Wisconsin Clinical Exercise Physiology Licensure Effort WISCPHR Committee members: Lisa Wenzel: lwenzel@meriter.com Cindy Ostrem: costrem@vmh.org Heather Grant: hgrant2@uwhealth.org Bonnie Anderson: banderson@vmh.org Nicole Meyer: nmeyer@uwhealth.org Chad Johnson: Johnson.Chad@lakeviewmedical.org Kenneth Ecker: kenneth.ecker@uwrf.edu A Few Housekeeping Items Webcast will be muted during the presentation. The presentation will be un muted at the end to allow for questions. Please use the Chat feature (left side of screen). To use Chat feature: 1. Click on Lisa Wenzel on left side of screen 2. Click the arrow next to Lisa Wenzel 3. Click on drop down and locate chat 4. Type your question to be answered at the end of the talk Slides/documents are located on the WISCPHR site Reimbursement/Legislative tab. Today s Webcast is being recorded and available for viewing. 1
W E L C O M E! 1. Recruit and Train you as CEP Advocates. 2. Understand the basic steps of introducing a bill. 3. Learn how to identify legislators in you district. 4. Identify tools to assist with contact of legislators. 5. Teach you how to canvass support for licensure. Professional Benefits While this effort is to benefit the PATIENT, our profession also receives fringe benefits : A defined Scope of Practice that is recognized and expected by employers. Prevention of unqualified individuals from representing themselves as CEPs. Recognition as a billable provider. All of the above result in enhanced marketability and job security! 2
Benefits of Licensure P A T I E N T S A F E T Y Currently in WI, Clinical Exercise Physiology is an unregulated profession. PT, OT, RT, AT and speech therapy require licensure. CEP is the only one of the therapies that does not require licensure. Lack of standardization in exercise related certifications has created confusion and caused a watering down of the profession. (there may be as many as 250 different exercise certifications offered by 75 different organizations!) Licensure Criteria: Who Qualifies? Licensed CEP will be required to: Hold a Masters in exercise physiology or related field Complete 600 hours of clinical experience Obtain RCEP certification Grandfather Clause: Bachelors in CEP field for 5 years or 10,000 hours in the last 10 years. Bachelors with CES or RCEP and in CEP field for 1 year or 2,000 hours over last 5 years. 3
Current Status of Licensure Senator Jennifer Shilling (D) is a sponsor Representative Lee Nerison (R) is a sponsor Licensure bill is in the final drafting stages Bill Introduction: Spring of 2015 (anticipated) Tentative Canvassing Timeline: December 2014: Training of CEP Advocates January May 2015: Active Campaigning Spring 2015 Introduction of Licensure bill Legislation in Wisconsin You can make a difference! 4
Legislation: The act or process of making or enacting law. Who has the power to affect legislation? You have the power! Each one of us has the power to affect legislation! Democracy is not a spectator sport. So, what are the steps involved in a bill becoming a law? First there has to be an idea for a bill. One or two members of Congress are identified who are willing to play a leadership role in supporting the issue. Senator Jennifer Schilling Representative Lee Nerison Bill is drafted The bill is introduced 5
So, what are the steps involved in a bill becoming a law? The bill is referred to a committee Public hearings are held The committee decides what to recommend to the Senate or Assembly Joint finance committee Floor Action The bill may pass through the Assembly or Senate at the same time. Often, it will start in one house and if passed, move to the next house. Sent to the governor So, what are the steps involved in a bill becoming a law? Throughout this whole process, we are seeking co sponsors for our bill. As advocates, we can aid in the passage of our bill during each step of this process. 6
Wisconsin Legislature Senate 33 Senators Assembly 99 Representatives As elected officials, their job is to represent the interests of people in their districts. We have the right and the responsibility to raise issues of concern. Remember They are working for us!!! Senate Districts 33 7
Assembly Districts 99 I want to help, but where do I start? It is important to contact BOTH your State of Wisconsin Representative and Senator Start by determining who your Representative and Senator is http://legis.wisconsin.gov/pages/waml.aspx Enter your address Make note of contact information (phone #, e mail, local office) Customize the Clinical Exercise Physiologist Licensure Summary document Consider looking for any political connections 8
Clinical Exercise Physiologist Licensure Summary Document How to Customize Change to your contact info! The first phone call Refer to Guidelines, Talking Points and E mail Templates Phone call best way to make the initial contact Introduce yourself and ask to speak with the Representative, Senator, or the legislative assistant for health issues Explain what a CEP does State that Senator Jennifer Schilling and Representative Nerison will be introducing a bill to obtain licensure for CEPs. You are calling to ask for the Representative s (or Senator s) support of this bill. 9
