Current Perspectives About Scope of Practice

Abstract

Current Perspectives About Scope of Practice Irecently attended the annual meeting for the Institute for Credentialing Excellence (ICE) in San Antonio. This is the organization that encompasses the National Commission for Certifying Agencies that accredits ACSM certifications. The issue of scope of practice was addressed at one session, and the following are some important points to take home in our profession. ACSM currently has a credentialing board, the Committee of Certification and Registry Boards, which has established the basics of who can be certified, how they are examined, and grants a certification based on an examination prepared from a Job Task Analysis. Often, the basis of forming a regulatory board in a state is based on the certification board’s standards. For some time now, there have been calls frommany certifiedmembers stating that we need licensure to stand our ground. However, we must be cautious as we pursue licensure because it truly is not the ‘‘holy grail’’ with respect to ensuring security for exercise professionals. There are a number of reality checks that must be considered with regard to licensure. First, licensure is granted at the state level; therefore, it would take an organized state effort for this process to begin. Second, as with many professions, the regulation of the profession would likely differ from state to state and there are never any guarantees that a bill will ever pass and be signed into law. Other factors to consider include the securing of two or three legislators who will sponsor the proposed bill for legislation and move the bill into a committee. The additional challenge to having a bill advance is countering the objections that other groups or professions may have against the proposed legislation. Opposing groups often hire lobbying firms who monitor legislative efforts and, when alerts come forth, register objections throughout the process. This can add many delays to getting a bill to the floor and voted on. In addition, there is a difference between the law itself, which is the legislation, and the regulations (parameters of practice), which follow if the bill is passed. The law becomes the practice act. However, a trend today is to see legislators writing language into the bill (sometimes during floor debate) that becomes regulatory in nature. This process can become problematic in the future. If, for example, the Job Task Analysis suggests changes in what a profession does, and those parts are actually written in the law, then a new law must be written and changed by most likely a new set of legislators. Therefore, it is best to have the law written with the regulatory issues determined by an established board that oversees the practice act. More desirable is to have the law written to establish a regulatory board. Then the board becomes the authority to write the regulatory statutes for the profession. Most license laws address: • Who is to be licensed? • Who is the authority to oversee the profession? • Establishes a board of advisors. •Grants authority to write regulations. • Grants authority to issue, suspend, or revoke credentials. State regulation may not always imply a ‘‘license’’ to practice. Some states, which have regulatory practice acts of a profession, may grant a license, which is most restrictive. However, other states may grant a certification or a registry for the same profession. The least restrictive level of regulation is trademark protection. The North American Registry of Midwives credential is the Certified Professional Midwife. Currently, only 28 states regulate this profession, and of those, 17 are actually ‘‘licenses’’ to practice. The same variances are seen in exercise-related professions. Currently, physical and occupational therapies are regulated in all 50 states, 49 states regulate athletic training, and 46 regulate registered dieticians. However, each state varies for each profession whether it’s a license or other form of regulation. Another consideration is the issue of the regulatory board. Once a law is passed, then a board must be established to oversee the credential. This, as everything in life, must be funded. Thus, the ACSM Certification