Bill H.1882

HOUSE DOCKET, NO. 2821 FILED ON: 1/21/2011

HOUSE . . . . . . . . . . . . . . . No. 1882

By Mr. Humason of Westfield, a petition (accompanied by bill, House, No. 1882) of Donald F. Humason, Jr. and others relative to the registration of clinical exercise physiologists. Consumer Protection and Professional Licensure.

The Commonwealth of Massachusetts

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In the Year Two Thousand Eleven

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An Act relative to the registration of clinical exercise physiologists.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Chapter 13: Section 11A. Board; membership; appointment; term; removal; election of officers; expenses; powers and duties

Section 11A. There shall be a board of allied health professions, hereinafter called the board, which shall consist of fourteen members to be appointed by the governor. Members of the board shall be residents of the commonwealth and citizens of the United States. Three of such members shall be athletic trainers licensed in accordance with the provisions of section twenty-three B of chapter one hundred and twelve; three of such members shall be clinical exercise physiologists licensed in accordance with the provisions of section twenty-three B of chapter one hundred and twelve; two of such members shall be occupational therapists licensed in accordance with the provisions of section twenty-three B of chapter one hundred and twelve, one such member shall be an occupational therapy assistant licensed in accordance with the provisions of said section twenty-three B; two of such members shall be physical therapists licensed in accordance with the provisions of said section twenty-three B; one such member shall be a physical therapist assistant licensed in accordance with the provisions of said section twenty-three B; except that such members constituting the first board shall be persons who are eligible for licensing as practitioners of said allied health profession. One of such members shall be a physician licensed in accordance with the provisions of section two of chapter one hundred and twelve, and one of such members shall be selected from and shall represent the general public.

Each member of the board shall serve for a term of three years. No member shall be appointed to more than two consecutive full terms, provided, however, that a member appointed for less than a full term may serve two full terms in addition to such part of a full term, and a former member shall again be eligible for appointment after a lapse of one or more years.

A member of the board may be removed by the governor for neglect of duty, misconduct, malfeasance or misfeasance in office after being given a written statement of the charges against him and sufficient opportunity to be heard thereon. Upon the death, resignation or removal for cause of any member of the board, the governor shall fill such vacancy for the remainder of that member’s year.

The board shall, at its first meeting, and annually thereafter, elect from among its members a chairman, vice-chairman, and a secretary. Such officers shall serve until their successors are elected and qualified. The board shall meet at least once a month or more often upon the call of the chairman at such times and places as the chairman shall designate.

Each member shall be reimbursed for necessary expenses incurred in the discharge of his official duties.

The board shall have the following powers and duties:

(a) The board shall administer, coordinate, and enforce the provisions of this section, evaluate the qualifications, and approve the examinations for licensure under this section, and may issue subpoenas, examine witnesses, and administer oaths, and may investigate allegations of practices violating the provisions of this section.

(b) The board shall adopt rules and regulations relating to professional conduct to carry out the policy of this section including, but not limited to, regulations relating to professional licensure and to the establishment of ethical standards of practice for persons holding a license to practice athletic training, occupational therapy, or physical therapy in the commonwealth.

(c) The board shall conduct such hearings and keep such records and minutes as are necessary to carry out its duties. The board shall provide reasonable public notice of the times and places of all hearings authorized under this section, in such manner and at such times as it may determine.

SECTION 2. Chapter 112: Section 23A. Definitions

Section 23A. The following words as used in sections twenty-three A to twenty-three P, inclusive, unless the context otherwise requires, shall have the following meanings:—

“Athletic trainer”, any person who is duly licensed in accordance with this section as an athletic trainer and who limits his practice to schools, teams or organizations with whom he is associated and who is under the direction of a physician or dentist duly registered in the commonwealth.

