School Meal Programs: Few Outbreaks of Foodborne Illness Reported (Letter
Report, 02/22/2000, GAO/RCED-00-53).

More than 33 million meals are served daily to children through two
federally assisted meal programs run by the Department of Agriculture
(USDA): the National School Lunch and School Breakfast programs. This
report provides information on the safety of foods served in the two
programs. GAO discusses the extent (1) of foodborne illness outbreaks
related to meals served in schools; (2) to which USDA-donated foods in
schools were removed, replaced, or disposed of; and (3) to which USDA
has established procurement policies and procedures for ensuring the
safety of foods it donates to the programs.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  RCED-00-53
     TITLE:  School Meal Programs: Few Outbreaks of Foodborne Illness
	     Reported
      DATE:  02/22/2000
   SUBJECT:  Food inspection
	     Safety regulation
	     Contaminated foods
	     Procurement regulations
	     Health hazards
	     Safety standards
	     Product safety
	     Food programs for children
	     Children
IDENTIFIER:  National School Lunch Program
	     National School Breakfast Program
	     FSIS Hazard Analysis and Critical Control Point System
	     USDA Meat and Poultry Inspection Program

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GAO/RCED-00-53

Appendix I: Comments From the U.S. Department of Agriculture

18

Appendix II: GAO Contacts and Staff Acknowledgements

23

CDC Centers for Disease Control and Prevention

FNS Food and Nutrition Service

HACCP Hazard Analysis and Critical Control Point

USDA U.S. Department of Agriculture

Resources, Community, and
Economic Development Division

B-284297

February 22, 2000

The Honorable Tom Harkin
Ranking Minority Member
Committee on Agriculture,
Nutrition, and Forestry
United States Senate

Dear Senator Harkin:

The safety of food served in schools is a matter of concern because of
children's vulnerability to foodborne illness. More than 33 million meals
are served daily to children through two federally assisted meal programs
administered by the U.S. Department of Agriculture's (USDA) Food and
Nutrition Service (FNS)--the National School Lunch and School Breakfast
programs. In fiscal year 1998, the two programs cost a total of about $7.1
billion for cash reimbursements to schools, USDA-donated foods, and program
administration. Local school food authorities purchase about 83 percent of
the food served in the lunch program and all of the food served in the
breakfast program. Food donated by USDA--such as beef, poultry, fruit,
vegetable, grain, and dairy products--make up the remainder of the food
served in the lunch program. USDA's Agricultural Marketing Service and Farm
Service Agency acquire the donated foods by contracting with various
suppliers; FNS' Food Distribution Division distributes the foods to state
agencies; and the state agencies distribute the foods to schools.

To obtain information on the safety of foods served in the National School
Lunch and School Breakfast programs, you asked us to determine the extent
(1) of foodborne illness outbreaks related to meals served in schools; (2)
to which USDA-donated foods in schools were removed, replaced, or disposed
of because of the potential to cause foodborne illness; and (3) to which
USDA has established procurement policies and procedures for ensuring the
safety of foods it donates to the programs.

Twenty outbreaks of foodborne illness in schools were reported to the
Centers for Disease Control and Prevention during calendar year 1997, the
most recent year for which national data were available.1 However, the
health department records of the states that reported these outbreaks and
other documentation indicate that only 8 of the 20 outbreaks were associated
with food served in the school meal programs. The other 12 outbreaks were
related to foods that were consumed in schools but that were brought from
home or obtained from other sources. Nationwide data were not available for
1998; however, the health department records of the states that reported
outbreaks in schools to the Centers for Disease Control and Prevention in
1997 identified nine outbreaks associated with food served in school meal
programs during 1998. These outbreaks in 1997 and 1998 affected an estimated
1,609 individuals.

