DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
BUREAU OF PROFESSIONAL LICENSING  
PUBLIC HEALTH CODE—GENERAL RULES  
(By authority conferred on the director of the department of licensing and regulatory  
affairs by sections 16145, 16194, 16201, and 16221(e)(iv)(B) of the public health code,  
1978 PA 368, MCL 333.16145, 333.16194, 333.16201, and 333.16221, and Executive  
Reorganization Order Nos. 1991-9, 1996-2, 2003-1, and 2011-4, MCL 338.3501,  
445.2001, 445.2011, and 445.2030)  
R 338.7001 Definitions.  
Rule 1. As used in these rules:  
(a) "Code" means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.  
(b) "Department" means the department of licensing and regulatory affairs.  
(c) “Implicit bias” means an attitude or internalized stereotype that affects an  
individual’s perception, action, or decision making in an unconscious manner and often  
contributes to unequal treatment of people based on race, ethnicity, nationality, gender,  
gender identity, sexual orientation, religion, socioeconomic status, age, disability, or  
other characteristic.  
(d) “Issue date” means the date that the initial license was granted to the licensee by the  
department.  
(e) “Limitation” means that term as defined in section 16106(4) of the code, MCL  
333.16106.  
(f) "Stark Law" means section 1877 of part E of title XVIII of the social security act, 42  
USC 1395nn.  
History: 1979 AC; 2009 AACS; 2014 AACS; 2017 AACS; 2020 AACS; 2021 MR 10, Eff. June 1, 2021.  
R 338.7001a Biennial license and registration renewal; expiration.  
Rule 1a. (1) The following licenses and registrations expire biennially and must be  
renewed every 2 years on or before the date indicated:  
Acupuncture  
Audiology  
Chiropractic  
Dental Therapy  
Marriage and family therapy  
Midwifery  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
6/1  
Nursing  
Nursing home administrators  
Occupational therapy  
Optometry  
Pharmacy  
Physical therapy  
Issue date  
Issue date  
8/1  
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Physician's assistants  
Psychology  
Respiratory care  
Sanitarians  
Issue date  
Issue date  
1/1  
Issue date  
Issue date  
Speech-language pathology  
(2) A license or registration having a limitation may be renewed for a term less than 2  
years.  
History: 1979 AC; 2009 AACS; 2014 AACS; 2017 AACS; 2020 AACS; 2021 MR 10, Eff. June 1, 2021.  
R 338.7002 Triennial license or registration renewal; expiration.  
Rule 2. (1) The following licenses and registrations expire triennially and must be  
renewed every 3 years on or before the date indicated:  
Athletic trainer  
Counseling  
Issue date  
6/1  
Dentistry  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
5/1  
Dental Assistant  
Dental Hygienist  
Massage therapy  
Medicine  
Osteopathic medicine and surgery  
Podiatric medicine and surgery  
Social work  
Veterinary medicine  
Issue date  
(2) A license having a limitation may be renewed for a term less than 3 years.  
History: 1979 AC; 2009 AACS; 2014 AACS; 2017 AACS; 2020 AACS; 2021 MR 10, Eff. June 1, 2021.  
R 338.7002a Quadrennial license renewal; expiration.  
Rule 2a. (1) The following license expires quadrennially and must be renewed every 4  
years on or before the date indicated:  
Behavior Analysts  
Issue date  
(2) A license having a limitation may be renewed for a term less than 4 years.  
History: 2020 AACS.  
R 338.7002b Minimum English language standard.  
Rule 2b. (1) Pursuant to section 16174(1)(d) of the code, MCL 333.16174, an applicant  
seeking licensure or registration must demonstrate a working knowledge of the English  
language under the minimum standards established by the department.  
(2) To demonstrate a working knowledge of the English language, the applicant must  
establish that he or she meets 1 of the following:  
(a) The applicant’s health professional educational program was taught in English.  
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(b) The applicant supplies transcripts establishing that he or she earned not less than 60  
college level credits from an English-speaking undergraduate or graduate school.  
(c) The applicant’s credentials and English proficiency have been evaluated and  
determined to be equivalent to the credentials required in this state by a board-approved  
credentialing agency.  
(d) The applicant obtained a passing score of 650 or higher on the Examination for the  
Certificate of Competency in English (ECCE) test developed by Michigan Language  
Assessment, as demonstrated by a certificate of competency or certificate of competency  
with honors.  
(e) The applicant obtained a passing score of 650 or higher on the Examination for the  
Certificate of Proficiency in English (ECPE) test developed by Michigan Language  
Assessment, as demonstrated by a certificate of proficiency or certificate of proficiency  
with honors.  
(f) The applicant obtained a total score of not less than 6.5 on the International English  
Language Testing System (IELTS) Academic test.  
(g) The applicant obtained an overall score of not less than 55 on the 4-skill Michigan  
English Test (MET) developed by Michigan Language Assessment.  
