DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

 

DIRECTOR'S OFFICE

 

CHIROPRACTIC - GENERAL RULES

 

Filed with the secretary of state on

 

These rules take effect become effective immediately after upon filing with the secretary of state unless adopted under section 33, 44, or 45a(9) 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, 16148, 16401, 16412, 16423, and 16431 of the public health code, 1978 PA 368, MCL 333.16145, 333.16148, 333.16401, 333.16412, 333.16423, and 333.16431, 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 338.12021, R 338.12031, R 338.12032, R 338.12034, R 338.12035, R 338.12036, R 338.12037, R 338.12041, and R 338.12042 of the Michigan Administrative Code are amended, as follows:

 

 

PART 2.  EDUCATION

 

 

R 338.12021  Educational program standards; adoption by reference.

  Rule 21.  (1) The process and requirements standards of the CCE, for the CCE’s accreditation of chiropractic educational programs as specified set forth in the publication entitled, titled "CCE Accreditation Standards:  Principles, Processes & Requirements for Accreditation" January 2018, July 2021, are adopted by reference.  The standards are which are available from The Council on Chiropractic Education, 8049 N. 85th Way, Scottsdale, Arizona 85258-4321, or at the council's website at http://www.cce-usa.org at no cost. cost, are approved and adopted by reference.  Copies of the standards are available for inspection and distribution at a cost of 10 cents per page from the Board of Chiropractic, Bureau of Professional Licensing, Department of Licensing and Regulatory Affairs, 611 West Ottawa Street, P. O. Box 30670, Lansing, Michigan 48909.

  (2) Any chiropractic educational program accredited by the CCE is considered approved.

 

 

PART 3.  LICENSURE

 

 

R 338.12031  Training standards for identifying victims of human trafficking;

  requirements.

  Rule 31.  (1) Under section 16148 of the code, MCL 333.16148, an individual seeking licensure or registration or who is licensed or registered shall complete training in identifying victims of human trafficking that satisfies the following standards:

   (a) Training content must cover all the following:

    (i) Understanding the types and venues of human trafficking in the United States.

    (ii) Identifying victims of human trafficking in health care healthcare settings.

    (iii) Identifying the warning signs of human trafficking in health care healthcare settings for adults and minors.

    (iv) Resources Identifying resources for reporting the suspected victims of human trafficking.

   (b) Acceptable providers or methods of 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 for initial licensure or registration, or by a college or university.

    (iv) Reading an article related to the identification of victims of human trafficking that satisfies the requirements of subdivision (a) of this subrule and is published in a peer-reviewed peer review journal, health care healthcare journal, or professional or scientific journal.

   (c) Acceptable modalities of training may include any of the following:

    (i) Teleconference or online seminar.

    (ii)  Online presentation.

    (iii) Live presentation.

    (iv) Printed or electronic media.

  (2) The department may select and audit an individual a sample of individuals and request documentation of proof of completion of training.  If audited by the department, the an individual shall provide an acceptable proof of completion of training, including either of the following:

   (a) Proof of completion certificate issued by the training provider that includes the date, provider name, name of training, and individual’s name.

   (b) A self-certification statement by an the individual.  The certification statement must include the individual’s name and either of the following:

    (i) For training completed under subrule (1)(b)(i) to (iii) of this rule, the date, training provider name, and name of training.

    (ii) For training completed under subrule (1)(b)(iv) of this rule, the title of article, author, publication name of peer-reviewed peer review journal, health care healthcare journal, or professional or scientific journal, and the date, volume, and issue of publication, as applicable.

  (3) Under section 16148 of the code, MCL 333.16148, the requirements specified in subrule (1) of this rule apply for license renewals beginning with the 2016 renewal cycle and for initial licenses issued after March 17, 2021.

 

R 338.12032  Educational limited license; requirements.

  Rule 32.  An applicant for a nonrenewable educational limited license under section 16412 of the code, MCL 333.16412, shall submit the required fee and a completed application on a form provided by the department.  In addition to satisfying satisfy the requirements of the code and the administrative rules promulgated under the code, an applicant shall satisfy as well as all the following requirements:

  (a) Submit proof that the applicant has successfully completed 2 years of education in a college of arts and sciences and have official transcripts provided to the department from the educational institution. Provide the required fee and a completed application on a form provided by the department.

  (b) Submit proof that the applicant has successfully completed at least 1 of the following requirements: Provide proof, as directed by the department, verifying the completion of 2 years of education in a college of arts and sciences.

   (i) Two years of attendance in a program or institution of chiropractic that satisfies the educational standards in R 338.12021 and has official transcripts provided to the department from the educational institution.

