safety, USDA, said that the recently created President’s Council on Food Safety will be interested in topics from this meeting including: state activities, better coordination of budgets, strategic planning and creating a seamless system. Ms. Wilcox also urged participants to appear and testify at the public meetings already published in the Federal Register, which are under the auspices of the President’s Council on Food Safety.

Mr. Gary Dykstra, Deputy Associate Commissioner for Regulatory Affairs, ORA/FDA, said that he kept hearing several key words during the discussions: seamless; omni-directional; trust; turf; standardized; and change. Mr. Dykstra asked the participants to think about the concept of "sharing" inspection information and analytical sample data and to talk to your supervisors and colleagues about this meeting.

Ms. Debbie Ralston, Deputy Director, Office of Regional Operations, ORA/FDA, said that FDA has started having 50 State telephone conference calls to provide updates on emergencies, outbreaks and other activities of interest. She asked the States to provide input on these calls.

Ms. Janice Oliver provided comments and next steps:

Mr. Carson closed the meeting by thanking everyone for attending.


APPENDIX*

Table of Contents

  1. Detailed meeting summary document
  2. Meeting attendee information (includes name, organization, address, telephone number)
  3. Figures / Diagrams presented at the meeting
  4. Meeting evaluation summary
  5. Pre-meeting materials (invitation, handouts, work group charges)

 

* Note: the Appendix will be available at a later date

 


"Meeting Challenges Together", Phase II December 8-11, 1998


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