(h) The applicant obtained an overall score of not less than 300 on the Occupational  
English Test (OET).  
(i) The applicant obtained a total score of not less than 80 on the Test of English as a  
Foreign Language Internet-Based Test (TOEFL-IBT) administered by the Educational  
Testing Service.  
History: 2020 AACS; 2021 MR 10, Eff. June 1, 2021.  
R 338.7003 "Stark Law" revision; adoption by reference.  
Rule 3. (1) Under section 16221(e)(iv)(B) of the code, MCL 333.16221(e)(iv)(B), the  
department has taken notice that the Stark Law was revised effective December 30, 2010.  
The department also takes notice the regulations promulgated under the Stark Law, 42  
CFR 411.350 to 411.389, were revised effective November 16, 2015. The department  
finds that the revisions to both the Stark Law and regulations under the Stark Law pertain  
to referrals by physicians for designated health services and continues to protect the  
public from inappropriate referrals by physicians. Therefore, the department adopts by  
reference the Stark Law, as revised December 30, 2010, and 42 CFR 411.350 to 411.389,  
as revised November 16, 2015.  
(2) All federal regulations noted in subrule (1) of this rule are available at no cost at  
www.access.gpo.gov. These regulations also are available for inspection and distribution  
at cost from the Bureau of Professional Licensing, Michigan Department Licensing and  
Regulatory Affairs, 611 West Ottawa, P.O. Box 30670, Lansing, MI 48909.  
History: 2009 AACS; 2017 AACS.  
R 338.7004 Implicit bias training standards.  
Rule 4. (1) Beginning 1 year after promulgation of this rule, an applicant for licensure  
or registration under article 15 of the code, MCL 333.16101 to 333.18838, except those  
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seeking to be licensed under part 188 of the code, MCL 333.18801 to 333.18838, shall  
have completed a minimum of 2 hours of implicit bias training within the 5 years  
immediately preceding issuance of the license or registration.  
(2) Beginning 1 year after promulgation of this rule and for every renewal cycle  
thereafter, in addition to completing any continuing education required for renewal, an  
applicant for license or registration renewal under article 15 of the code, MCL 333.16101  
to 333.18838, except those licensed under part 188 of the code, MCL 333.18801 to  
333.18838, shall have completed a minimum of 1 hour of implicit bias training for each  
year of the applicant’s license or registration cycle.  
(3) The implicit bias training must be related to reducing barriers and disparities in  
access to and delivery of health care services and meet all of the following requirements:  
(a) Training content must include, but is not limited to, 1 or more of the following  
topics:  
(i) Information on implicit bias, equitable access to health care, serving a diverse  
population, diversity and inclusion initiatives, and cultural sensitivity.  
(ii) Strategies to remedy the negative impact of implicit bias by recognizing and  
understanding how it impacts perception, judgment, and actions that may result in  
inequitable decision making, failure to effectively communicate, and result in barriers  
and disparities in the access to and delivery of health care services.  
(iii) The historical basis and present consequences of implicit biases based on an  
individual’s characteristics.  
(iv) Discussion of current research on implicit bias in the access to and delivery of  
health care services.  
(b) Training must include strategies to reduce disparities in access to and delivery of  
health care services and the administration of pre- and post-test implicit bias assessments.  
(c) Acceptable sponsors of this training include any of the following:  
(i) Training offered by a nationally-recognized or state-recognized health-related  
organization.  
(ii) Training offered by, or in conjunction with, a state or federal agency.  
(iii) Training obtained in an educational program that has been approved by any  
board created under article 15 of the code, MCL 333.16101 to 333.18838, except under  
part 188 of the code, MCL 333.18801 to 333.18838, for initial licensure or registration or  
for the accumulation of continuing education credits.  
(iv) Training offered by an accredited college or university.  
(v) An organization specializing in diversity, equity, and inclusion issues.  
(d) Acceptable modalities of training include any of the following:  
(i) A teleconference or webinar that permits live synchronous interaction.  
(ii) A live presentation.  
(iii) Interactive online instruction.  
(4) Submission of an application for licensure, registration, or renewal constitutes an  
applicant’s certificate of compliance with the requirements of this rule. A licensee or  
registrant shall retain documentation of meeting the requirements of this rule for a period  
of 6 years from the date of applying for licensure, registration, or renewal. The  
department may select and audit a sample of a licensees or registrants and request  
documentation of proof of compliance with this rule. If audited by the department, a  
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licensee or registrant shall provide the proof of completion of training, including either of  
the following:  
(a) A completion certificate issued by the training program that includes the date of  
the training, the program sponsor’s name, the title of the program, and licensee’s or  
registrant’s name.  
(b) A self-attestation by the licensee or registrant that includes the date of the training,  
the program sponsor’s name, the title of the program, and licensee’s or registrant’s name.  
History: 2020 AACS; 2021 MR 10, Eff. June 1, 2021.  
R 338.7005 Rescinded.  
History: 2014 AACS; 2019 AACS.  
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