We identified five instances during the last 5 years in which USDA, in
collaboration with others, removed, replaced, or disposed of USDA-donated
foods because of the potential for the foods to cause foodborne illness. Two
of the five actions were associated with the foodborne illness outbreaks
involving USDA-donated foods during 1997 or 1998. The five actions involved
approximately 1.7 million pounds of strawberries, 556,000 pounds of beef
patties, 400,000 pounds of poultry, 25,000 pounds of beef-and-vegetable
protein patties, and an unknown quantity of ground beef. However, these five
actions may not represent all the food safety actions taken because USDA
lacks a process to systematically identify and document such actions. A
multiagency food distribution reengineering team has proposed that FNS' Food
Distribution Division establish a database to continuously track all food
safety actions taken on donated foods.

USDA has established procurement policies and procedures that are intended
to help ensure the safety of foods donated to schools. USDA's provisions for
the safety of donated foods are contained in procurement contracts used to
purchase the foods from various suppliers. Some of these contract provisions
are based on the same food safety regulations that are intended to protect
food sold to the general public. For example, the contracts require
suppliers to ensure that plants processing USDA-donated foods are operated
and inspected in accordance with national food safety laws. Additionally,
for certain foods with special safety concerns, such as eggs and diced
chicken, USDA contracts require more stringent safety testing than is
required by law for food sold to the general public. Finally, USDA contracts
require that donated food be maintained at appropriate temperatures during
processing, storage, and transportation. In addition to specific contract
provisions, USDA officials told us that they consider potential suppliers'
food safety compliance records before awarding contracts. However, the food
safety provisions in USDA's procurement policies and procedures do not apply
to schools, which purchase 83 percent of the food served in the school lunch
program and all of the food for the breakfast program. Furthermore, USDA
provides schools with limited guidance on procuring safe foods. Therefore,
the extent to which school food procurement contracts address safety may
vary, depending on state and local laws and the procurement guidance that is
available to schools.

This report recommends that the Secretary of Agriculture (1) expeditiously
develop a database for continuously documenting all food safety actions
taken on foods donated to the Department's food assistance programs and (2)
provide information to assist schools in developing food procurement
contracts that further ensure food safety.

The goals of both the National School Lunch and School Breakfast programs
are to improve children's nutrition, increase lower-income children's access
to nutritious meals, and help support the agricultural economy. The school
lunch program is available in almost all public schools and in many private
schools. About 70 percent of those schools also participate in the breakfast
program. FNS' Child Nutrition Division administers both school meal
programs.

Schools that participate in the school lunch or breakfast programs receive a
per-meal federal cash reimbursement for all meals they serve to children, as
long as the meals meet federal nutrition standards. For 1998, the combined
cash reimbursements for the two programs totaled about $6.3 billion. In
addition, schools participating in the lunch program are entitled to
USDA-donated foods, at a value of 14.75 cents per meal served, which
amounted to $643 million in fiscal year 1998. Overall, USDA provides about
17 percent of the dollar value of food that goes on the table in school
lunch programs. Schools purchase the remaining 83 percent of food served
using USDA's cash reimbursement and their own funds. With 1998 federal
administrative costs totaling about $100 million, the total cost in fiscal
year 1998 of the national lunch and breakfast programs--cash reimbursements,
donated food purchases, and administration--was about $7.1 billion.

USDA's Agricultural Marketing Service and Farm Service Agency are
responsible for procuring USDA-donated foods. The Agricultural Marketing
Service purchases meat, poultry, fish, and fruits and vegetables for
donation, while the Farm Service Agency purchases grains, oils, peanut
products, dairy products, and other foods. USDA contracts for the purchase
of these products with suppliers who are selected through a formally
advertised competitive bidding process. FNS' Food Distribution Division
administers the Food Distribution Program, which provides the donated foods
to state agencies for distribution to schools and other eligible local
outlets.

While no federal agency specifically monitors the safety of school meals,
USDA's Food Safety and Inspection Service and the U.S. Department of Health
and Human Services' Food and Drug Administration are responsible for
enforcing regulations that ensure the safety of the nation's food supply.
The Food Safety and Inspection Service is responsible for the safety of
meat, poultry, and some eggs and egg products, while the Food and Drug
Administration is responsible for all other foods, including fish, fruit,
vegetable, milk, and grain products. When unsafe foods are detected, neither
agency has the authority to recall them from distribution, but the
appropriate agency can request manufacturers to do so voluntarily.2
Additionally, each agency announces recalls to keep the public informed.
However, the announcements do not include detailed information, such as
whether the recalled food was delivered to a USDA food assistance program or
was USDA-donated food.

