Faced with harsh budget realities on just about every level, state and local public health associations are ratcheting up their efforts to urge Congress to fund the implementation of the new federal food safety law, which requires increased coordination among local, state and federal authorities.
“We are in a crisis,” said Joseph Reardon, the director of Federal-State Relations at the U.S. Food and Drug Administration last week, citing nationwide cuts to state and local public health agencies at a time when the agency is trying to build a more integrated system and build capacity on the state and local level.
The House recently passed an appropriations bill that would reduce FDA’s overall budget by more than 11 percent, including an $87 million cut to food safety for fiscal year 2012. At the same time, states are tightening budgets and reducing capacity for food facility and kitchen inspections and epidemiological investigations.
“We think Congress needs to fund [the new law].” added Reardon during a presentation at a National Association of County and City Public Health Officials in Hartford, CT last week. Reardon announced FDA is planning to submit a preliminary report to Congress on state and local food safety capacity within 60 to 90 days, far ahead of the 24-month deadline required by the FDA Food Safety Modernization Act, which was signed by President Obama in January.
The report is required to look at communication systems for rapid information dissemination, surveillance systems and laboratory networks — critical for epidemiological investigations –and outreach, education and training to state and local governments.
The preliminary report will help public health advocates make the case that FDA should be funded so it can implement the new law, which will include helping state and local governments with grants for training and capacity building.
“We have a problem,” says Eli Briggs, senior government affairs specialist for the National Association of County and City Public Health Officials (NACCHO). “We have a [House] Appropriations chair who doesn’t think we have a food safety problem.”
NACCHO recently held a strategy session to rally members to lobby for FSMA funding.
“For the past several months, we’ve been educating congressional staff on what local health departments do on food safety and the nature of the enterprise, including local, state and federal,” says Briggs. “There needs to be more collaboration, which is definitely reflected in FSMA.”
“We’re looking at August recess as an opportunity for our members to contact members of Congress directly,” adds Briggs. NACCHO hopes its members can explain the critical role of public health to members of Congress.
City, county, and state health departments — and agriculture agencies — are the front lines of the federal food safety system. They detect and report foodborne illnesses, educate businesses on best practices, and conduct food safety inspections. And virtually all states are facing fiscal challenges in the wake of the economic downturn and the growing movement for limited government.
Health departments, for example, have lost roughly 19 percent of their workforce since 2008, according to a recent survey. NACCHO estimates 6,000 health department jobs were eliminated last year, by attrition or layoffs, bringing the total number of local health department jobs lost since 2008 to 29,000. The survey found that 40 percent of health departments have reduced services in at least one program area.
Nearly three-quarters, 74 percent, of the U.S. population lives in a jurisdiction impacted by these staff reductions, according to the survey.
“The annual budget cuts and job losses threaten the ability of local health departments to prepare for and respond to emergencies, and provide basic services that all individuals and families count on,” said NACCHO executive director Robert Pestronk. “The future of our nation’s health is jeopardized.”
According to Reardon, some of those layoffs and capacity losses could be helped by FSMA funding and grants to state and local governments for coordination and training. “We need hundreds of millions of dollars to push down to the states,” added Reardon, arguing that the new mandate needs to be met with new funding.
“There is a clear recognition of the primary importance of local and state in food safety,” said Andy Maccabe, the Centers for Disease Control and Prevention’s liaison to FDA for food safety, at a gathering of state food and drug officials last month. “Our whole system depends on state and local epidemiologists going out and investigating foodborne illness”
“It is absolutely foundational,” said Maccabe.
“All public health is local,” as one CDC official put it at NACCHO’s annual meeting last week, explaining that local capacity was essential for building a better, quicker foodborne illness response system. “Funding is a sine wave (it comes and goes), but outbreaks are still going to happen.”