     (ii) Four semesters of attendance in a program or institution of chiropractic that satisfies the educational standards in R 338.12021 and has official transcripts provided to the department from the educational institution.

     (iii) Six quarter terms of attendance in a program or institution of chiropractic that satisfies the educational standards in R 338.12021 and has official transcripts provided to the department from the educational institution.

  (c) Submit proof that the applicant will be supervised by a licensed chiropractor on a form provided by the department. Provide proof, as directed by the department, verifying the completion of 1 of the following requirements:

   (i) Two years of attendance in a program or institution of chiropractic that satisfies the educational requirements under R 338.12021.

   (ii) Four semesters of attendance in a program or institution of chiropractic that satisfies the educational requirements under R 338.12021.

   (iii) Six quarter terms of attendance in a program or institution of chiropractic that satisfies the educational requirements under R 338.12021.

  (d) Provide proof, as directed by the department, verifying that a licensed chiropractor shall supervise the applicant.

 

R 338.12034  Licensure by examination; requirements.

  Rule 34.  An applicant for a chiropractic license by examination shall submit the required fee and a completed application on a form provided by the department.  In addition to satisfying satisfy the requirements of the code and the administrative rules promulgated under the code, an applicant shall satisfy both of as well as all the following requirements:

  (a) Have graduated from a program or institution of chiropractic that satisfies the educational standards in R 338.12021 and have final and official transcripts provided to the department from the educational institution. Provide the required fee and a completed application on a form provided by the department.

  (b) Have passed parts I, II, III, and IV of the national board examination conducted and scored by the NBCE, under R 338.12033.  The applicant shall ensure that the NBCE issues proof of official passing scores directly to the department. Provide proof, as directed by the department, verifying graduation from a program or institution of chiropractic that satisfies the educational requirements under R 338.12021.

  (c) Provide proof, as directed by the department, verifying passing scores on parts I, II, III, and IV of the national board examination conducted and scored by the NBCE, under R 338.12033. 

 

R 338.12035  Licensure by endorsement; requirements.

  Rule 35.  (1) An applicant for a chiropractic license by endorsement shall submit the required fee and a completed application on a form provided by the department.  In addition to satisfying satisfy the requirements of the code and the administrative rules promulgated under the code, an applicant shall satisfy either of as well as all the following requirements:

   (a) Have been licensed in another state of the United States for 5 years or more immediately preceding the date of application. Provide the required fee and a completed application on a form provided by the department.

   (b) Have been licensed in another state of the United States for less than 5 years immediately preceding the date of filing an application and have passed parts I, II, III, and IV of the national board examination that is conducted and scored by the NBCE, under R 338.12033.  The applicant shall have the NBCE issue proof of official passing scores directly to the department. Provide proof, as directed by the department, verifying a current and full chiropractic license in another state or in a province of Canada.

   (c) If the applicant is licensed as a chiropractor in a province of Canada, provide proof, as directed by the department, verifying that the applicant completed the educational requirements in Canada or in the United States for licensure as a chiropractor in Canada or the United States.

   (d) Provide proof, as directed by the department, verifying passing scores on either of the following examinations for a chiropractic license in another state or in a province of Canada to obtain licensure as a chiropractor in another state or in a province of Canada:

    (i) Parts I, II, III, and IV of the national board examination conducted and scored by the NBCE, under R 338.12033.

    (ii) Component A – Chiropractic Knowledge, Component B – Clinical Decision Making, and Component C – Clinical Skills Demonstration of the Canadian Chiropractic Examining Board’s (CCEB) examinations.

  (2) An applicant shall have his or her license verified by the licensing agency of any state of the United States in which the applicant holds or has ever held a license to practice chiropractic.  Verification includes, but is not limited to, showing proof of any disciplinary action taken or pending against the applicant. An applicant that provides proof, as directed by the department, verifying a current and full chiropractic license in good standing in another state or in a province of Canada for not less than the last 5 years before the date of filing the application for a chiropractic license by endorsement is presumed to satisfy the requirements of subrule (1)(c) and (d) of this rule.

  (3) An applicant that is or has been licensed, registered, or certified in a health profession or specialty by another state, the United States military, the federal government, or another country shall disclose that fact on the application form.  The applicant shall satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application.  If licensure is granted and it is determined that sanctions have been imposed, the disciplinary subcommittee may impose appropriate sanctions under section 16174(5) of the code, MCL 333.16174.

 

R 338.12036  Relicensure requirements.

