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.

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

Speech-language pathology

(2) A license or registration having a limitation may be renewed for a term less than 2

years.

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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

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

(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

(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.

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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.

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,

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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

SUBPART - Financial Relationships Between Physicians and Entities Furnishing

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.

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(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.

(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.

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