“Athletic training”, the application of principles, methods and procedures of evaluation and treatment of athletic injuries, preconditioning, conditioning and reconditioning of the athlete through the use of appropriate preventative and supportive devices, temporary splinting and bracing, physical modalities of heat, cold, massage, water, electric stimulation, sound, exercise and exercise equipment under the discretion of a physician. Athletic training includes instruction to coaches, athletes, parents, medical personnel and communities in the area of care and prevention of athletic injuries.

“Board”, the board on allied health professions, established under section eleven A of chapter thirteen.

“Clinical Exercise Physiology”, an allied health profession that utilizes the application of scientific principles to design, implement, supervise and evaluate outcomes for exercise services provided to individuals with chronic diseases, conditions and/or functional deficits. Clinical Exercise Physiology services focus on the enhancement of physical capabilities for the purpose of: (1) chronic disease management; (2) reducing risks for premature development of or recurrence of chronic diseases; (3) promoting behavioral patterns consistent with maintenance of health; (4) improving performance of activities of daily living; (5) increasing the potential for physical, social and economic independence. The Clinical Exercise Physiologist (CEP) possesses the scientific knowledge, technical skills, interpretive abilities, and practical experiences necessary to provide individualized exercise for clinical populations. The CEP is uniquely competent to educate, motivate and counsel individuals with medical considerations in their efforts to reduce functional deficits, safely improve and maintain their physical fitness and develop healthy lifestyles. The CEP also measures, evaluates, and provides supportive consultation to other allied-health providers relative to multidimensional physical fitness and exercise testing. The CEP formulates, develops and implements exercise protocols and programs, administers graded exercise tests, and provides education regarding such exercise programs and tests and risk factor modification in a rehabilitation or diagnostic setting to individuals with cardiovascular, pulmonary, and metabolic diseases, neoplastic (oncology)/immunologic/hematologic conditions, along with chronic orthopedic and neuromuscular diseases and disabilities.

“Clinical Exercise Physiologist”, a person who is duly licensed to practice clinical exercise physiology in the commonwealth in accordance with section twenty-three B.

”Exercise Protocols and Programs”, the intensity, duration, frequency, volume, and mode of activity to improve and/or maintain an individual’s functional capacity.

“Occupational therapy”, the application of principles, methods and procedures of evaluation, problem identification, treatment, education, and consultation which utilizes purposeful activity in order to maximize independence, prevent or correct disability, and maintain health. These services are used with individuals, throughout the life span, whose abilities to interact with their environment are limited by physical injury or illness, disabilities, poverty and cultural differences or the aging process. Occupational therapy includes but is not limited to: (1) administering and interpreting tests necessary for effective treatment planning; (2) developing daily living skills, perceptual motor skills, sensory integrative functioning, play skills and prevocational and vocational work capacities; (3) designing, fabricating or applying selected orthotic and prosthetic devices or selected adaptive equipment; (4) utilizing designated modalities, superficial heat and cold, and neuromuscular facilitation techniques to improve or enhance joint motion muscle function; (5) designing and applying specific therapeutic activities and exercises to enhance or monitor functional or motor performance and to reduce stress; and (6) adapting environments for the handicapped. These services are provided to individuals or groups through medical, health, educational, industrial or social systems.

Occupational therapy shall also include delegating of selective forms of treatment to occupational therapy assistants and occupational therapy aides; provided, however, that the occupational therapist so delegating shall assume the responsibility for the care of the patient and the supervision of the occupational therapy assistant or the occupational therapy aide.

“Occupational therapist”, a person who is duly licensed to practice occupational therapy in the commonwealth in accordance with section twenty-three B.

“Occupational therapy assistant”, a person duly licensed in accordance with section twenty-three B and who assists in the practice of occupational therapy who works under the supervision of a duly licensed occupational therapist.

