Expanding the AMC Risk Factor-Specific Best Practices with Progressive Enforcement/Intervention for Food Establishments and an Active Managerial Control (AMC) Inspection Model expansion

Project Summary/Abstract The Lincoln-Lancaster County Health Department (LLCHD) Food SafetyProgram's primary goal is preventing foodborne illness through a comprehensiveprogram based on the 2013 FDA Food Code and on FDA's Retail Program Standards.LLCHD retail food inspection trend data revealed that violations of key risk factors forfoodborne illness had stabilized and a subset of establishments continued to havesignificantly higher numbers of Critical Item Violations (or Priority and PriorityFoundation). While many regulatory programs have worked with retail food industry toimplement Active Managerial Controls (AMC), success has been limited. Through previous FDA grants, LLCHD developed and implemented a FoodSafety Consultation program and adapted Food Enforcement strategies, developing ahybrid approach of progressive-enforcement-consultation strategy with the goal ofachieving high levels of AMC adoption. To build on the increased focus of developingAMCs with facilities, a new Active Managerial Control Inspection approach was createdin 2019. Melding both consultation and inspection, the goal was to create acollaborative, educational experience for managers to develop solutions for risk factorsidentified during visits. The goal of LLCHD's proposal is to reduce foodborne illness originating fromretail food establishments and the outcome will be fewer illnesses, hospitalizations anddeaths. LLCHD's objective is to strengthen AMCs at the retail level by continuing todevelop and expand the Active Managerial Control Inspection Pilot and build upon theInfuse program by creating a method of determining levels of AMC adoptions byfacilities. First, components of the AMC inspection will be assessed, policies andprocedures will be developed, and the project expanded. Customer Discovery Surveysand subsequent regular and AMC Inspections will be conducted, and data gained willbe used to further improve the project. Second, policies for an AMC Inspection processand training program will be created. With the newly developed training program, theAMC Inspection Pilot will incorporate additional LLCHD Food Safety field staff. Second, a system for measuring the level of adoptions of AMCs will bedeveloped to improve communication between the consultant, facilities, and inspectors.Levels of adoption will be defined, with standards for each, along with a visual aid todemonstrate progress through these levels. The aid can serve as a quick, visual tool toexpress how facilities have progressed or need to improve. This visual aid will serve asa reward system to encourage sustained behavior change. This proposal provides a unique opportunity for the FDA to continue to test aninnovative approach to Food Safety Consultation and Active Managerial ControlInspections. If successful, these models can provide new strategies to achieve a higherlevel of retail food safety across the U.S., reducing foodborne illness.