For individual states, regulation of Grade A milk is usually under the jurisdiction of either the State Department of Agriculture or the State Health Department. States often adopt the PMO standards as a minimum, and in many cases, enforce more stringent standards. Recommendations for revisions or updates in the PMO are put forth by the National Conference on Interstate Milk Shipments (NCIMS), a group that includes voting representatives from state and local regulatory agencies, and nonvoting representatives from the dairy industry and FDA. As a general rule, the FDA accepts the NCIMS recommendations and incorporates them into the revised PMO. In recent years, NCIMS has come under increased pressure to recommend tighter standards, in order to improve consumer confidence in the safety and quality of the domestic milk supply, reduce antimicrobial residues and bacterial contamination risks, and to be more closely aligned with tightened guidelines in the European Union (EU) for milk and dairy ingredients used in any foods it imports. Failure to meet the EU standards could have a negative impact on U.S. dairy exports.