  Rule 36.  (1) An applicant for relicensure whose chiropractic license has been lapsed for less than may be relicensed within 3 years preceding the date of application may be relicensed after the expiration date of the license under section 16201(3) of the code, MCL 333.16201, if the applicant satisfies the requirements of the code and the rules promulgated under the code, as well as all the following requirements:

   (a) Establishes that he or she is of good moral character. Provides the required fee and a completed application on a form provided by the department.

   (b) Submits the required fee and a completed application on a form provided by the department. Establishes good moral character as defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47.

   (c) Submits Provides proof, as directed to by the department, verifying of the completion of, in the 3-year period immediately preceding the application for relicensure, 45 hours of continuing education in programs approved under R 338.12041, that include all both the following requirements:

    (i) The required continuing education hours listed in R 338.12041(1)(d) to (h).

    (ii) Not more than 15 continuing education hours in distance learning programs.

   (d) An applicant shall have his or her license verified by the licensing agency of any state of the United States in which the applicant holds or has ever held a license to practice chiropractic.  Verification includes, but is not limited to, showing proof of any disciplinary action taken or pending against the applicant.

  (2) An applicant for relicensure whose chiropractic license has been lapsed for may be relicensed more than 3 years or more may be relicensed after the expiration date of the license under section 16201(4) of the code, MCL 333.16201, if the applicant satisfies the requirements of the code and the rules promulgated under the code, as well as all the following requirements:

   (a) Establishes that he or she is of good moral character. Provides the required fee and a completed application on a form provided by the department.

   (b) Submit fingerprints as set forth in section 16174(3) of the code, MCL 333.16174. Establishes good moral character as defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47.

   (c) Submits the required fee and a completed application on a form provided by the department. Provides fingerprints as required under section 16174(3) of the code, MCL 333.16174.

   (d) Provides proof, as directed by the department, verifying either of the following:

    (i) Submits proof to the department of the The completion of, in the 3-year period immediately preceding the application for relicensure, 45 hours of continuing education in programs approved under R 338.12041 that include all the following requirements:

     (A) Twenty-four live and in-person continuing education hours on chiropractic adjusting techniques.

     (B) The required continuing education hours listed in R 338.12041(1)(d) to (h).

     (C) Not more than 15 continuing education hours in distance learning programs.

    (ii)  Documentation to the department that the The applicant holds or has held a valid and unrestricted license in another state or a province of Canada within in the 3 years 3-year period immediately preceding the application for relicensure.

   (e) An applicant shall have his or her license verified by the licensing agency of any state of the United States in which the applicant holds or has ever held a license to practice chiropractic.  Verification includes, but is not limited to, showing proof of any disciplinary action taken or pending against the applicant.

  (3) An applicant that is or has been licensed, registered, or certified in a health profession or specialty by another state, the United States military, the federal government, or another country shall disclose that fact on the application form.  The applicant shall satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application.  If licensure is granted and it is determined that sanctions have been imposed, the disciplinary subcommittee may impose appropriate sanctions under section 16174(5) of the code, MCL 333.16174.

 

R 338.12037  License renewal; continuing education.

  Rule 37.  (1) An applicant for license renewal shall complete 30 hours of continuing education in the 2-year period immediately preceding the application that satisfy R 338.12041. An applicant for renewal shall satisfy the requirements of the code and the rules promulgated under the code.

  (2) An applicant for renewal shall complete 30 hours of continuing education in the 2-year period immediately preceding the renewal application that satisfy R 338.12041.  This rule does not apply to a licensee who has obtained his or her initial chiropractic license within the 2-year period immediately preceding the expiration date of the initial license.

  (3) Submission of an application for renewal constitutes the applicant's certification of compliance with the requirements of this rule.  The licensee shall retain keep documentation of satisfying the requirements of this rule for a period of 4 years after from the date of applying for license renewal.  Failure to satisfy this rule is a violation of section 16221(h) of the code, MCL 333.16221.

  (4) The department shall receive a request for a waiver of continuing education requirements for the board’s consideration not less than 30 days before the last regularly scheduled board meeting before the expiration date of the license.

 

 

PART 4.  CONTINUING EDUCATION

 

 

R 338.12041  Acceptable continuing education.

  Rule 41.  (1) The 30 hours of continuing education required under R 338.12037 must satisfy all the following requirements:

   (a) No more than 12 credit hours of continuing education may be earned during 1 one 24-hour period.

   (b) At least Not less than 15 hours of continuing education must be completed by attending a live, in-person program.

   (c) Credit for a continuing education program or activity that is identical to or substantially identical to a program or activity for which the licensee has already earned credit during the license cycle must shall not be granted.