“Physical therapy”, a health profession that utilizes the application of scientific principles for the identification, prevention, remediation and rehabilitation of acute or prolonged physical dysfunction thereby promoting optimal health and function. Physical therapy practice is evaluation, treatment and instruction related to neuromuscular, musculoskeletal, cardiovascular and respiratory functions. Such evaluation shall include but is not limited to performance and interpretation of tests as an aid to the diagnosis or planning of treatment programs. Such treatment shall include but is not limited to the use of therapeutic exercise, physical activities, mobilization, functional and endurance training, traction, bronchopulmonary hygiene postural drainage, temporary splinting and bracing, massage, heat, cold, water, radiant energy, electricity or sound. Such instruction shall include teaching both patient and family physical therapy procedures as part of a patient’s ongoing program. Physical therapy also shall include the delegating of selective forms of treatment to physical therapist assistants and physical therapy aides; provided, however, that the physical therapist so delegating shall assume the responsibility for the care of the patient and the supervision of the physical therapist assistant or physical therapy aide.

Physical therapy shall also include the providing of consultation services for health, educational, and community agencies.

“Physical therapist”, a person who is duly licensed to practice physical therapy in the commonwealth in accordance with section twenty-three B.

“Physical therapist assistant”, a person duly licensed in accordance with section twenty-three B and who assists in the practice of physical therapy under the direction of a duly licensed physical therapist.

“Recognized educational institution”, a degree-granting college or university recognized as such by the United States Office of Education of the Commonwealth.

Chapter 112: Section 23B. Examinations; applications for licensure; fees; renewal of license

Section 23B. The board shall examine applicants for licensure in each of the fields it supervises at such times and places as it may determine and shall conduct at least two such examinations in each field in each calendar year. The board shall establish examination and testing procedures to enable the board to ascertain the competency of persons wishing to be licensed as qualified athletic trainers, clinical exercise physiologists, occupational therapists, occupational therapy assistants, physical therapists and physical therapist assistants. Applications for such licenses, signed and sworn by the applicants shall be made on forms furnished by the board. An applicant who furnished satisfactory proof that he is of good moral character and that he has met the educational and clinical practice requirements set forth in section twenty-three F, twenty-three F1/2, twenty-three G, twenty-three H, twenty-three I, or twenty-three J, shall, upon payment of a fee determined by the secretary of administration and finance, be examined by the board, and if found qualified, and if he passes the examination, shall be licensed to practice.

Licenses shall expire every 2 years on the birth anniversary of the licensee. Licensees shall pay to the board a renewal fee determined by the secretary of administration and finance. The board may require specific continuing education as a condition of license renewal. The board may provide for the late renewal of a license that has lapsed and may require the payment of a late fee, an examination, continuing education, and supervised experience before issuing the renewed license. For purposes of implementing the transition to birthday renewals, for licenses renewing on or about January 2006, the board may issue licenses that expire in less than 2 years.

Chapter 112: Section 23C. Practice upon filing of license application

Section 23C. A person who meets the qualifications to be admitted to the examination for licensure as an athletic trainer or a clinical exercise physiologist or an occupational therapist or occupational therapy assistant or physical therapist or physical therapist assistant, may between the date of filing an application for licensure and the announcement of the results of the next succeeding examination for licensure, according to which application he has filed, practice as an athletic trainer; as a clinical exercise physiologist; as an occupational therapist or as an occupation therapy assistant under the direction of an occupational therapist duly licensed under this chapter; as a physical therapist or physical therapist assistant under direction of a physical therapist duly licensed under this chapter. If any person so practicing fails to qualify for or pass the first announced examination after filing for licensure, all privileges under this section shall automatically cease upon due notice to the applicant of such failure. Such privileges shall be renewed upon filing for a second examination for licensure and shall automatically cease upon notice to the applicant that he has failed to pass the second examination. Such privileges may again be renewed upon the applicant petitioning the board for permission to file a third application and said permission being granted by the board, and shall automatically cease upon due notice that he has failed to pass the third examination. The privilege shall not exceed beyond the third examination.

