NEHA September 2023 Journal of Environmental Health

cally adopt the newest edition of the Food Code when it is released. Jurisdictions with a section-by-section approach have adopted sections of the Food Code individually and must enact a full legislative process to adopt newer editions of the Food Code . The process to adopt newer editions of the Food Code var- ies from jurisdiction to jurisdiction and both approaches allow for the adoption of the Food Code in its entirety or in parts. FDA revises the Food Code in a full edition every 4 years and a supplement to the full edition in the intervening 2 years; the revi- sion process includes a strategic review of the recommendations made by representatives in the food industry, government, academia, and consumer organizations as a part of the Conference for Food Protection Biennial Meeting (Conference for Food Protection, 2023). While 49 states have adopted some edition of the FDA Food Code , only 34 states have adopted one of the two most recent edi- tions and 18 of those 34 states currently use the most recent edition (FDA, 2023). Complete and uniform adoption of the Food Code facilitates the standardization of inspections across jurisdictional lines. Train- ing programs and standard operating proce- dures can vary from jurisdiction to jurisdic- tion to comply with inconsistent regulations, which makes compliance particularly diŠ- cult for retailers with operations in multiple jurisdictions (FDA, 2020). In a 2020 survey of key industry representatives, respondents reported it was overwhelming to keep up with code requirements across multiple juris- dictions (Mandernach et al., 2023). Further- more, 85% of respondents felt uniform adop- tion of the Food Code throughout the U.S. would be beneficial. These findings indicate support for uniform adoption of the Food Code among industry members. Initial surveying of U.S. states indicates a majority are considering adopting a newer edition of the Food Code (Nutt et al., 2022). Many states, however, face significant barriers to updating their regulations. The top three barriers to adopting a newer edition of the Food Code identified in the survey include: 1.Lack of sta˜ knowledge in state regulatory agencies about the adoption process. 2.Lengthy and time-consuming adoption processes that compete with other opera- tional priorities. 3. Resistance by legislators and administrations.

Challenges also include a lack of buy- in from key partners, resistance to change, pushback from a˜ected groups and poor communication between regulators and industry members, limited sta˜ capacity, and limited resources (Retail Food Safety Regula- tory Association Collaborative, 2020). To support jurisdictions in overcoming these challenges and barriers, the Retail Food Safety Regulatory Association Collabora- tive (Collaborative) has undertaken a multi- pronged approach to Food Code adoption that leverages the resources and strengths of the organizations that make up the Collabora- tive. The Collaborative includes the Associa- tion of Food and Drug OŠcials, Centers for Disease Control and Prevention, Conference for Food Protection, FDA, National Associa- tion of County and City Health OŠcials, and National Environmental Health Association. Members of the Collaborative work together to reduce the incidence of food- borne illness. Increasing the number of juris- dictions that have adopted the most recent edition of the FDA Food Code is one of the Collaborative’s primary objectives. The Col- laborative’s Food Code adoption activities include several projects that provide access to information, tools, resources, contacts, and sound reasoning to support Food Code adoption. The projects highlighted in this special report represent a subset of numerous projects undertaken by the Collaborative and include tools and collections of information that can be leveraged by regulatory programs to aid in the Food Code adoption process in their jurisdiction. The Collaborative’s Food Code Adoption Activities and Projects Food Code Adoption Toolkit To address identified barriers to Food Code adoption, the Collaborative has created the Food Code Adoption Toolkit. The Toolkit is a resource for SLTT jurisdictions and decision makers to learn about the Food Code , how it is implemented around the country, and the importance of using current, evidence-based standards to safeguard food. Contents include: • Resources for understanding the Food Code and its benefits. • Answers to common questions and sum- maries of changes from one edition of the Food Code to the next.

• Statements and letters of support for uni- form adoption of the Food Code from national associations, members of the retail food industry, regulatory jurisdictions, and Collaborative partners. • Scientific studies that support Food Code adoption. • Support for jurisdictions including train- ing, industry education materials, and lessons learned from peers about Food Code adoption. The Toolkit is a living resource that is peri- odically updated with new materials. The contents were informed by the results of a survey sent to 221 SLTT retail food regulatory jurisdictions that assessed each jurisdiction’s Food Code adoption processes, challenges, and successes (Retail Food Safety Regulatory Association Collaborative, 2021). The Tool- kit aids food safety professionals and decision makers at all levels in implementing holistic adoption of the Food Code .

Targeted Approaches to Adoption

Specific Strategies for States Each state and jurisdiction has a unique con- stellation of legislative processes, retail food safety regulation, and regulatory authority and responsibility that make a singular path to Food Code adoption impossible. Adop- tion of the latest edition of the Food Code is beneficial for all states; however, individual approaches tailored to each state’s unique circumstances could be the most effec- tive method to achieve this goal. Under this methodology, the Collaborative is providing direct support—along with assistance and governmental insight from partner organiza- tions—to South Dakota, a state working with the 1995 edition of the Food Code . Collaborative representatives, alongside FDA Retail Food Specialists, have been meet- ing with partners in South Dakota to under- stand the history of the state’s food safety regulations and specific legislative processes for Food Code adoption. A comparison of the 1995 edition of the Food Code to the current 2017 edition was conducted by Collaborative representatives. This comparison revealed several key revisions to the 2017 Food Code based on scientific advancements and new knowledge. Adoption of the 2017 Food Code could significantly and positively impact South Dakota public health. For example,

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