CEO Profile: Paul Grace, MS, CAE

An appointment to a licensing board by Governor Michael Dukakis of Massachusetts in 1982 sparked the credentialing career of Paul Grace, MS, CAE, eventually leading him to the helm of the National Board for the Certification of Occupational Therapists (NBCOT) as its president/CEO. It is a path Grace says many of his colleagues in credentialing management take, a field he calls the “accidental profession.”

Throughout his more than 25-year career, Grace has proved to be a dedicated volunteer and thought leader for the community, serving as president of the Institute for Credentialing Excellence (ICE) in 1992 and again for a two-year term in 2008-2010. He served as the chair of the National Commission for Certifying Agencies from 1990-1992 and recently co-chaired the ICE work group charged with completing a comprehensive review and revision of the Standards for the Accreditation of Credentialing Programs for the National Commission for Certifying Agencies, ICE’s accrediting arm, in 2013-2014.

Drawing on lessons learned from his mentor, Dennis Faulk, known as an influential ambassador for the growth of the profession, Grace leads a team of 36 at NBCOT, a certifying body offering two credentials and certifying more than 190,000 occupational therapy certificants

ICE Digest asked Grace to share his perspectives on the challenges and opportunities the industry faces and his advice for other leaders or members aspiring to become CEOs.


For the other practitioners finding their way to the CEO position in this “accidental profession” of credentialing management, what advice do you have?

The real challenge of moving from a volunteer to a staff leadership position is to remember why you are there in that role at that time. Your role as the head of a certifying organization is to promote reliance on the credential. You have to know who your public is and keep focused on the differences between the role of the credentialing organization and that of the membership organization.

What do you believe are some of the most pressing challenges certifying organizations face today?

There are a few challenges I believe are the most important for us to address right now. Many boards do not consider the value proposition of the program they offer enough, even though the literature shows us it is a key ingredient to success. Not advancing the value proposition to customers effectively is an ongoing element of our programs and needs to stay as a priority. Governance is another significant challenge we face. The governance models certification organizations use are quite old and don’t permit us to be as nimble as we need to be. We talk a lot about the importance of public members in our governance, but I don’t see many organizations effectively using their one public member to advocate for the credential.

I also see cybersecurity as an important challenge. As certifying agencies, we need to be thinking about data integrity and protecting the information we collect from candidates from their demographics to their credit card numbers. Another challenge I see is staying aware of what is coming out of Washington, D.C., in terms of changes in regulation, FTC guidelines and compliance with ADA, for example. This would be an issue for ICE to focus on, bringing these issues to the table and providing a forum to discuss strategies to mitigate them.

How is your organization, NBCOT, handling these challenges?

First, we continually review our value proposition by focusing on three main components: What are the attributes of the products we offer? What is the image of our products to the organization and to the customers? And what is the relationship we want to have with our customers? We also operate under the premise of answering the question, “how can we fail and how do we avoid failure?”

One strategy we use is to ensure we have adequate discussion and participation in our decision-making process. For NBCOT, this means going to the public — to our certificants — for comment and feedback on significant decisions. In fact, our bylaws require us to seek public comment on major decisions. Our mission is to have evidence-based standards for certification, and a hallmark of evidence is collecting information and analyzing it. Giving certificants the opportunity to comment and criticize builds trust. It is hard to complain later when you didn’t participate when you had the opportunity. 

Besides these challenges, what other topics do you hope to hear the ICE community addressing at future events?

Going back to governance, I can see a case where an individual gets disenfranchised because of a decision a certification board makes. This thought is quite striking. I would also like to hear more conversations around the financing of the enterprise. When does our reliance on certification fees as the primary revenue source begin to strangle you as an organization?

What are some of the opportunities certifying agencies should be aware of and preparing for coming down the pipeline?

The role of technology in assessment is something we are exploring, and I believe it is a topic area in which ICE can take a leadership role. I don’t necessarily mean technology such as computer-based testing, but using emerging technology from other industries that help apply scenario planning to assessment of knowledge and practice or the technology we have available now such as digital badging. The whole issue of social media is another place for credentialing bodies to take advantage of opportunities, not only to educate but to inform. NBCOT has a robust social media presence, but it is an area in which we are constantly learning and an area in which I hope to see ICE focus in the future.

What advice do you have for other CEOs given your experience?

Never let someone believe that you are not reliable. If people believe you are not reliable they will doubt the organization’s reliability also. If we want to build a reliance on the credential, we can’t make it difficult for the public to trust us or the organization we serve. It is also critical that CEOs lead the organization to produce results and provide rational for the decisions made.



About the National Board for the Certification of Occupational Therapists


Serving the public interest by advancing client care and professional practice through evidence-based certification standards and the validation of knowledge essential for effective practice in occupational therapy.


Certified occupational therapy professionals providing effective evidence-based services across all areas of practice worldwide.



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