Chapter 112: Section 23D. Licensing of persons registered or licensed in other states, territories, etc.; fees

Section 23D. The board may without examination, license as an athletic trainer, or a clinical exercise physiologist, or an occupational therapist or occupational therapy assistant, or physical therapist or physical therapist assistant, any applicant who is duly licensed or registered under the laws of another state or territory of the United States, the District of Columbia, or the Commonwealth of Puerto Rico. At the time of making such application, the applicant shall pay a fee determined by the secretary of administration and finance to the board.

Chapter 112: Section 23E. Construction

Section 23E. Nothing in this section shall be construed as preventing or restricting the practice, services, or activities of:

(a) any person licensed in this commonwealth by any other statute from engaging in the profession or occupation for which he is licensed, or

(b) any person employed as an athletic trainer or clinical exercise physiologist or occupational therapist or occupational therapy assistant or physical therapist or physical therapist assistant by the Government of the United States or any agency of it, if such person provides occupational therapy or physical therapy solely under the direction or control of the organization by which he is employed, or

(c) any person pursuing a supervised course of study leading to a degree or certificate in athletic training or clinical exercise physiology or occupational therapy or physical therapy at an accredited or approved educational program, if the person is designated by a title which clearly indicates his status as a student or trainee, or

(d) any person fulfilling the supervised field work experience requirements of this section, if the experience constitutes a part of the experience necessary to meet the requirement of that section, or

(e) any person performing athletic training services or clinical exercise physiology services or occupational therapy services or physical therapy services in the commonwealth if these services are performed for no more than two days in a calendar year in association with an athletic trainer or clinical exercise physiologist or occupational therapist or physical therapist licensed under this section, if the person is licensed under the law of another state which has licensure requirements at least as stringent as the requirements of this section.

Chapter 112: Section 23F. Athletic trainers; qualifications

Section 23F. An applicant for licensure as an athletic trainer shall:

(a) be a graduate of a college or university approved by the board and completed such college’s or university’s curriculum in athletic training, or other curricula deemed acceptable to the board: and has completed a program of practical training in athletic training deemed acceptable to the board.

(b) have passed an examination administered by the board. Such examination shall be written, and, in addition, at the discretion of the board, may be oral and demonstrative, and shall test the applicant’s knowledge of the basic and clinical sciences as they apply to athletic training theory and practice, including the applicant’s professional skills and judgment in the utilization of athletic training techniques and methods, and such other subjects as the board may deem useful to determine the applicant’s fitness to act as an athletic trainer. The examination shall be conducted at least twice a year at times and places to be determined by the board.

Chapter 112: Section 23F1/2. Clinical Exercise Physiologist; qualifications

Section 23I. An applicant for licensure as a clinical exercise physiologist shall:

(a) hold a master’s degree or higher with a major course of study in clinical exercise physiology, exercise science, kinesiology, or applied exercise physiology from an accredited college or university approved by the board, or be a graduate of an accredited educational program in Exercise Physiology, and including a minimum of 600 hours of clinical experience as a clinical exercise physiologist,

(b) or have graduated from an educational program in clinical exercise physiology, exercise science, kinesiology, or applied exercise physiology chartered in a sovereign state outside the United States and have furnished to the board such evidence as it may require: (1) that his education is substantially the equivalent of that of graduates of approved programs in the United States, and (2) that he has sufficient qualifications, including the proficiency in the English language, to practice clinical exercise physiology,

(c) and passed the American College of Sports Medicine examination for Registered Clinical Exercise Physiologists or Clinical Exercise Specialists or equivalent as determined by the board.

Chapter 112: Section 23G. Occupational therapists; qualifications

Section 23G. An applicant for licensure as an occupational therapist shall:

(a) successfully completed an accredited occupational therapist educational program approved by the board,

(b) successfully completed the therapist level field work requirements as stipulated in the essentials of an accredited educational program for the occupational therapist or its equivalent,

(c) successfully passed an examination approved by the board for licensure as an occupational therapist. Such examination shall be written and shall test the applicants’ knowledge of the basic and clinical sciences related to the occupational therapy theory and practice, including the applicant’s professional skills and judgements in the utilization of occupational therapy techniques and methods, and such other subjects as the board may deem useful to determine the applicant’s fitness to act as an occupational therapist. The examination shall be conducted by the board at least twice each year and at times and places to be determined by the board; provided, however, that the board may utilize any existing national examination that meets the requirements in this section.

