Editor’s Note: We are pleased to present this anonymous guest submission.
The American Council on Exercise (ACE) states on its website, “ACE serves as America’s Authority on Fitness.” ACE appears to be using the National Commission for Certifying Agencies (NCCA) to accomplish this goal.
In the early 2000s, ACE, the National Strength and Conditioning Association (NSCA), the American College of Sports Medicine (ACSM) and other organizations in the fitness industry chose to become accredited by the NCCA. Since then, these organizations formed a trade association, the Coalition for the Registration of Exercise Professions (CREP), to aggressively advocate for requiring the rest of the industry to buy the NCCA credential. This would create a bottleneck of fitness trainers for consumers and employers. And it would force trainer credential providers to purchase an accreditation that some believe is inadequate for real public protection.
Where Did the Initiative Start?
In 1999, ACE’s new CEO Ken Germano stated to Club Industry that ACE’s “grand designs are similar to his.” He went on to say that “ACE is growing more aggressive in its attempts to bring health and exercise to all people.” In an effort for ACE to pursue its mission to be “America’s Authority on Fitness” he said, “We’re going to become the true leader. Not just the leader in word. We’re going to become the leader in deed.”
Germano reiterated this mission when ACE acquired NCCA accreditation. He stated,
“The American Council on Exercise is now one of only two certification organizations in the fitness industry whose programs have been accredited by the NCCA. With hundreds of fitness certifications available, we are proud to be nationally recognized for our quality programs that help protect the public against unqualified fitness professionals and unsafe and ineffective fitness instruction.”
Now that ACE had become NCCA-backed, Germano’s plan was always to get ACE to “take the initiative by driving this information to clubs, suppliers and consumers,” and to push the narrative that it is the “credible” organization for fitness information. Additionally, he felt ACE needed a powerful ally to push its initiative, and it gained one. As Germano states,
“ACE is lending its training assets to strategic alliances. For example, ACE recently joined forces with IHRSA. Since IHRSA sets standards for clubs and ACE sets standards for instructors, they make a perfect team for pushing exercise education up a notch in fitness facilities.”
IHRSA currently represents more than 8,000 club members and certainly has a big effect on the marketplace and legislation.
Another Club Industry article pointed out that the decision for ACE and other organizations to seek NCCA accreditation was a business move. The organizations involved in pushing NCCA accreditation in the early stages, such as ACE and the NSCA, feared that more clubs and organizations would start certifying. As the article pointed out, this competition would “cut into certifying agencies’ business” and “make it difficult to verify minimum levels of competency throughout the industry.” So ACE turned its attention toward marketplace reduction, also known as competitor foreclosure.
Germano laid the foundation for a competition-reduction plan in early 2002 when he complained that there were “300-plus certifying bodies out there,” and that this created a landscape that is “fragmented and confusing to club owners.”
When a Club Industry reporter then asked him whether those 300 organizations would survive in ACE’s vision of the future, his response was enlightening:
“There is more than enough room in this industry for seven, eight or even 10 organizations to provide service.”
That’s only 10 fitness certifiers out of 300 surviving. Which ones might those be? Germano highlighted, “ACE, NSCA, ACSM, and NASM.” Three of those went on to form the core of the licensure-lobbying group CREP more than 10 years later.
That same year, 2002, IHRSA put together a commission to set credentialing standards for certification companies and gym owners. The commission moved toward exclusively requiring NCCA-accredited certifications. The proposal was met with deep concerns.
Linda Pfeffer, who was president of the Aerobics and Fitness Association of America (AFAA) at the time, stated that the “so-called ‘industry-based’ initiative” and its non-inclusivity would have “a negative impact on employment opportunities for fitness professionals and competition in the industry.” She even hinted at antitrust concerns when she mentioned “the legal implications of a select group of the largest competitive (certification) companies banding together and acting in concert to impose a rigid system on the fitness industry as a whole.”
And yet, as Athletic Business noted in 2004,
“… proponents of accreditation are not concerned about (having) a ‘negative impact on employment opportunities for fitness professionals.’”
Quite the opposite, in fact. As Graham Melstrand of ACE argued,
“If employers didn’t accept certifications of questionable quality, that route would have been cut off long ago. Until people’s ability to be employed is affected, there isn’t going to be positive change.”
