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 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. (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) "Stark Law" means section 1877 of part E of title XVIII of the social security act, 42  
USC 1395nn.  
(2) Terms defined in the code have the same meanings when used in these rules.  
History: 1979 AC; 2009 AACS; 2014 AACS; 2017 AACS; 2020 AACS; 2021 AACS; 2023 AACS.  
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  
Nursing  
Nursing home administrators  
Occupational therapy  
Optometry  
Pharmacy  
Psychology  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
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.  
Page 1  
History: 1979 AC; 2009 AACS; 2014 AACS; 2017 AACS; 2020 AACS; 2021 AACS; 2022 AACS; 2024  
MR 10, May 16, 2024.  
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  
Dentistry  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Dental Assistant  
Dental Hygienist  
Genetic Counseling  
Massage therapy  
Medicine  
Osteopathic medicine and surgery  
Podiatric medicine and surgery  
Social work  
Veterinary medicine  
(2) The following licenses issued or renewed on or after the effective date of these rules  
expire triennially and must be renewed every 3 years on or before the date indicated:  
Marriage and family therapy  
Physician's assistants  
Respiratory care  
Issue date  
Issue date  
Issue date  
(3) The following licenses issued or renewed on or after the effective date of these rules  
and on or after the effective date of the applicable profession’s next rules revision expire  
triennially and must be renewed every 3 years on or before the date indicated:  
Midwifery  
Physical Therapy  
Sanitarians  
Issue date  
Issue date  
Issue date  
(4) A license or registration 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 AACS; 2022 AACS; 2023  
AACS; 2024 MR 10, May 16, 2024.  
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.  
Page 2  
R 338.7002b Minimum English language standard.  
Rule 2b. (1) Under section 16174(1)(d) of the code, MCL 333.16174, an applicant  
seeking licensure, registration, relicensure, if lapsed for more than 3 years, or  
reregistration, if lapsed for more than 3 years, shall 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 shall  
establish that the applicant meets 1 of the following:  
(a) The applicant’s health professional educational program was taught in English.  
(b) The applicant supplies transcripts establishing that the applicant 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 an overall score of not less than 176 overall and 185  
speaking on the Cambridge English (B2 First, C1 Advanced, or C2 Proficiency)  
Examination.  
(e) 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.  
(f) 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.  
(g) The applicant obtained a total score of not less than 6.5 on the International English  
Language Testing System (IELTS) Academic test within 2 years of the date of  
application.  
(h) The applicant obtained an overall score of not less than 55 on the 4-skill Michigan  
English Test (MET) developed by Michigan Language Assessment.  
(i) The applicant obtained an overall score of not less than 300 on the Occupational  
English Test (OET).  
(j) The applicant obtained an overall score of not less than 55 and not less than 50 on  
any section of the Pearson PTE Academic Examination.  
(k) 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 within 2 years of the date of application.  
(l) The applicant obtained a score of not less than 725 on the reading and listening  
section, not less than 150 on the writing section, and not less than 160 on the speaking  
section of the Test of English for International Communication (TOEIC) within 2 years  
of the date of application.  
History: 2020 AACS; 2021 AACS; 2022 AACS; 2024 MR 10, May 16, 2024.  
R 338.7003 "Stark Law" revision; adoption by reference.  
Rule 3. (1) Under section 16221(e)(iv)(B) of the code, MCL 333.16221, the department  
has taken notice that the Stark Law, 42 USC 1395nn, was revised effective February 9,  
Page 3  
2018. The department also takes notice that the regulations promulgated under the Stark  
Law, 42 CFR 411.350 to 411.389, were revised effective January 19, 2021, and January  
1, 2022. The department finds that the revisions to both the Stark Law, 42 USC 1395nn,  
and regulations under the Stark Law, 42 CFR 411.350 to 411.389, 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, 42 USC 1395nn, as revised February 9, 2018, and regulations promulgated  
under the Stark Law, 42 CFR 411.350 to 411.389, as revised January 19, 2021, and  
January 1, 2022.  
(2) All federal regulations noted in subrule (1) of this rule are available at no cost at  
Designated Health Services (govregs.com). These regulations also are available for  
inspection and distribution at a cost of 10 cents per page from the Bureau of Professional  
Licensing, Michigan Department Licensing and Regulatory Affairs, 611 West Ottawa,  
P.O. Box 30670, Lansing, Michigan 48909.  
History: 2009 AACS; 2017 AACS; 2022 AACS.  
R 338.7004 Implicit bias training standards.  
Rule 4. (1) An individual applying for licensure or registration under article 15 of the  
code, MCL 333.16101 to 333.18838, except those 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) An individual applying for licensure or registration renewal, reregistration, or  
relicensure 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. Unless prohibited by the code or rules, this training may be used to  
satisfy other training or continuing education requirements for license renewal.  
(3) A licensee or registrant shall not carry forward implicit bias training hours earned  
during 1 renewal cycle to the next renewal cycle.  
(4) A licensee or registrant shall not earn implicit bias training hours for completing  
implicit bias training that is identical or substantially identical to implicit bias training  
that the licensee or registrant has already completed during the same renewal cycle.  
(5) The implicit bias training must be related to reducing barriers and disparities in  
access to and delivery of healthcare 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 healthcare, 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 healthcare services.  
Page 4  
(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  
healthcare services.  
(b) Training must include strategies to reduce disparities in access to and delivery of  
healthcare 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 was 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) Training offered by 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 allows live synchronous interaction that provides  
for the opportunity for participants to interact with the instructor and other participants.  
(ii) A live presentation that provides for the opportunity for participants to interact with  
the instructor and other participants.  
(iii) An asynchronous teleconference or webinar.  
(6) Submission of an application for licensure, registration, or renewal constitutes an  
applicant’s certificate of compliance with the requirements of this rule. The licensee or  
registrant shall retain documentation of meeting the requirements of this rule for a period  
of 6 years after the date of applying for licensure, registration, or renewal. The  
department may select and audit a sample of licensees or registrants and request  
documentation of proof of compliance with this rule. If audited by the department, the  
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 AACS; 2022 AACS; 2023 AACS; 2024 MR 10, May 16, 2024.  
R 338.7005 Rescinded.  
History: 2014 AACS; 2019 AACS.  
Page 5  
;