Chapter 112: Section 23H. Occupational therapy assistant; qualifications

Section 23H. An applicant for licensure as an occupational therapy assistant shall:

(a) successfully completed an accredited occupational therapy assistant educational program approved by the board,

(b) successfully completed a minimum of two months of supervised field work,

(c) successfully passed an examination conducted by the board for licensure as an occupational therapy assistant. Such examination shall be written and shall test the applicant’s knowledge of the basic and clinical sciences related to the occupational therapy theory and practice, and such other subjects as the board may deem useful to determine the applicant’s fitness to act as an occupational therapy assistant. The examination shall be conducted by the board at least twice each year and at times and places to be determined by the board; provided, however, that the board may utilize any existing national examination that meets requirements of this section.

Chapter 112: Section 23I. Physical therapist; qualifications

Section 23I. An applicant for licensure as a physical therapist shall:

(a) be a graduate of a three or four year secondary school or has passed a high school equivalency test deemed acceptable by the board,

(b) be a graduate of an accredited educational program leading to professional qualification in physical therapy and approved by the board,

(c) or have graduated from an educational program in physical therapy chartered in a sovereign state outside the United States and have furnished to the board such evidence as it may require: (1) that his education is substantially the equivalent of that of graduates of approved programs in the United States, and (2) that he has sufficient qualifications, including the proficiency in the English language, to practice physical therapy,

(d) have passed an examination administered by the board. Such examination shall be written, and may, at the discretion of the board, in addition, be oral and demonstrative, and shall test the applicant’s knowledge of the basic and clinical sciences as they relate to physical therapy, including the applicant’s professional skills and judgment in the utilization of physical therapy techniques and methods, and other subjects as the board may deem useful to determine the applicant’s fitness to act as a physical therapist. The examination shall be conducted by the board at least twice each year and at times and places to be determined by the board.

Chapter 112: Section 23J. Physical therapist assistants; qualifications

Section 23J. An applicant for licensure as a physical therapist assistant shall:

(a) be a graduate of a three or four year secondary school or has passed a high school equivalency test deemed acceptable to the board,

(b) be a graduate of an accredited educational program leading to professional qualification as physical therapist assistant and approved by the board,

(c) have passed an examination administered by the board. Such examination shall be written, and may, at the discretion of the board, in addition, be oral and demonstrative, and shall test the applicant’s knowledge of the basic and clinical sciences as they relate to physical therapy and other subjects as the board may deem useful to determine the applicant’s fitness to act as a physical therapist. The examination shall be conducted by the board at least twice each year and at times and places to be determined by the board.

Chapter 112: Section 23K. Revocation, suspension, etc. of licensee

Section 23K. The board may, after a hearing pursuant to chapter thirty, revoke, suspend, cancel the license of or place on probation, reprimand, censure or otherwise discipline a licensee upon proof satisfactory to a majority of the board that said person:

(a) obtained or attempted to obtain a license by fraud or deception,

(b) been convicted of a felony or of a crime involving moral turpitude,

(c) has been grossly negligent in his practice of athletic training or clinical exercise physiology or occupational therapy or physical therapy,

(d) been adjudged mentally ill or incompetent by the court of competent jurisdiction,

(e) used drugs or intoxicating liquors to the extent which adversely affects his practice,

(f) acted in manner which is professionally unethical according to ethical standards of the professions of clinical exercise physiology or occupational therapy or physical therapy.

Chapter 112: Section 23L. Practice of medicine or other form of healing

Section 23L. Nothing in this section shall be construed as authorizing an athletic trainer, clinical exercise physiologist, occupational therapist, occupational therapy assistant, physical therapist, or physical therapist assistant to practice medicine or any other form or method of healing not specified in said section.