   (d) Under section 16431(2) of the code, MCL 333.16431, at least 1 hour of continuing education must be in pain and symptom management.  Continuing education in pain and symptom management includes, but is not limited to, courses in any of the following:

    (i) Chiropractic manipulative treatment.

    (ii) Manual therapies.

    (iii) Therapeutic exercises for pain management.

    (iv) Behavior management.

    (v) Psychology of pain.

    (vi) Pharmacology.

    (vii) Behavior modification.

    (viii) Stress management.

    (ix) Clinical applications.

    (x) Drug interventions as they related to the practice of chiropractic.

   (e) At least 1 hour of continuing education must be in sexual boundaries.

   (f) At least 1 hour of continuing education must be in ethics.

   (g) At least Not less than 2 hours of continuing education must be in physical measures. and must be completed by attending a live, in-person program.

   (h) At least Not less than 2 hours of continuing education must be in performing and ordering tests. and must be completed by attending a live, in-person program.

  (2) In addition to those programs approved under R 338.12042, the following are considered acceptable continuing education:

   (a) Attendance at or participation in a continuing education program or activity related to the practice of chiropractic, or any non-clinical subject relevant to the practice of chiropractic education, administration, management, or science, which includes, but is not limited to, live in-person programs, interactive or monitored teleconferences, audio-conferences, web-based programs, online programs, and review of journal articles or other self-study programs approved or offered by the Michigan Association of Chiropractors (MAC) according to the following:

    (i) If audited, the licensee shall submit provide a copy of a letter or certificate of completion showing the licensee’s name, number of continuing education hours earned, the sponsor’s provider’s name or the name of the organization that approved the program or other activity, and the date on which the program or activity was completed.

    (ii) The number of continuing education hours for a specific program or activity is the number of hours approved by the approving organization for the specific program or activity.

    (iii) A maximum of 30 hours of continuing education may be earned for this category in each renewal period.

   (b) Successful completion of a course or courses related to the practice of chiropractic, which are offered by a chiropractic school approved under R 338.12021, according to the following:

    (i) If audited, the licensee shall submit provide a copy of a letter or certificate of completion showing the licensee’s name, the number of continuing education hours earned, the school’s name, and the date on which the course or courses was completed.

    (ii) The number of continuing education hours for a specific course or courses is the number of hours approved by the school for the specific course or courses.

    (iii) A maximum of 30 hours of continuing education may be earned for courses completed in this category in each renewal period.

   (c) Initial presentation by the licensee of a continuing education program related to the practice of chiropractic to a state, regional, national, or international organization.  To receive credit, the presentation must not be a part of the licensee’s regular job description and must be approved or offered for continuing education credit by the American Chiropractic Association (ACA), the International Chiropractors Association (ICA), or an approved program under this rule or R 338.12042.  Continuing education under this subdivision is subject to the following:

    (i) If audited, the licensee shall submit provide a copy of the presentation notice, or advertisement, or letter from the approved program under this rule or R 338.12042, showing the date of the presentation and the licensee’s name listed as a presenter.

    (ii) Two hours of continuing education credit are granted for each 50 to 60 minutes of presentation.  No other credit is granted for preparation of a presentation.

     (iii) A maximum of 10 hours of continuing education may be earned in this category in each renewal period.

  (3) This rule takes effect beginning with the first renewal cycle after January 7, 2019.  Continuing education programs approved before the effective date of this amended rule are considered approved.

 

R 338.12042  Approval of continuing education programs.

  Rule 42.  (1) An organization may A continuing education program provider that is not pre-approved under R 338.12041(2) shall petition the board for approval of a continuing education program. 

  (2) The petition shall be filed at least 60 days before the commencement of the program.  The continuing education program provider shall complete an application provided by the department, file the application and supporting documentation with the department for review not less than 120 days before the program date, and satisfy the requirements of subrule (3) of this rule.  

  (3) The petition shall include all of the following information: The application and supporting documentation must include all the following information:

   (a) A description of the sponsoring organization.

   (b) Name, title, and address of the program director.

   (c) An outline of the course.

   (d) A resumé for all speakers or presenters, or both.

   (e) A description of the delivery method.

   (f) The dates and location or locations that the course will be delivered.

   (g) A description of how attendance is will be monitored, sample documents, and identification of the person individual monitoring attendance.

   (h) A sample certificate or other document that will be issued upon after completion and a description of how the participant will be notified.

   (i) If appropriate, a request for recognition in a specific topic area required by R 338.12041(1)(d) to (h).

  (4) Continuing education programs approved before the effective date of this amended rule are considered approved.