For 1997, the most recent year for which nationwide data were available, 20
outbreaks of foodborne illness in schools were reported to the Centers for
Disease Control and Prevention (CDC).3 According to CDC's documentation and
the health department records from the 10 states that reported outbreaks to
CDC's database, only 8 of the 20 outbreaks were actually associated with
food served in the school meal programs. The other 12 outbreaks were not
linked to foods served in the school meal programs but with foods brought to
schools from home or other sources. Among the eight outbreaks associated
with school meals, USDA-donated strawberries were the suspected source for
four, while the other four were not linked to USDA-donated foods. The 1997
outbreaks associated with the school meal programs affected an estimated 688
individuals.

For 1998, nationwide data on outbreaks of foodborne illness in schools were
not available from CDC. However, the health department records from the 10
states reporting outbreaks of foodborne illness in schools to CDC in 1997
showed nine additional outbreaks associated with food served in the school
meal programs during 1998. USDA-donated ground beef and potato rounds served
in school meals were the suspected sources for two outbreaks, while the
other seven were not linked to USDA-donated foods. The 1998 outbreaks
associated with the school meal programs affected an estimated 921
individuals.

Unsafe USDA-Donated Foods in Schools Are Incomplete

We identified five instances during the last 5 years in which USDA, in
collaboration with others, took actions to remove, replace, or dispose of
USDA-donated foods that had the potential to cause foodborne illness. Two of
these actions--involving strawberries and ground beef--were associated with
five of the outbreaks of foodborne illness involving USDA-donated foods that
were reported in schools during 1997 or 1998.

ï¿½ In April 1997, the Food and Drug Administration announced the recall of
about 1.7 million pounds of frozen strawberries purchased by USDA for the
school lunch program. The supplier initiated the recall after the product
was determined to be associated with a March 1997 outbreak of infectious
hepatitis A among schoolchildren in Michigan. The strawberries were
subsequently associated with outbreaks in schools in Arizona, Maine, and
Wisconsin, and affected 254 individuals in the four states.

ï¿½ In May 1997, the Food Safety and Inspection Service and the Food and Drug
Administration participated in an investigation of dioxin-contaminated
products after the Environmental Protection Agency detected elevated levels
of dioxin in poultry. USDA had purchased some potentially tainted poultry
for donation to the school lunch program. The agencies subsequently
determined that the levels of dioxin detected did not warrant a recall;
however, as a precautionary measure, USDA requested that the supplier stop
distributing the product to schools. The supplier replaced about 400,000
pounds of potentially tainted poultry; no illnesses in schools were
identified.

ï¿½ In May 1998, the Food Safety and Inspection Service announced the recall
of beef-and-vegetable protein patties, of which about 25,000 pounds had been
donated by USDA to the school lunch programs in North Carolina and Georgia.
A single illness prompted testing of the product. After testing showed the
presence of E. coli O157:H7, USDA recovered and replaced the tainted
product.

ï¿½ In September 1998, a meat processor recalled over 2 million pounds of
products contaminated with salmonella, of which approximately 556,000 pounds
were beef patties destined for the school lunch program. The processor
picked up and replaced all of the tainted products in 11 states. No
illnesses in schools were associated with the tainted meat.

ï¿½ In October 1998, USDA-donated ground beef was suspected in an outbreak of
E. coli O157:H7 that infected 11 school children in Washington State.
However, when the Food Safety and Inspection Service and the state tested
samples of the meat that was the suspected source, they found no
contamination. Most of the meat suspected in the outbreak had already been
consumed, and no other illnesses had been reported; USDA took no further
action.

