The Impact of Letter Grading in NYC

 Reasons to Speak at CASA

THERE ARE THREE THINGS THAT I AM VERY PASSIONATE ABOUT

My daughter Rachel

Who is now 13……..

BRUCE SPRINGSTEEN

Who I am going to see tonight ….

And the success of the NYC Restaurant Grading System

The DOHMH Landscape

• Approximately 24,000 Restaurants

• Restaurant Inspections FY ‘13 = 83,914– Initial Inspections = 40,050– Re-inspections = 25,391– Others (Survey’s Complaints, etc.) = 18,473

• Avg. No. Restaurant Inspectors FY ‘13 = 85

Letter Grading Launched July 2010

GOALS:• Use consumer purchasing power to motivate restaurants

• Reduce unsafe food handling practices and improve restaurant hygiene

• Publicly reward high-performing restaurants

• Increase government transparency

• Reduce, over time, foodborne illness

Grading Creates Multiple Incentives for Excellent Performance

A-grade card posted in window, website, mobile apps

Initial A grade no inspection for year

Initial or Re-inspection A grade no fines

Improved performance less frequent inspections, lower fines

Better practices protect customers

Adapting Scores to Grades

• Earlier Scoring System– Public Health Hazards - 7 Points– Critical Violations – 5 Points– General Violations – 2 Points– Condition Levels - Indicate extent to which

violations exist and modifies points– 28 or more combined points – Compliance

Inspection

Adapting Scores to Grades

• “Administrative” Violations – Scores not counted toward grades. Example:– Permits violations– Calorie labeling– Trans fat

How Restaurant Grading Works

• Scores counted toward grade only include sanitary violations

• Grading summarizes inspection results into a grade based on a score:– A = 0-13 Points– B = 14-27 Points– C = 28 or more points

How Restaurant Grading Works

• Two types of grading inspections:– Initial inspections

• Only restaurants receiving an “A” are issued a grade card following this inspection

• An “A” grade must be posted immediately• There are no hearings or fines issued to

restaurants receiving an “A” following an inspection, providing an additional incentive to perform well

• Restaurants scoring 13 or more points are scheduled for a follow-up inspection 2-4 weeks later

How Restaurant Grading Works

– Re-Inspection• Restaurants receiving an “A” must post

that grade immediately• There are no hearings or fines for

restaurants issued an “A” grade following an inspection

• Restaurants receiving a “B” or “C,” are issued a grade card reflecting their score, and a Grade Pending card

• Either the grade card or the Grade Pending card must be posted at the end of the inspection

How Restaurant Grading Works

• Due Process –OATH Tribunal– Restaurants are entitled to a hearing before

having to post a grade card– A grade card must be posted on the day of the

hearing, unless granted an adjournment– If a hearing changes a score to the extent the

grade would change, a new grade card is issued and must be posted immediately

• Restaurants receiving an adjudicated “A” grade must pay incurred fines

– Only one adjournment is allowed before the grade must be posted

Posted Grades

How Restaurant Grading Works

• Inspection Cycles– Inspection cycles include the:– Initial Inspections– Re-Inspections – Compliance Inspections

• Compliance Inspections may be assigned to FSEs that have scored poorly on their Initial and Re-Inspections.– May also be assigned in lieu of closing a FSE that

has previously performed well on inspections

How Restaurant Grading Works

• Inspection Intervals

– The amount of time between the end of one inspection cycle and the start of another is determined by the score received following the initial inspection

– Inspection Intervals are determined by the higher score of either the Initial or Re-Inspection.

– The interval is not affected by a hearing’s outcome– Intervals (+ or – 1 Month)

• “A” = 12 Months• “B” = 6 Months• “C” = 4 Months• Closed = 3 Months

Summary

• Promotes high food safety standards

• Assures restaurants fairness: – Dual-inspections for a grade– Inspection frequency based on performance– Impartial inspection review by a tribunal– Financial incentives

• Consumer engagement through greater transparency of inspection results

Overview

Evaluate grade program impact on• Restaurant hygiene & food handling

practices• Diner behavior• Foodborne illness

Methods: Hygiene AnalysisItem DescriptionData Source Food Safety and Community Sanitation

Tracking System (FACTS)• Inspection descriptors & outcomes,

restaurant characteristicsTime Period July 2007-July 2013Inspection Type Recent initial inspections in time periodInspection Score Adjustments