What might Melstrand have meant by “that route”? He provided more clarity here:
“If things do move in the direction of licensure, legislators will likely look at the processes in place rather than creating a whole new board exam … One of the first questions they’ll ask is whether there is already a group of accredited credentials in the field.”
IHRSA claimed its certification guidelines were a “recommendation,” but Angie Wickstrom, vice president of operations for the National Federation of Professional Trainers (NFPT), said, “IHRSA’s stance is a little disingenuous. Unfortunately, what happens is that IHRSA recommends things to its member clubs, and each club in turn carves it in stone.”
By 2012, Mike Bannan of the IDEA fitness association stated that his organization had verified around 154 certification and education providers through their relationships and its exercise professional registry, Fitness Connect. That’s half the figure that ACE’s Germano had complained of in 2002. The ACE-IHRSA alliance and its plan to require exclusively NCCA-accredited fitness certifications certainly seemed to be working. The number of competitors in fitness-certifying had been cut in half over the past decade.
NSF Fitness Facility Certification
In 2008, ACE and IHRSA joined a NSF standards committee to develop and approve fitness facility operational standards. Germano had left ACE at this point, so ACE Vice President Graham Melstrand grabbed the torch and began pushing NCCA accreditation on the industry. And the committee moved toward requiring all facilities to exclusively employ trainers with NCCA-accredited fitness certifications.
Graham Melstrand of ACE.
By 2010, David Herbert, a non-voting member on the committee, had raised concerns regarding the exclusive requirement of NCCA-accredited fitness certifications. Instead, Herbert suggested also accepting additional accrediting bodies.
Melstrand and ACE did not approve of Herbert’s proposal to accept accreditation from the U.S. Department of Education, Council for Higher Education Accreditation or other accrediting bodies. Herbert’s proposal to accept credentials accredited by educational organizations was probably a matter of contention for ACE since the ACE personal training certification prerequisites do not require education or training. The ACE business model seems to be only selling textbooks and administering written exams. That would explain Melstrand and ACE’s aggressive support of NSF exclusively accepting NCCA accreditation. Melstrand alleged, “the standard could be beneficial not just for members but for the referring community — physical therapists, physicians and dieticians, to name a few.”
The NSF fitness facility standard was passed in 2011 and adopted in 2012. In 2014, the American National Standards Institute (ANSI) directed NSF International to withdraw the standard. Herbert had petitioned ANSI to look into the matter. Club Industry reported an apparent conflict of interest:
“At issue was the representation of the NSF joint committee and its affiliation with the National Commission for Certifying Agencies (NCCA). In the audit, ANSI determined that 14 of the 21 NSF joint committee members were affiliated with or had some affiliation with the NCCA.”
Furthermore, the letter from ANSI stated:
“The (ANSI executive standards council) is very troubled by the record, despite NSF’s corrective action plan, and reminds NSF of its obligation, as an ANSI Audited Designator, to ensure the integrity of its ANSI standards development process in all instances.”
ANSI would not even let the NSF reinstate its facility certification proposal with changes made. Jay Del Vecchio, owner of World Instructor Training Schools (W.I.T.S.), said of the ruling:
“The recent ANSI-NSF ruling to not accept NCCA as a standalone standard of acceptance for the quality of fitness certifications says volumes. A certification of merit includes serious higher learning components to be valid for a health occupation. A psychometrically reviewed written exam is not enough.”
CREP Trade Association
In 2013, led by ACE’s Melstrand, the CREP Coalition was formed. It then launched the USREPS registry of exercise professionals with exclusively NCCA-accredited certifications in 2014. CREP member ACE stated that the industry must,
“Establish strict standards based on NCCA-accredited certification for well-qualified health and fitness professionals, up to and including registry and/or licensure, so the profession may be recognized and trusted as part of the healthcare continuum.”
CREP also echoed this objective.