We cannot be certain that these five incidents represent all of the safety
actions taken for USDA-donated foods suspected of contamination. USDA lacks
comprehensive documentation of safety actions taken for donated food because
the Food Distribution Division's Food Hold and Recall Coordinator did not
start to record such actions until October 1998. As a result, we had to rely
on USDA procurement officials to identify some of the actions mentioned
above. USDA is considering establishing a database to continuously track all
safety actions associated with USDA-donated foods, as recommended in the
final report of a USDA-led multiagency team charged with reengineering the
process for handling potentially unsafe foods. According to the current Food
Hold and Recall Coordinator, the database would include all safety-related
actions from October 1998 forward. However, USDA has not yet approved the
reengineering proposals; therefore, it is not certain that actions will be
taken to develop this food safety database.

USDA Provides Little Guidance to Help Schools Procure Safe Food

USDA has established procurement policies and procedures intended to ensure
the safety of the food it donates to schools. However, the agency provides
limited guidance to help ensure the safety of foods procured by school food
authorities, who purchase 83 percent of the food served in the school lunch
program and all of the food served in the school breakfast program.

Safety of Foods Purchased for Donation to Schools

USDA procurement officials rely on many of the same food safety regulations
that are intended to protect food sold to the general public to help ensure
the safety of foods they purchase to donate to schools. For example, USDA's
contract provisions require plants that process USDA-donated foods to be
operated under and inspected in accordance with applicable federal food
safety laws and regulations. Specifically, USDA's contracts require meat
suppliers to adhere to the Federal Meat Inspection Act and poultry suppliers
to the Poultry Products Inspection Act. Under these laws, suppliers must
adhere to the Food Safety and Inspection Service's regulations, including a
requirement that meat and poultry plants operate Hazard Analysis and
Critical Control Point (HACCP) systems.4 The Service's inspectors monitor
these plants daily. In November 1999, a Food Safety and Inspection Service
enforcement action against a beef processor that was not complying with
HACCP standards prompted USDA to terminate its school food contracts with
the processor the following day.

Foods not subject to daily USDA inspection--such as dairy products and
processed fruits and vegetables, including juices--must be produced in
plants that operate under the Federal Food, Drug and Cosmetic Act. These
products are subject to periodic inspections by the Food and Drug
Administration to ensure that they are produced in accordance with its
regulations on good manufacturing practices. According to USDA officials,
annual plant surveys, which cover good manufacturing practices, among other
things, are required of all successful bidders of processed fruit and
vegetable products. In addition, USDA contracts require that USDA graders
inspect most finished products to ensure compliance with contract
specifications. While the graders are not specifically monitoring safety
issues, they are in a position to identify evidence of potential food safety
problems, such as swollen cans or discolored meat.

USDA's procurement contracts also address safety concerns associated with
certain foods by including provisions that specify more stringent testing
than is required by the Food Safety and Inspection Service or the Food and
Drug Administration. For example, the Agricultural Marketing Service's
contracts for diced chicken specify pathogen testing for every lot because
this product is highly susceptible to contamination. Procurement contracts
for egg products specify that every lot of eggs be tested after
pasteurization to ensure that they have not been recontaminated with
salmonella. After contamination occurred several years ago, USDA specified
that peanut products, such as peanut butter, be tested for arsenic. While
the problem has not recurred, USDA has retained the specification to ensure
the product's safety.

Finally, USDA's procurement contracts have provisions that are intended to
ensure that suppliers maintain USDA-donated food products at appropriate
temperatures during processing, storage, and transportation. For example,
USDA's contracts establish standards for suppliers that indicate how quickly
frozen meat and poultry products must reach zero degrees Fahrenheit for safe
storage. Other contract specifications establish specific temperature
requirements for chilled and frozen products during processing and storage
at the plant, transportation between processing plants, upon shipment from
the plant, and upon arrival at the final destination. According to USDA
procurement officials, the trucks or railcars used to transport meat or
poultry products and frozen or chilled fruit and vegetable products from the
plant to their final destination must have refrigeration units capable of
maintaining the required temperatures for delivery.

