Top Ten Things that CDM’s should know about the FDA Food Code

1. The U. S. Food and Drug Administration (FDA) publishes the Food Code. The FDA Food Code is based on recommendations from the Conference for Food Protection. This group of industry professionals (inspectors, educators, scientists, manufacturers, foodservice managers, etc.) meets every two years. The group brings forth and discusses food safety issues and makes recommendations to the FDA for changes in the Federal Code. The FDA Food Code is a “model” code (guideline) that provides over 3000 local, state, tribal and federal food control agencies scientifically sound food safety information that follows national food regulatory policies. The FDA Food Code is not federal law. It is the FDA’s best “advice” for ways to ensure that food at retail and in foodservice is safe, properly protected and presented. It is up the agencies that have responsibility for food safety to either adopt or adapt the FDA code to their own jurisdiction. The FDA Food Code is currently updated every four years with the last full update in 2013. The FDA may issue supplements between full editions if something needs to be updated or clarified. You may find the latest version of the FDA Food Code on the FDA website.

2. It is important for a CDM to know what agency oversees their facility or place of work. This determines what food code is being followed. States may follow the federal code or adopt their own version. Facilities that receive federal funding, such as those receiving Medicare or Medicaid reimbursements, and/or regulated by the Center for Medicaid and Medicare Services are governed by the recommendations in the FDA Federal Code. If you work in another type of facility you may be governed by a state or even a local code. You can find out what code is in effect for your state at this link: Food Code > State Retail and Food Service Codes and Regulations by State

3. The FDA Food Code is organized into 8 chapters: 1) Purpose and Definitions; 2) Management and Personnel; 3) Food; 4) Equipment, Utensils, and Linens; 5) Water, Plumbing and Waste; 6) Physical Facilities; 7) Poisonous or Toxic Materials; and 8) Compliance and Enforcement. These chapters contain the specific guidelines for those topics. In addition the FDA Code contains a series of annexes. These annexes provide the backup information (scientific data, references, or rational, etc.) for the guidelines in each chapter. If you want to further understand the “why” behind something in the food code, the Annexes give you that information. In addition, Annex 2 provides detailed information regarding employee health, hygienic practices and response to contamination events. Annex 4 can be a useful resource if you are implementing or strengthening the HACCP process in your operation. The FDA Food code and the Annexes can be accessed free online.

4. The FDA Food Code specifies that “at least one employee that has supervisory and management responsibility and the authority to direct and control food preparation and service shall be a Certified Food Protection Manager who has shown proficiency of required information through passing a test that is part of an accredited program. Accredited programs are those that have been approved by the Conference on Food Protection and accredited through the American National Standards Institute (ANSI). Depending on which edition of the FDA Food Code or other code (state or local) that is in effect in your jurisdiction you may not need to have a CFM. It is important for CDM’s to determine what their jurisdiction or oversight agency requires. The FDA Food Code excludes those foodservice operations which relate to resident or patient care in licensed hospitals, nursing homes, and board and care homes where care standards are set by other federal certification standards such as the Center for Medicare and Medicaid Services (CMS) or Joint Commission. However, the regulations from those organizations require that a CDM or foodservice manager procure and serve safe food and that the person in charge be able to demonstrate knowledge of food safety principles and have policies and procedures in place that protect the clients that are served food in that facility. Your expertise as a CDM may be enough to satisfy surveyors or inspectors but that is not a guarantee. So it is vitally important that CDM’s know what is required in their facility and their jurisdiction.

5. Not every issue facing a CDM or foodservice manager will be covered in the FDA Food Code. Therefore it is important for a CDM to establish policies and procedures that cover situations that may develop in a foodservice operation and that are not spelled out specifically in the code. The Food Code gives you the rules for keeping the food prepared and served in your operation safe. Your policies and procedures are an extension of the Food Code. As the CDM in charge of a foodservice department you have the responsibility to set the food safety standards for your operation. Use the Food Code and other food safety education that you receive to accomplish that task.