The plan to reduce the scope of competition in fitness-certifying is clear. Melstrand, then CREP’s president, stated the following on the launch:
“Today is a big step towards the inevitable inclusion of highly qualified exercise professionals into the healthcare continuum … Recognition of exercise professionals as health providers is a logical progression due to their unique expertise in the areas of disease prevention and wellness promotion. Until now, truly capable professionals have been inhibited by concerns regarding the qualifications of individuals representing themselves as exercise professionals, and the lack of an easily accessible mechanism to identify and verify professionals with current NCCA-accredited certification programs. That barrier is gone, which we expect will help exercise professionals gain the respect and recognition they deserve.”
CREP and its member organizations, such as ACE, have advocated and lobbied legislators and regulators to make only NCCA-accredited exercise professionals legal. All other exercise professionals could face severe penalties, including jail time.
In 2015, at the height of the Washington, D.C., battles over the regulation of fitness professionals, the Washington Post stated that Melstrand “has been among the few voicing strong support for the District’s effort.” Melstrand at this point represented both CREP and ACE.
Melstrand even stated, “First and foremost, the purpose of the law is to enhance consumer protection for the residents of the District of Columbia.” He went on to say, “industry estimates show 40 percent of all trainers have no gym affiliation, meaning they are accountable to no one even though they are often in positions of authority with clients.”
The new D.C. licensure law seemed to be the opportune time for ACE and Melstrand, with CREP, to start to realize their early market reduction plan. CREP also pushed regulation language to D.C. and the D.C. physical therapy board to grant CREP and its members regulatory authority over the fitness industry.
The NCCA “Special Relationship”
Richard Morrison wrote about licensing in the health-care field in the early 90s in “Web of Affiliation,” a piece for the Council on Licensure, Enforcement and Regulation (CLEAR).
When recommendations were made against licensing many potential health-care providers, Morrison stated,
“In response to recommendations that states carefully evaluate the need for new occupational regulation, more than a dozen states now have formal sunrise review evaluations using criteria derived from those suggested by USDHEW. The preeminent criterion is that licensure be reserved for those professions whose practices place the public at a clear risk for harm. Yet professions (interior designers, massage therapists, recreational therapists) continue to be licensed not so much on that basis as on their persistence and the size of their state-level political action funding. The National Commission of Health Certifying Agencies (now a part of the National Organization for Competency Assurance [NOCA]) was formed in response to the last recommendation, but the existence of private certification has not stemmed the growth of licensure of government certification programs for allied health occupations. In fact, NOCA provides an arena for private certification principals to learn from one another the strategies and tactics of lobbying for state licensure.”
In other words, through licensure, the NCCA helps its member organizations learn how to push for state regulatory processes that ultimately create monopolies. (NOCA is a previous name for ICE, NCCA’s parent organization.)
CREP certainly seems to confirm Morrison’s statement. And the NCCA, CREP and CREP’s members all overlap in personnel.
Besides representatives of organizations that offer NCCA-accredited certifications, CREP even includes a non-voting member of NCCA on its board. The USREPS website states,
“The two Advisory Directors represent elected individuals from the Commission for the Accreditation of Exercise Science (CoAES) which accredits two-year, four-year and graduate level programs in Exercise Science and the National Commission for Certifying Agencies (NCCA), which works to ensure the health, welfare, and safety of the public through the accreditation of a variety of certification programs/organizations that assess professional competence.”
Todd Galati, an ACE official, sits on the NCCA commission. ACE’s Melstrand serves on the CoAES board. ACE donates to the NCCA and CoAES. As pointed out earlier, the NSF fitness facilities standards were heavily stacked with NCCA-affiliated members. The Medical Fitness Association (MFA) is now partnering with CREP and ACE on facility certification after the repeal of the NSF standard. ACE was involved with MFA in writing professionals guidelines as early as 2002. Melstrand sits on MFA’s Facility Certification Committee.
Trademark Suit Opens More ACE/NCCA Questions
In 2015, Dr. Mike Jones filed a trademark lawsuit against ACE over the use of the certification, “Medical Exercise Specialist.” ACE had a business relationship with Jones in the late 90s until ACE launched a competing certification, the “Clinical Exercise Specialist” in 1999. ACE then changed the certification’s name from “Clinical Exercise Specialist” to “Advanced Health Fitness Specialist” to “Medical Exercise Specialist.” Jones alleged that this term, Medical Exercise Specialist, infringed upon his trademark as he’d been using that term for years, and had even been a continuing education provider for ACE decades earlier.