Besides including contract provisions that are intended to address food
safety, USDA takes steps to address safety before contracting. USDA
procurement officials said they consider the potential suppliers' records
for compliance with food safety regulations in their reviews of bids before
contracting. The officials said that through their continual contact with a
relatively small pool of potential suppliers, contacts with various agency
inspectors and graders, and knowledge of the industry, they are aware of a
potential supplier's record of compliance with food safety regulations and
take this record into account when determining whether this potential
supplier is responsible.

Furthermore, because of quality concerns, the Farm Service Agency has
developed a precontracting procedure for a few of the foods that it
purchases, such as peanut butter, that indirectly helps to ensure foods'
safety. The agency formally rates suppliers' food quality and safety
programs before allowing them to bid on a contract. Bidding companies are
required to establish food safety controls, which USDA reviewers assess for
specific criteria in several categories, such as the use of good
manufacturing practices, appropriate inspection and testing of products, and
appropriate storage and handling procedures. Suppliers are ineligible to bid
if they fail to achieve the minimum score established by agency contracting
officials. Agency officials anticipate that over the next 5 years this
procedure will become effective for all foods purchased by the Farm Service
Agency for USDA's food assistance programs.

Procurements

While USDA has established procurement policies and procedures that are
intended to ensure the safety of foods donated to schools, these policies
and procedures do not apply to foods purchased by local schools, which
account for 83 percent of the food served in the school lunch program and
all of the food served in the school breakfast program. According to USDA's
regulations for schools participating in the school meal programs, the
responsible "school food authority may use its own procurement procedures
which reflect applicable State and local laws and regulations," provided
that the procedures comply with applicable federal standards for economy and
efficiency in contracting, including free competition and access to
contractors' records.5 Therefore, the extent to which schools address safety
in their food procurement contracts may vary, depending on state and local
laws and procurement guidance that is available to them.

Although USDA provides general guidance to school food authorities on food
procurement, this guidance is not specific or complete with regard to
ensuring the safety of purchased food. For example, some procurement
guidance appears in USDA's food safety technical assistance publication,
Serving It Safe: A Manager's Tool Kit, which was published and distributed
to all school food authorities in 1996 and updated in 1999. This tool kit is
one of USDA's major efforts to provide school food service personnel with
guidance on safe food handling practices. However, the discussion of
purchasing in the tool kit is limited and provides only general information.
For example, it suggests that school officials "put food safety standards in
your purchase specification agreement" but offers no examples or guidance on
appropriate standards or specifications. The guidance states "suppliers must
meet federal and state health standards" but does not identify these
standards or attempt to explain what they might entail.

USDA has distributed two guidance manuals on food purchasing to all school
food authorities and conducts procurement-related training. In 1995, USDA
distributed First Choice: A Purchasing Systems Manual for School Food
Service, which provides a step-by-step overview of the procurement process
for schools. In 1996, USDA distributed Choice Plus: A Reference Guide for
Foods and Ingredients as complementary guidance to First Choice, explaining
how to describe specific foods in developing purchase specifications, along
with purchasing tips for each food. While these manuals discuss in detail
the development of product descriptions and contract specifications that
ensure food quality and nutrition, neither one specifically addresses the
topic of ensuring the safety of food in procurement, with one exception--the
First Choice manual directly addresses safety in the procurement of pre-cut
fresh produce. Without recommending contract provisions to ensure the safety
of such produce, the manual suggests visiting the vendor's plant before
contracting and suggests evaluating key areas, such as processing procedures
and food safety measures. However, the manual contains no specific guidance
for ensuring safety in the procurement of other types of food, such as meat,
poultry, and dairy products or processed fruits, vegetables, and juices.

Information is readily available from USDA that, if made available to school
food authorities, could help ensure the safety of foods that they procure.
Such information appears in (1) USDA's contract specifications for
inspecting, storing, and transporting donated food products, as well as for
addressing special safety concerns presented by certain foods and (2) the
Farm Service Agency's methodology for formally examining the quality and
safety practices of suppliers before accepting their bids. In addition, the
Agricultural Marketing Service's Food Quality Assurance staff, which has
provided presentations to some school food service professionals on
procurement practices that promote the safety of purchased food, has
developed a list of about 140 "commercial item descriptions," which specify
the prominent characteristics of each product. While USDA's First Choice
manual refers to these descriptions as a source of information about food
products, the descriptions also include useful information on other topics,
such as microbiological testing and other safety-related standards, as well
as the sources for governmental and nongovernmental standards and other
guidance documentation.

