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SAMPLE LETTER OF SUPPORT FROM CEPS Yout Reps Name and Address Here State House Boston, MA 02133 RE: HB 2252 (An Act Relative To The Licensure of Clinical Exercise Physiologists) Dear _________________: I am a Registered Clinical Exercise Physiologist at SOMEHOW _DESCRIBE YOUR JOB TITLE AND PLACE OF EMPLOYMENT. (I AM ALSO A CONSTITUENT). I am writing to ask for your support of HB 2252 (An Act Relative To The Licensure of Clinical Exercise Physiologists), the bill filed to create a system of licensure for CEPs through the existing Allied Health Board at the Division of Professional Licensure. This bill has been reported favorably by the Joint Committee on Public Health and the Joint Committee on Health Care Financing and awaits reading on the House floor. What is a Clinical Exercise Physiologist? The Clinical Exercise Physiologist is an allied health professional who works with persons with chronic diseases and conditions in which exercise has been shown to be beneficial. The CEP performs health, physical activity, and fitness assessments, and prescribes exercise and physical activity to assist in recovery from illness, to manage disease (complementary treatment), or to prevent disease (primary and secondary prevention). The CEP works primarily in hospital, clinic, or other health-care provider settings and is qualified to work with healthy clients as well as patients who are referred by and are under the care of a licensed physician. CEPs are required to hold a Bachelor’s or Master’s Degree in Exercise Science, Exercise Physiology or Physiology. A Master’s Degree in exercise sciences, a minimum of 600 hours of supervised clinical experience and a passing score on a 4-hour written National Registry Examination administered by the American College of Sports Medicine is required to become a Registered Clinical Exercise Physiologist. Most CEPs currently practice in medical, or private settings or teach in academic institutions, In my case, I have a Bachelors degree from __________ in __________ and a Masters degree from __________ in ______________. SOMEHOW DESCRIBE OTHER CLINICAL INTERNSHIPS AND/OR WORK YOU HAVE DONE RELATED TO CEP. Who do CEPs treat? In addition to healthy clients, CEPs are trained to work with patients with chronic diseases and conditions, such as cardiovascular disease, pulmonary disease, cancer, obesity, and diabetes. The scope of practice of CEPs includes evaluation, treatment, exercise prescription, instruction and counseling of the aforementioned patients. Counseling is directed towards providing patients with self-help skills for promoting independent disease management as well as safe and effective exercise therapy. In my case, clinical work includes DESCRIBE YOUR PATIENT POPULATION AND WHAT YOU DO. Why should this bill be passed? The licensure of Clinical Exercise Physiologists (CEP) is important to the protection of the health and safety of the public, and I strongly urge you to support this legislation. As you are probably aware, there is no regulation of any persons working in the health and fitness field, and at the present time any individual can purport to be an exercise physiologist. This presents a clear and present danger to the public, which can result in injury and even death. To illustrate this risk, approximately 4-10% of all heart attacks occur during or shortly after exercise (Mittleman MA et al,N Engl J Med 1993;329(23):1677-1683; Giri et al, JAMA 1999;282(18):1731-1736). This risk of injury and death is increased substantially when the client or patient has a medical problem that can be worsened by exercise. For example, a person with heart disease treated by coronary artery angioplasty has about a 12 times greater risk of having a heart attack during exercise than a healthy person (Giri et al, JAMA 1999;282(18):17311736). In all persons, with or without coronary heart disease, it is very clear that the risk of having a heart attack during exercise is substantially elevated in persons who smoke, have high levels of cholesterol and other blood lipids (fats), are overweight, have diabetes and those who are sedentary.(Thompson PD, The Physician And Sports Medicine. 2001; 29 (4)). These conditions have become epidemic in the United States. Making the need for good supervision during exercise obvious is the fact that it is very difficult to predict in a population in advance which persons are most likely to suffer these adverse consequences during exercise (Gibbons RJ et al. J Am Coll Cardiol 1997;30(11):260-311) The risk of adverse cardiovascular events during exercise supports the need for persons with these conditions to exercise under the supervision of a person trained to recognize and respond to signs and symptoms of heart attack and other serious adverse effects (such as low blood sugar) during exercise, particularly when beginning exercise. It is clear that the risks of exercise can be reduced by the provision of appropriate exercise and cardiovascular disease risk management, and careful monitoring of signs and symptoms during exercise (American College of Sports Medicine, 2005) CEPs have the advanced training that is necessary to work with people with diverse medical conditions. In order to become registered, CEPs must have a Master’s Degree in exercise science, accumulate a minimum 600 hours of supervised clinical experience and pass a 4-hour written National Registry Examination administered by the American College of Sports Medicine, the leading professional organization for Sports Medicine organization in the world. The lack of regulation of professionals in this field means that it is up to the public to determine if they are working under the supervision of an adequately trained person. It is the “buyers beware” in the marketplace, but most persons, including health professionals, do not have adequate information on how to select a well qualified exercise professional. While this might be an acceptable situation for a consumer when, say buying a washing machine, this totally unacceptable in this case, when the result could lead to injury or death. Consider the case of a Massachusetts woman who after breaking a hip works with a personal trainer who is said to be “well trained’ to work with older people. During the course of her training, she is asked to perform some exercises that were totally inappropriate for her condition, and she falls and breaks her other hip. This woman thought she was hiring a highly trained person, but she suffered a very serious injury which could have been prevented by working with a CEP. CEPS are not Physical Therapists or Personal Trainers, although a personal trainer could be a CEP. Physical Therapists are well-trained health professionals who “focus on both preventing injuries and helping individuals recover [from injury and disability due to illness]” (American Physical Therapy Association). Personal Trainers are paraprofessionals who provide private exercise instruction. The personal trainer may or may not have any education or training or hold a certification as a personal trainer . Further, there are hundreds of organizations that provide a personal trainer certification, with the requirements for these certifications varying from requiring an individual to undergo a weekend of training to having a formal college-level coursework or a bachelor’s degree in exercise science. So, you can see that the CEP profession is distinct from these often-confused professions, and it has a unique scope of practice. (IF YOU ARE WRITING FROM OUT OF STATE, YOU CAN ADD: Licensure for CEPs in Massachusetts will lead the way for other states to follow suit, and will contribute greatly to the quality of care of many people struggling with chronic disease.) Please help by supporting HB 2252. I hope that you will support this legislation, which will do much to protect the health and safety of residents of Massachusetts. If you would like to discuss this issue further or like more information about the profession of Clinical Exercise Physiology, please feel free to contact me at EMAIL ADDRESS or PHONE NUMBER. Respectfully yours, NAME Registered Clinical Exercise Physiologist JOB TITLE STREET ADDRESS TOWN, STATE ZIP