Executive summary. Food-Pool-Tourist Program, Department of Human Resources / Performance Audit Operations Division, Department of Audits and Accounts

EXECUTIVE SUMMARY
Food-Pool-Tourist Program
Department of Human Resources March 2002

Russell W. Hinton, State Auditor

Performance Audit Operations Division Department of Audits and Accounts

254 Washington St. Atlanta, GA 30334

Background
The purpose of the Food-Pool-Tourist Program is to protect the public health and safety by regulating food service establishments, swimming pools, and tourist accommodations. Acting on behalf of DHR, county boards of health are responsible for permitting and inspecting restaurants and other food service establishments, public swimming pools, and tourist accommodations (such as hotels and motels). The Food-Pool-Tourist Unit within the Environmental Health Section of DHR's Division of Public Health is responsible for developing Program regulations, providing technical assistance and training, and monitoring the overall Program.
The state began regulating tourist accommodations in 1953 and food service establishments in 1958. Legislation requiring the state to regulate public swimming pools was enacted in 2000. Currently, there are approximately 23,200 restaurants and 2,135 tourist accommodations in the state. Complete information regarding the number of swimming pools was not available at the time of this audit.
The state's 159 county boards of health are organized into 19 Public Health Districts, ranging in size from one to 16 counties. In addition to regulating food service establishments, swimming pools, and tourist accommodations, county environmentalists are responsible for regulating the installation and maintenance of on-site sewage management systems (septic tanks) and for responding to other types of environmental health issues, such as the West Nile virus. The operations of the county health departments are funded in part through grant-in-aid funds provided by DHR. For fiscal year 2002, the county health departments were budgeted to receive $162.9 million in Public Health grant-in-aid funds, of which $87.3 million was for specific programs and $75.6 million was for general operations, including their environmental health units. (The $75.6 million was subsequently reduced to $70.1 million.)
Summary Recommendation
The Department of Human Resources should take a more proactive role in ensuring that the Food-Pool-Tourist Program is administered in an efficient and effective manner throughout the state. Currently, Georgia does not have a uniform statewide system for regulating restaurants, swim-

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ming pools, or motels. Our review of the food-pool-tourist programs in 19 county health departments (one in each Public Health District) found an overall lack of uniformity and consistency. Major areas in which improvements should be effected are discussed below.
Program Administration Although DHR provides about $70.1 million per year in general grant-in-aid funds to
county health departments, it does not know how much is spent on individual programs, such as the Food-Pool-Tourist Program. In addition, DHR does not require county boards of health to comply with DHR regulations as a condition of receiving the funds.
Absent strong administrative oversight, there are substantial differences in the way the Program is administered at the local level. Our review of a sample of 19 county health departments found they used different restaurant and tourist accommodation inspection forms, had different restaurant scoring procedures, and had different restaurant re-inspection policies.
Restaurants The Department should continue its efforts to revise the restaurant inspection form. Using
the current form, a restaurant can be cited for significant deficiencies (including those defined by DHR as being hazardous or critical) and still receive an above-average inspection score (as perceived by the general public).
DHR should take action to ensure that health departments are reasonably consistent in their evaluations of restaurants' compliance with food safety standards. In five of the 19 sampled counties, at least one in every four restaurants received a perfect score of 100; in six other counties, however, fewer than 10 restaurants out of 100 received a perfect score.
Restaurants cited for serious deficiencies should be re-inspected in a timely manner to verify they no longer pose a serious public health risk. Our review found that county health departments have developed their own re-inspection policies that differ substantially from one another and do not always provide for timely re-inspections.
Swimming Pools Under current state law, swimming pools at apartment complexes, country clubs, and subdi-
visions are exempt from regulation. Environmental health personnel interviewed during this performance audit expressed concern that these exemptions could result in the public using pools that did not meet minimum health and safety standards.
Tourist Accommodations The need to conduct twice yearly inspections of motels and other tourist accommodations is
questionable and should be reconsidered. Many of the items that are checked during the inspections are readily apparent to consumers.
In its written response to the audit report, DHR indicated that it concurred with most of the recommendations and was taking steps to implement corrective action as appropriate.
For additional information or to request a copy of the Audit, contact Paul Bernard at 404-657-5220.

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