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WC CWF Health District Board Minutes - 11/13/2015WICHITA FALLS - WICHITA COUNTY PUBLIC HEALTH BOARD MINUTES November 13, 2015 Wichita Falls- Wichita County Public Health District 1700 Third Street - Parker Conference Room Wichita Falls, Texas BOARD MEMBERS PRESENT: Scott Plowman, Chair Julie Gibson, D.V.M., Vice -Chair David Carlston, Ph.D. Robin Moreno, MHA -HAS, ACHE Larry Rains, D.D.S Keith Williamson, M.D. i BOARD MEMBERS EXCUSED ABSENCE: Diane Stewart, R.N., Secretary OTHERS PRESENT: Lou Kreidler, R.N., B.S.N. Director of Health Amy Fagan, M.P.A. Assistant Director of Health Ray Gonzalez County Commissioner 1. CALL TO ORDER Scott Plowman called the Health Board meeting to order at 12:00 pm after a quorum of members was attained. II. APPROVAL OF MINUTES AND ABSENCES Scott Plowman called for the review and approval of minutes from the meeting held on Friday August 28, 2015. Dr. Williamson introduced a motion to approve the minutes as presented and Dr. Carlston seconded the motion. The motion passed unanimously. At this time it was noted the excused absence of Diane Stewart, Ill. HEALTH AUTHORITY AND ASSOCIATE HEALTH AUTHORITY APPOINTMENT Lou Kreidler stated the Health Authority and Associate Health Authority appointments are brought to the Board for approval every two years. The appointments have been held by the Medical Director and Associate Medical Director of North Central Texas Medical Foundation of the Family Health Center (FHC) since the organization of the Health District. The FHC Medical Director Dr. Mattar serves as the Health District Medical Director and current Local Health Authority his reappointment was requested for approval from the Board. Dr. Szczerba returned to the FHC as the Associate Medical Director therefore serves as the Health District Associate Medical Director so his appointment as the Associate Health Authority was requested for approval from the Board. It was noted Dr. Szczerba while at the FHC in the past did serve as the Health Authority. Scott Plowman called for a motion to approve the Local Health Authority appointments. Dr. Rains introduced a motion to approve the appointments and Dr. Gibson seconded the motion. The motion passed unanimously. IV. FOOD ESTABLISHMENT ORDINANCE Susan Morris the Environmental Health Administrator introduced the Environmental staff that would explain the food code changes. The food code Chapter 229 expired October 11, 2015 and the State adopted Chapter 228. The presentation today was presented at the stakeholders meeting held several days ago with 100 restaurant providers in attendance out of 685 invitations. Brian Railsback the Food Code Standardization Trainer standardized the Public Health Inspectors on the FDA code to insure uniform inspections, handles the paperwork and trains inspectors through the 18 month process. Samantha Blair has been a Sanitarian -in- Training for about a year upon her graduation from Midwestern University. Samantha Blair supplied handouts that contained the notice sent out for the TX DSHS training provided to the Regulators and Industry on the new Texas Food Establishment Rules (TFER), a Summary of Changes to TFER and the new inspection report. Brian Railsback presented a brief Power Point on why the rules changed, the new inspection report, new additions to the code, new chapter numbers, definitions, verbiage, ROP process, Sous Vide process, self - service mini marts, and lemonade stands. ROP is reduced oxygen packaging where the restaurant prepares a large batch of an item (rice, beans, etc.) placed in bags with all the oxygen removed then the bags placed in an ice batch (quick chill) to bring the temperature down to freeze the bags. The bags last before the need of another batch the process has been seen more often. Sous Vide is to place meat usually with a marinade in a package with all the oxygen removed. The meat is cooked at a low temperature usually at 131 degrees from 2 -6 hours sometimes 8 hours similar to boiling to make for a tender the meat. The State of Texas made a determination about lemonade stands that has been included in the new rules. A new addition on self - service mini marts an unmanned mini mart ran by surveillance cameras that have started to grow in popularity mostly at colleges, big industries and offices. The new Sub- chapter J are provisions about private water wells the FDA food code does not cover private water wells due to the size of Texas the State established their own rules to cover the communities that do operate off these water sources. A food establishment ordinance had been established in Wichita County that required food handler cards but outside the county it was not required by TFER or the FDA food code. The State added a new rule to TFER that everyone in a food establishment must have a food handler card so the TFER are followed and not the FDA food code. Exotic animals are dealt with in a lot of Texas restaurants that the food code did not cover so that had to be added. Bare hand contact is allowed by TFER but not by the FDA food code the TFER require a procedure to be followed along with documentation provided to insure it is done safely. In addition are the mobile food units including outfitters where an individual or individuals are taken out similar to a camping trip and provided food while out. Some of the additions are to be reviewed further. Samantha Blair touched on some of the important changes to the rules but the hand out packet explained every change. The last time TFER had been updated was in 2006 with a minor revision since then things have changed especially with science and food. The reason for the rules and chapter number change as their stated intention was to make it easier to update every 4 years. The revisions put Texas on par with the 2013 updated food code still behind but much better it puts Texas as the 8`h State to require comprehensive food handlers training which means Texas requires a food establishment have at least one full time employee as a Certified Food Protection Manager and all employees a food handler card. The most major