Audit calls inspection shortages dangerous

Local food inspection departments are dangerously understaffed and underfunded, with the state Department of Public Health doing little to solve a problem that specialists say could have catastrophic consequences, according to a report released yesterday by state Auditor A. Joseph DeNucci.

The audit found that some health inspectors, who are unlicensed in Massachusetts, were less qualified than the food establishment managers they regulate and that state and local systems that report and respond to food-borne illnesses are inadequate.

"We question [the Department of Public Health's] ability to adequately conduct food-borne illness surveillance and response activities . . . as well as DPH's ability to determine that local authorities are properly investigating" local food poisoning complaints, the report states.

The audit said the shortcomings could lead to a widespread health crisis in an era of food-borne illnesses and potential terrorist attacks on the nation's food supply.

The audit also found that staffing shortfalls have gone uncorrected since the auditor inspected the same program 18 years ago, with less than one full-time state position to oversee "the thousands of retail food establishment inspections conducted across the Commonwealth's 351 cities and towns," the audit states.

The report calls for a systematic overhaul of the local and state food inspection program, which DPH officials have said will require changes in state law and additional funding.

Suzanne Condon, an associate commissioner for the Center for Environmental Health at the health department , said the department is targeting its resources efficiently, with the number of complaints about food-borne illnesses going down over the past three years, from 613 complaints in 2004 to 436 last year.

In the last two years, there have been 24 confirmed food-borne illness outbreaks in Massachusetts, including some of the recent multistate incidents involving Taco Bell and tainted spinach.

Condon said the department has also mandated that food workers become certified in food safety, created 15 regional health coalitions to promote better communication among city and town health inspectors, and is linking some local health inspectors to a statewide computer network.

To many critics, however, it's not enough. "In some ways, I think we can be thankful we haven't had more emergencies," said Geoff Wilkinson, executive director of the Massachusetts Public Health Association, an advocacy and education group of health professionals. "Still, people are getting sick because of food-borne illness because it's not getting detected . . . We're just around the corner from some unfortunate crisis that [local health professionals] can only hold back so far."

After a similar audit in 1988, DeNucci spokesman Glenn A. Briere said state health officials pledged to beef up staffing, a move later delayed by a state fiscal crisis.

"If there were a serious outbreak of salmonella poisoning . . . there are serious questions as to whether the Commonwealth's response would be appropriate," Briere said. "There's just not enough cooperation between the state and local authorities and the feds, as well. This coordination, which should provide an effective safeguard, just isn't happening."

The audit does not cite any specific failures of the system.

The audit acknowledges that local food inspectors are forced to compete with school and public safety for funding and are handling an array of public health duties. The audit looked at 2002 data for 156 communities that found food inspectors are understaffed in most of the state, in many instances at staffing levels a third less than those recommended by federal agencies.

The audit also found that local food inspectors are not inspecting restaurants, nursing homes, and convenience stores often enough. Eleven of 13 local health authorities audited were found to be violating federal and state standards for inspection frequency.

In some instances, high-risk establishments like nursing homes, hospitals, and large restaurants did not get a routine inspection for more than a year, "and we even found some establishments that had gone as long as seven years without a routine inspection," the report said.

In addition, unlike most states that have regional or county health authorities, Massachusetts is one of the few states to leave that responsibility to cities and towns, where health inspectors in charge of food establishments have a host of duties, including oversight of Title V septic inspections, where state requirements have recently doubled. All the while, funding is tight.

"They're really hard pressed," Wilkinson said. "They just don't have enough money coming in . . . to do everything that they're expected to do. The state is supposed to provide backup, and it doesn't have the funding to do what it's supposed to do."

Mac Daniel can be reached at mdaniel@globe.com.