Pre-grade program exclude points from administrative violations

Analysis of Inspection scores, cited violations

NYC Restaurant Population

• Approximately 24,000 restaurants operating each day

• 2007-2013: 43,892 restaurants 38% in Manhattan, 4% in Staten Island 11% chain restaurants 45% quick service with limited seating

or take-out

A Grades by UHF42 in 2011 and 2013

Source. NYC Environmental Public Health Tracking Portal, accessed March 2014

2011 2013

Score on Recent Initial Inspection, NYC Restaurants, 2010-2013

Inspection Performance Improvement Estimated Success of Scoring 13 Points or Less on Initial Inspection in NYC Restaurants, July 2007 - July 2013 (n=172,067)Indicator Success Ratio 95% CL (LL, UL)Time Period

13-36 months before grading Reference0-12 months before grading 1.05 (1.01, 1.09)0-12 months after grading 0.87 (0.84, 0.90)13-24 months after grading 1.26 (1.22, 1.31)25-36 months after grading 1.35 (1.31, 1.40)

Season July-September ReferenceOctober-December 1.20 (1.16, 1.24)January-March 1.30 (1.26, 1.35)April-June 1.20 (1.16, 1.24)

Chain Restaurant No ReferenceYes 3.46 (3.31, 3.61)

Note. BESP frozen initial inspection dataset, initial inspections in restaurants between July 27, 2007 - July 26, 2013

Kitchen Cleanliness

Kitchen Managers & Workers

Food Handling and Holding

Pest Control

New Yorkers Overwhelmingly Support & Use Grading

Response Percentage (95% CL)Eats out more than once per week 68 (63 - 72)Concerned about getting sick from eating restaurant food in NYC

72 (68 -76)

Considers grades when dining out 89 (85 - 92)Approve of letter grades 91 (87 - 94)Approve of more frequent inspection if an A grade is not earned

89 (85 - 92)

More confident eating in an A grade restaurant

77 (72 - 82)

Note. July 2011 (n=502) & Jan 2012 (n=511) surveys conducted by Baruch College Survey Research.

Grade Distribution following reinspections

Grades Awarded Not Reinspected Reinspected Reinspection pending Estimated Total

Percent

A Grade (ini/reinsp) 15315 6627 0 67.00

B Grade 0 6604 0 24.00

C Grade 0 2571 0 9.00

Not Graded for B/C initial 0 0 4169 0.00Total 15315 15802 4169 100.00

Pre-Adjudicated Score Distribution on Previous Initial Inspection to Recent Initial Inspection as of 3/31/2014

Recent Initial Inspection Score Category

Previous Initial Inspection Score

Category0-13 Points 0-13 Points % 14-27 Points 14-27 Points % 28+ Points 28+ Points % Total

0-13 Points 5227 69.61 1620 21.57 662 8.82 750914-27 Points 3408 43.76 2985 38.33 1395 17.91 778828+ Points 1808 32.35 2216 39.65 1565 28 5589

Total 10443   6821   3622   20886

Note: Includes active gradable FSEs as of 3/31/2014. Pre-adjudicated inspection scores on each FSEs two most recent initial inspections as of 3/31/2014 are compared . Report generated on 3/31/2014.

Next Steps

• Use results to inform development of educational food safety resources and outreach efforts with operators

• Analyze hygiene metrics stratified by restaurant characteristics

• Use other data sources to evaluate program impact on foodborne illness

[1

Facts

December

2013

Like Any successful program we have our critics

Not our fault

• Due to the video that was released, the health department used it as evidence to ask us to re-cement and closed down the bakery for extermination. As a small one-shop bakery, we often feel like we're being looked at under a tremendous microscope. A lot of time people don't see the larger ramifications of their actions and how a tiny video of a mouse running across the screen for 3 seconds can cause harm and damages to an honest, small business that people's livelihood depends on. We of course believe that we run a clean and good operation, but see that we were targeted and will rise to the occasion to be even better.

• Chef says we will be doing everything that was asked of us, and hope to reopen on Monday. And he's sadden for our customers who had plans this weekend that we weren't able to welcome them.

Restaurant Grading is a success

A majority of Restaurants are Posting an A

87 per cent of Restaurants post an A

11 per cent of Restaurants post a B

2 per cent of Restaurants post a C

Salmonella

• Between 2010 ( the year before grading ) and 2013 there has been a 14 % decline in Salmonella Cases

Questions ?