Although USDA has provided little guidance to help schools ensure the safety
of the foods they procure for the school meal programs, it is currently
participating in a group that provides a potential mechanism for
disseminating such guidance. USDA officials are participating in the
CDC-initiated National School Food Safety Working Group, which is composed
of government agencies, industry, and other interested groups to assist the
nation's schools in preventing foodborne illness. The group meets bimonthly
to share information about school food safety, disseminate relevant
information, explore opportunities for interagency collaboration and
coordination, and conduct strategic planning toward reducing foodborne
illness in schools. Formed in mid-1999, the group is gathering information
and identifying issues to address. Furthermore, according to FNS officials,
the need for additional educational materials and information on
safety-related procurement practices will be discussed when the National
Food Service Management Institute, under a cooperative agreement with FNS,
convenes an advisory group of school lunch program professionals in January
2000.

Few outbreaks of foodborne illness have been reported in connection with
USDA's school meal programs. Furthermore, USDA may have prevented or
mitigated such outbreaks by collaborating with others to remove, replace, or
dispose of USDA-donated foods that posed possible safety concerns. However,
the full extent of these actions is unknown because USDA has not maintained
comprehensive records of the actions it has taken to address possible safety
concerns associated with donated food. Without such records, USDA lacks a
reliable basis for identifying safety trends and for documenting the
agency's responsiveness to concerns over the safety of USDA-donated foods.

USDA has established procurement policies and procedures that are intended
to ensure the safety of foods it purchases and donates to school meal
programs. However, most of the food served in these programs is purchased by
schools. Despite the volume of food that schools purchase, USDA has provided
little guidance on procurement practices that could help ensure the safety
of these purchases. As a result, schools lack a valuable source of
information that could bolster the safety of food served in school meal
programs. USDA could use existing communication channels to provide such
guidance at minimal expense.

To better ensure that donated food safety actions are documented and that
school contract provisions help ensure the safety of foods purchased for the
school lunch and school breakfast programs, we recommend that the Secretary
of Agriculture direct the Administrator of the Food and Nutrition Service to

ï¿½ expeditiously develop the proposed Food Distribution Division's food
safety action database and

ï¿½ provide information to state or local authorities on safety provisions
that could be included in school food procurement contracts.

We provided USDA with a copy of this report for review and comment. USDA
generally concurred with the accuracy of the information presented in the
report. However, USDA was concerned that the report did not address its
efforts and resources devoted to providing school food service personnel
with guidance on safe food handling practices. USDA said it considers food
handling and preparation to be the most significant areas affecting the
safety of food served to schoolchildren because foods purchased by schools,
like food purchased by the general public, are already protected by federal,
state, and local food safety regulations. We agree that such food handling
practices are important in ensuring the safety of school meals. However,
evaluating this particular aspect of USDA's food safety activities was
beyond the scope of the work we had been requested to conduct. Accordingly,
we did not highlight a discussion of these activities in the report.

In commenting on the draft report's recommendations, USDA agreed to take
action on the recommendation to provide schools with information on safety
provisions that could be included in school food procurement contracts. In
response to a USDA concern regarding the implementation of this
recommendation, we clarified the final recommendation to give the agency
more flexibility in implementing it. USDA did not address our recommendation
to expeditiously implement the Food Distribution Division's proposed
database for food safety action in its written comments. However, the
director of this division advised us that the agency concurred with the
recommendation and stated that USDA would develop the database.

USDA provided a number of technical comments, which we incorporated into the
report as appropriate. USDA's comments and our responses are included as
appendix I.