6. One of the more recent additions to federal, state and local food codes is guidelines for highly susceptible populations. CDM’s must be aware of these precautions and ensure that they are followed if this group is their primary customer.

a. Chapter 1 of the FDA Food Code defines highly susceptible population as “those persons that are more likely than other people in the general population to experience foodborne illness because they are:

i. Immunocompromised; preschool age children, or older adults; and
ii. Obtaining food at a facility that provides services such as custodial care, health care or assisted living, such as a child or adult day care center, kidney dialysis center, hospital or nursing home, or nutritional or socialization services such as a senior center.”

b. These safeguards are found in Chapter 3, Section 801.11. This section includes these requirements: 1) the use of pasteurized juice, eggs and egg products; 2) the list of foods prohibited for service to this group (raw or undercooked meat, poultry, eggs or fish, raw seed sprouts), 3) foods that should not be served to this group, including juice that is not pasteurized, and egg or egg products that are not pasteurized; 3) the prohibition of bare hand contact with ready-to-eat foods by food employees; and 4) rules for when re-service or food is allowed (unopened packages) or not allowed (medical isolation or quarantine).

7. As we learn more about the nature of foodborne illness we are increasingly aware of the role food service workers have in controlling food safety. Over 50% of foodborne illness is diagnosed as Norovirus which is spread through infected food handlers. The Food Code spells out the responsibility of the person in charge or the permit holder to require that all food employees report any foodborne illness symptoms or if any diagnosis or a foodborne illness. However, this also includes exposure or knowledge of situations where an employee attends or works in a setting where there is a confirmed outbreak, or lives in the same household as someone who has symptoms of or has been diagnosed with a foodborne illness. Such employees need to be excluded from the food establishment until they or their household member are symptom free for 24 hours – or released by a regulatory authority. The food employee does not have to be excluded if the symptoms are from a non-infectious condition such as nausea or vomiting related to pregnancy. The guidelines for employee health are contained in Chapter 2 Section 2 of the FDA Food Code.

8. As healthcare facilities adopt “culture change” and seek to change their foodservice model into a more customer-friendly and less institutional setting, or to implement changes related to current trends, it is important not to compromise food safety in the process. For example, if a healthcare facility wants to implement purchasing foods from local sources, it is important that CDM’s know what is permitted in their jurisdiction. Food has to come from a safe source. A safe source is one that is licensed, reputable, and follows all applicable regulations in your jurisdiction. Purchasing food from local farmers or vendors requires that the CDM scrutinize and inspect that source for adherence to food safety practices. Diligent record keeping, and following guidelines regarding labeling and dating food products is also vital. CDM’s should also become familiar with other agencies that may oversee food purchased locally. Their state Department of Agriculture or a University Extension Service often will provide guidance in this area.

9. In the section of the FDA Food Code that addresses highly susceptible populations (3-801.11 (D), the code states that food employees serving this group may not contact Ready-to-Eat (RTE) foods with bare hands under any circumstances. There is some bare hand contact allowed (with restrictions) for employees who do not serve this population but the code is stricter for those serving highly susceptible populations. There is nothing in the code that requires the use of gloves to prevent bare hand contact, only that food is protected from bare hands. We know that proper handwashing is vital to keeping food safe and that food workers can spread illness in the foodservice environment when their hands come in contact with ready-to-eat foods. The addition of some sort of barrier between bare hands and ready-to-eat food gives the client an additional layer of protection from possible foodborne illness. Those barriers can be deli tissue, utensils, forks or gloves but need to be used correctly. Utensils need to be cleaned and sanitized after each use, and gloves must be used correctly. Gloves and other barriers do not replace proper handwashing. CDM’s should educate all employees on the importance of thorough handwashing and the proper use of such barriers.

10. Food safety is a cooperative effort. The agencies that regulate retail and foodservice oversee and inspect over 1 million food establishments - restaurants and grocery stores, as well as vending machines, cafeterias, and other outlets in health-care facilities, schools, and correctional facilities. The FDA assists regulatory agencies and the industries they regulate by providing a model Food Code. However it is the implementation of that code that keeps food safe. The FDA Code contains a lot of information and isn’t the easiest document to read or absorb. It also includes guidelines that may not be relevant to a CDM’s current operation. Education programs that are provided by ANFP and other groups assist CDM’s in interpreting and adhering to the code and keeping up on changes that occur. It is important that CDM’s be familiar with the guidelines in the code as it is periodically updated and keep up on current issues in food safety. Food safety is everybody’s job – all the way through the food chain.