Chapter 112: Section 23M. Rules and regulations; record of proceedings; roster of licensees

Section 23M. The board shall adopt reasonable rules and regulations to carry into effect sections twenty-three A to twenty-three P inclusive and may amend and revoke such rules and regulations at its discretion. The board shall keep a record of its proceedings and a roster of all persons licensed by it under this section. The roster shall include the licensee’s name, last known business and residential address; date of licensing, and license number.

Chapter 112: Section 23N. Athletic trainers; necessity for licensure

Section 23N. No person shall hold himself out as an athletic trainer or as being able to practice athletic training or to render athletic training services in this commonwealth unless he is licensed in accordance with section twenty-three B.

Chapter 112: Section 23N1/2. Clinical Exercise Physiologists; necessity for licensure

Section 23N1/2. No person shall hold himself out as a clinical exercise physiologist or as being able to practice clinical exercise physiology or to render clinical exercise physiology services in this commonwealth unless he is licensed in accordance with section twenty-three B. No person not so licensed may use in connection with his name the words or letters, “C.E.P.”, “R.C.E.P.”, “L.C.E.P.”, or any other words, letters, abbreviations, or insignia indicating that he is a clinical exercise physiologist.

Chapter 112: Section 23O. Occupational therapists or assistants; necessity for licensure; use of letters, abbreviations, etc.

Section 23O. No person shall hold himself out as an occupational therapist or as an occupational therapy assistant or as being able to practice occupational therapy or to render occupational therapy services in the commonwealth unless he is licensed in accordance with section twenty-three B. No person not so licensed may use in connection with his name or place of business the letters, “O.T.R.”, or “C.O.T.A.”, or any other words, letters, abbreviations, or insignia indicating that he is an occupational therapist or occupational therapy assistant.

Chapter 112: Section 23P. Physical therapists or assistants; necessity for licensure; use of letters, abbreviations, etc.

Section 23P. No person shall hold himself out as a physical therapist, or as a physical therapist assistant or as being able to practice physical therapy or to render physical therapy services in the commonwealth unless he is licensed in accordance with section twenty-three B. No person not so licensed may use in connection with his name the words or letters, “P.T.”, “R.P.T.”, “L.P.T.A.”, “PH.T.”, “P.T.A.”, “P.T.D.”, “P.T.T.”, “physical therapist”, “physiotherapist”, “physical therapist assistant”, or any other words, letters, abbreviations, or insignia indicating that he is a physical therapist or physical therapist assistant.

Chapter 112: Section 23Q. Citation

Section 23Q. Sections twenty-three A to twenty-three P, inclusive, shall be known and may be cited as the Registered Physical Therapists Law.

Grandfather Clause:

SECTION 11.

{omit any MGL reference, then grandparenting is written only in the Acts

and will "vanish" from the MGL after the period expires}

A license as a clinical exercise physiologist may be issued without examination to an applicant who does not meet the educational requirements of section 23F1/2 of chapter 112 of the General Laws, if the applicant has a bachelor’s degree in exercise science, exercise physiology, or kinesiology and provides to the board's satisfaction that THE APPLICANT has been in paid professional practice in the field of clinical exercise physiology for five years or 10,000 hours out of the last ten years preceding the effective date of THE REGULATIONS IMPLEMENTING THIS ACT.

The provisions of this section shall expire one year following the

effective date of the IMPLEMENTING REGULATIONS

Name:	District/Address:	Date Added:
Donald F. Humason, Jr.	4th Hampden	1/21/2011
Ruth B. Balser	12th Middlesex	2/4/2011
Angelo J. Puppolo, Jr.	12th Hampden	2/4/2011
Frank I. Smizik	15th Norfolk	2/4/2011
Randy Hunt	5th Barnstable	2/3/2011
Byron Rushing	9th Suffolk	2/3/2011
Cory Atkins	14th Middlesex	1/31/2011