To determine the extent of foodborne illness in schools that participate in
the school meal programs, we obtained the CDC's state-reported nationwide
information on outbreaks of foodborne illnesses for schools for calendar
year 1997, the most recent year for which data were available, and reviewed
CDC's published outbreak investigation reports. We contacted state health
department officials and obtained information regarding the outbreaks
reported to CDC for 1997, as well as for 1998 school outbreaks in the state.
We used the state health department information to determine whether the
illness at the school was associated with a meal prepared and served at the
school. We contacted the school where the outbreak occurred to determine
whether the meal was served as part of the National School Lunch or School
Breakfast programs. If necessary, we contacted the county health department
where the outbreak occurred for additional information.

To determine the extent to which USDA-donated foods in schools were removed,
replaced, or disposed of because of the potential to cause foodborne
illness, we interviewed USDA procurement officials of the Agricultural
Marketing Service and the Farm Service Agency. We also interviewed FNS' Food
Distribution Division Food Hold and Recall Coordinator and reviewed
documentation of safety-related actions.

To determine USDA's procurement policies and procedures for ensuring the
safety of foods served in the programs, we examined and discussed relevant
regulations, policies, and procedures with USDA officials and reviewed
selected USDA procurement contracts. We also examined the USDA procurement
guidance provided to states and school districts.

We conducted our work from July 1999 through December 1999 in accordance
with generally accepted government auditing standards.

As agreed with your office, unless you publicly announce its contents
earlier, we plan no further distribution of this report for 30 days. At that
time, copies of this report will be sent to the Honorable Dan Glickman,
Secretary of Agriculture; the Honorable Jacob J. Lew, Director, Office of
Management and Budget; and other interested parties. We will make copies
available to others on request.

If you have any questions about this report, please contact me at
(202) 512-5138. Major contributors to this report are listed in appendix II.

Sincerely yours,

Robert E. Robertson
Associate Director, Food and
Agriculture Issues

Comments From the U.S. Department of Agriculture

1. We do not agree that the report is incomplete because it does not
enumerate the U.S. Department of Agriculture's (USDA) efforts to provide
guidance to schools regarding safe food storage, handling, and serving
practices. While we agree that such practices are important in ensuring the
safety of school meals, an evaluation of USDA's actions in this area is
beyond the scope of work that we were requested to conduct. Therefore, we
did not highlight these actions in the report. Rather, our report addresses
the requester's concerns regarding procurement policies and procedures to
ensure the safety of foods served in the federally supported school meal
programs.

2. We revised the report to include USDA's authority to detain products.

GAO Contacts and Staff Acknowledgements

Robert E. Robertson (202) 512-5138
Keith Oleson (415) 904-2218

In addition to those named above, Leo Acosta, Kathy Colgrove-Stone, Brad
Dobbins, Oliver Easterwood, and Jonathan Silverman made key contributions to
this report.

(150148)
  

1. The Centers for Disease Control and Prevention (CDC), an agency of the
Department of Health and Human Services, is responsible for monitoring and
investigating outbreaks of foodborne disease. CDC defines an outbreak as
foodborne illness from a common source affecting two or more individuals.
CDC notes that such outbreaks are underreported for a variety of reasons.

2. The Food Safety and Inspection Service also has the authority to
temporarily detain potentially contaminated products for up to 20 days while
it seeks a court order for seizure. The Food and Drug Administration may
seize adulterated products, but such action generally requires a court
order.

3. According to CDC, foodborne illnesses are underreported because (1)
milder cases are often undetected; (2) pathogens that are transmitted
through food may also be spread through water or from person to person,
obscuring the role of foodborne transmission; and (3) some proportion of
foodborne illness is caused by pathogens or agents that have not yet been
identified and thus cannot be diagnosed. Furthermore, CDC relies on states
to voluntarily report outbreak information.

4. HACCP systems are designed to actively monitor and control contamination
throughout the food production process by identifying places where the
greatest food safety risks exist, implementing methods to control the risks
at those points, and then monitoring the efficacy of the controls.

5. A school food authority is responsible for the administration of the
program in one or more schools.
*** End of document. ***