change the restaurants will notice is the change from a 27 to 47 item inspection form with the reason to get back at the root cause of some of the major violations. The 47 item inspection form still is at a 100 point total and 70 for the pass fail mark. Wording changed from critical violations to non - critical violations now to three sections Priority Items, Priority Foundation, and Core Items. The Priority Items contribute directly to a hazard, Priority Foundation the support items, and Core Items are typically general maintenance. A third page was added to the inspection report to give the OFF inspectors a place to record temperatures and develop a corrective action plan. The top section of the Inspection are 3 Point violations Priority items typically temperatures and general knowledge, the middle section are 2 Point violations Priority Foundation items supportive paperwork and methods such as the cooling could be out in the top section because of improper cooling that would be a violation and last section are 1 Point violations Core items the floors, walls, ceilings, light levels, insects in the establishment. The second page states some of the common violations and the appropriate corrective action. The third page top section allocates a place to record the item /location /good or bad temperatures that can establish a history reference on whether there had been problems in the past. The bottom section allots for the explanation, comments, and corrective action plan. General changes are the Chapter citation changed from 229 to 228, definitions consist of 39 new, 5 deletions, 9 changeslamendments, new addition of major food allergen becoming more prominent, and the botulism definition changed to fit with the FDA definition also a change in the format and update in the way the definitions are written to fit with State status. One of the major changes Restaurants will notice are the foods called potentially hazardous changed to TimelTemperature Control for Safety (TCS) food because of the FDA classification the whole point of the food changes are to get on par with FDA. ROP the Reduced oxygen packaging (ROP) in the new TFER was divided into three categories; single barrier (cook -chill and sous vide), double barrier, and 48 hours. The 48 hours are the items kept packaged for 48 hours or less would not require a variance or HACCP plan. The single and double barrier would require a HACCP plan but no longer a variance. Wichita County does not currently have any self - service mini marts but a section was added on the regulations and length of time video surveillance footage needs to be kept in the attempt to determine if the food was tampered with and resolve the issue. Lemonade stands and Texas regulators made the news over the summer due to some communities tried to shut down lemonade stands. The State made a point to assert they want to limit enforcement and lemonade stands hold a minimal health risk. Subchapter J provides additional guidance for those food establishments in Texas that do fall on private water systems basically it states the same rules are to be followed as anyone on a public water system required to have the same water quality. Scott Plowman questioned if the Food Protection Manager Certification would be one person for multiple establishments or each establishment. Samantha Blair answered on multiple establishments it would be one person per each establishment Lou Kreidler stated that the addition of the requirement was to have a person in charge with knowledge about the processes so when the inspectors came in they are directed to that one person to ask questions pertinent to the processes at that establishment. In addition she pointed out a new rule that you cannot use a toilet, urinal or shower as a mop sink. Samantha Blair responded you can as long as it no longer functions as a toilet, urinal or shower. Susan Morris added the Food Establishment Ordinance changes are planned to be taken to the City Council in Burkburnett on Monday, Wichita Falls on Tuesday, and Wichita County in two weeks. Cities can adopt more stringent rules and set the price structure. The County can only adopt by reference with limits on what can be charged in the County and posted in the newspaper for 3 days 2 weeks prior contact has been made with the Judge and Commissioners Court Administrator to place on their agenda. There are no dates set for Electra and Iowa Park at this time. Scott Plowman responded that these are State mandated. Lou Kreidler stated these rules are the updates of TFER State law, currently the TFER referenced in the Food Establishment Ordinance is out of date does not exist therefore a call was made to the City Attorney to determine when a Board of Health meeting could be held to place it on the agenda. The Food Establishment Ordinance changes are needed to be in compliance with State law. The changes being made are not Health District changes it is an adoption of what the State adopted. We need a motion to recommend or not recommend to Council for approval. 3 A motion was made by Dr. Carlston to recommend the Food Establish Ordinance changes to City Council and Dr. Williamson seconded the motion. The motion passed unanimously. Lou Kreidler continued with the news that the Health District received a Community Diabetes Education Grant that can intensify the Diabetes Education Empowerment Program (DEEP) that has been established now for a year. The grant enabled the addition of three staff members; Program Administrator, Public Health Specialist, Health Educator and contractor a Registered Dietician for the Nutrition component. The State called to ask if the Health District was interested in some hypertension money they had so that will be an additional program. It will be partnered up with the Diabetes Program knowing that hypertension correlates with Diabetes. V. NEXT MEETING DATE December 18, 2015 VI. ADJOURN The meeting adjourned at 12:50 pm. Signature' Vvv LA- Print Name Scott Plowman, Chair, Julie Gibson, D.V.M.. Vice -Chair, orbiane Stewart R.N. Secreta Wichita Falls- Wichita County Public Health Board City -County Board 12