When ACE changed the name from AHFS to MES, it also dramatically changed the requirements, textbook, and other aspects of the certification. In other words, “MES” could more accurately be called a new credential than a new name. Yet somehow, the certification’s NCCA accreditation was continued. And ACE rolled over the individuals who had taken the original CES exam. So their credentials changed names twice, and they were not required to sit for the new exams, despite the new curriculum, exam and requirements.
The judge during Jones’ lawsuit against ACE wrote,
“(ACE official Cedric) Bryant discusses how when ACE was using the name ‘ACE Clinical Exercise Specialist Certification Program,’ it received calls and email stating that the use of ‘clinical’ was not appropriate and that ACE therefore initiated the Role Delineation Study, which led to the use of the term ‘Medical Exercise Specialist.’ Dkt. 28-7 ¶ 26. ACE relies on paragraph 26 to show that ACE ‘received feedback that the phrase Advanced Health and Fitness Specialist did not sufficiently communicate what the professional does.”
In December of 2017, Phillip Godfrey and Donald Alley of Health Care Fitness Integrations LLC filed a formal complaint with the NCCA. Godfrey and Alley had questions for the NCCA regarding alleged potential NCCA violations with the rollover of NCCA accreditation from ACE’s CES to AHFS, and finally to the MES certification. Some of the complaint’s main points pertained to ACE’s front-to-back content and scope-of-knowledge changes, the fact that ACE’s requirements to sit for the exam changed from not requiring a degree to requiring a degree, and the new requirement of an additional 200 hours of work-related experience. And the complaint questioned whether the NCCA was aware of the trademark infringement case.
The NCCA investigation committee swiftly responded with a letter stating that ACE conducted a role-delineation study in 2013 on the AHFS certification. Then in 2014, ACE submitted the results to the NCCA. In 2015, ACE sent the NCCA a letter stating its intentions of using the MES credential title. NCCA’s response thus opened up many more questions.
Any layperson can see that requiring a degree versus not requiring one and adding 200 more hours of experience constitute quite a step up from the previous credential. Such a step clearly would be in violation of NCCA standards.
ACE’s role-delineation study then comes into question. A federal judge said ACE’s activities around its MES certification were “disingenuous.” Additionally, did ACE not conduct a role-delineation study between the CES and AHFS? One would think the results would have told ACE not to use the AHFS title. If ACE admitted the credential title and scope of practice did not match for the CES or AHFS, should the credentials even have been awarded NCCA accreditation to begin with?
The operations of the NCCA and the organization’s ability to truly have the public interest at heart are questionable given the evidence and a careful study of its standards. First, the NCCA does not check content and therefore could not verify if ACE actually improved its old program or created a new one.
Secondly, the NCCA does not conduct its own role-delineation studies to be a true third party evaluator. How could NCCA evaluate whether ACE was in compliance if ACE did the role-delineation study in-house?
Third, if there are potential trademark-infringement issues, as the Jones trial implies, then the NCCA must not take into account whether the organization can legally use the credential mark.
And finally, the NCCA apparently does not require education or skill-based evaluation of certifications it accredits. The ACE fitness trainer certifications state that an individual is certified to “design and implement” fitness programs. ACE does not have any means of measuring how an individual “implements” a program. And the NCCA only evaluates a written exam for the ACE personal trainer certification. Again, this certification has no education and training or hands-on testing. So does the NCCA accredit certifications without any means of evaluating practical ability?
Conclusion
There is ample evidence and history of ACE, IHRSA, CREP and the NCCA cooperating to advance a collective agenda. This relationship could be considered an antitrust issue. Questions remain.
Did ACE see Dr. Jones’ MES program in the late 90s and copycat the content to launch the CES (which eventually went on to take the MES name)? Did ACE use this credential to launch its initiatives for insurance reimbursement and market reduction? Is the NCCA a public interest accreditor or simply a place where big industry pockets can learn to lobby for market control? Do ACE and other CREP members truly act as nonprofits or do they only pursue their business interests? The public needs to investigate these activities further and scrutinize those who claim to be “America’s Authority on Fitness.”