The first phone call Explain why licensure for CEPs is needed Focus should be patient safety Can also highlight transparency of services, professional integrity, and access to healthcare Ask Do you have any questions? Will the senator (or representative) support this bill as a cosponsor? Can we set up an appointment to visit with you (or Representative/Senator) in person? Can I send you an e mail for follow up? Ask for legislative assistant s e mail Summary e mail after first phone call Refer to e mail templates Send e mail to summarize the initial phone call, attach CEP Licensure Summary document and signatures of support, ask for support and cosponsorship of the bill. Confirm date/time of in person meeting 10
In Person Visit Refer to Guidelines, Talking Points, and E mail Templates document for the visit (in person visit section) In many cases you will meet with a legislative assistant, but always ask if the legislator is available. Stay positive and show confidence Remember you are the expert on this issue. Provide a copy of the CEP Licensure Summary Document Have a Firm ASK at the end: Can we count on your support? If not, why? Send a follow up e mail (refer to template) Role Play Exercise 11
Answering Tough Questions As much as we prepare, questions that we didn t anticipate might come up. Refer to CEP Licensure Summary Document Quick Facts for Licensure Justification CEP Licensure Justification Question and Answer It s okay to say you don t know. Just follow up with the Licensure Committee (e mail) and get back to them. Sample Questions Q: How do CEPs differ from Physical Therapists? A: CEPs concentrate on metabolic and pathologic (rather than orthopedic or musculoskeletal) conditions and the beneficial effects of cardiovascular conditioning, generalized muscle strengthening and flexibility. Physical Therapists primarily treat patients with musculoskeletal ailments using strengthening, ROM and flexibility exercises. It is important to realize that each discipline compliments the other without infringing upon the scope of practice of either profession. 12
Sample Question Q: Why Should CEPs be licensed? A: Clinical Exercise Physiologists have been working in Cardiac and Pulmonary Rehabilitation programs since the 1970 s. In 2010, the US Department of Labor added an Occupational Code for the Exercise Physiologist. In 2011 a code for the CEP was added to the taxonomy for the National Provider Identifier (NPI). The last 20 years have seen the emergence of CEPs in pulmonary rehab, obesity clinics, and diabetes centers, and in rehabilitation settings. Many CEPs are working in clinical settings. The citizens of Wisconsin deserve to know these professionals meet clinical requirements of care. Sample Question Q: Why should I support more regulation for a profession? Don t hospitals prevent unqualified people from working as a CEP? A: Unfortunately, hospitals and clinics are not always acting as an adequate gate keeper WISCPHR recently survey cardiac and pulmonary rehab programs. 20 of 44 managers reported that they have staff that do not meet the recommended requirements or have adequate ACSM certifications Only 61% of managers stated that their organization requires a BS or MS in an exercise field. At least one third of hospitals/clinics are NOT acting as a gate keeper. 13
Sample Question Q: Why is Licensure of CEPs Needed? A: Licensure is needed to reduce the potential for public harm from therapeutic exercise in a clinical setting. The risk of serious injury or death during exercise is not trivial in persons with known or at risk of developing cardiovascular diseases. About 4 10% of all myocardial infarctions occur during or following vigorous exercise. The CEP is trained to maximize safety of the participant during exercise, by providing appropriate pre exercise screening and evaluation and appropriate monitoring of the patient during and following exercise. Licensure ensures that those calling themselves CEPs meet legal standards for education, skill, and experience. I ve called and I ve visited. Now what? Following any contact, please send follow up e mail. Inform CEP Licensure committee at the following e mail: wieplicensure@gmail.com Date of contact, who you talked to, outcome Continue to put pressure on the Representative and Senator to be a co sponsor. If they decline to co sponsor, find out why and report reasons to CEP Licensure committee for strategy. These strategies will be posted to the WISCPHR website in a Q&A format. 14
I ve called and I ve visited. Now what? The Representative or Senator may be noncommittal. It s our job to convince them. Provide support signatures. Get more people involved (medical director, hospital leadership, all of your colleagues). Find connections in your community. CEP Advocate E mail G mail Account: wieplicensure@gmail.com Use this e mail site for questions, concerns or comments as well as for support as you campaign for CEP licensure. 15
Thank you for your support of this important effort! Questions? 16