DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
BUREAU OF PROFESSIONAL LICENSING  
PUBLIC HEALTH CODE—GENERAL RULES  
Filed with the secretary of state on June 1, 2021  
These rules take effect immediately upon filing with the secretary of state unless adopted under  
section 33, 44, or 45a(6) of the administrative procedures act of 1969, 1969 PA 306, MCL  
24.233, 24.244, or 24.245a. Rules adopted under these sections become effective 7 days after  
filing with the secretary of state.  
(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, R 338.7001a, R 338.7002 and R 338.7002b of the Michigan Administrative Code  
are amended and R 338.7004 is added, as follows:  
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.  
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  
Nursing  
Nursing home administrators  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
Issue date  
April 5, 2021  
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Occupational therapy  
Optometry  
Pharmacy  
Physical therapy  
Physician's assistants  
Psychology  
Respiratory care  
Sanitarians  
6/1  
Issue date  
Issue date  
8/1  
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.  
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.  
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.  
(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.  
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(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.  
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 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.  
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(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 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.