DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

BUREAU OF PROFESSIONAL LICENSING

PUBLIC HEALTH CODE—GENERAL RULES

Filed with the secretary of state on

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. 

(c) (d)  “Issue date” means the date that the initial license was granted to the licensee by the department.

(d) (e)  “Limitation” means that term as defined in section 16106(4) of the code, MCL 333.16106.

(e) (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                                                   10/1 Issue date

Audiology                                                       1/1 Issue date

Chiropractic                                                    12/1 Issue date

Dental Therapy                                             Issue date

Marriage and family therapy                          2/1 Issue date

Midwifery                                                       Issue date

Nursing                                                           Issue date

Nursing home administrators                         11/1 Issue date

Occupational therapy                                      6/1

Optometry                                                       Issue date

Pharmacy                                                        Issue date

Physical therapy                                              8/1

Physician's assistants                                      Issue date

Psychology                                                     9/1 Issue date

Respiratory care                                              1/1

Sanitarians                                                      12/1 Issue date

Speech-language pathology                            10/1 Issue date

  (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                                                10/1 Issue date

Counseling                                                      6/1

Dentistry                                                         Issue date

Dental Assistant                                             Issue date

Dental Hygienist Issue date

Massage therapy                                             11/1  Issue date

Medicine                                                         Issue date

Osteopathic medicine and surgery                  Issue date

Podiatric medicine and surgery                      Issue date

Social work                                                     5/1

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 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.

    (d) 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.

    (e)  The applicant obtained a total score of not less than 6.5 on the International English Language Testing System (IELTS) Academic test.

    (f) The applicant obtained a total an overall score of not less than 55 on the 4-skill Michigan English Test (MET) developed by Michigan Language Assessment.    

    (g)  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 shall include, but is not limited to, 1 or more of the following topics:

      (i)  Information on implicit bias, equitable access to medical 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 providers 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.

    (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 provider that includes the date of the training, the provider’s name, the title of the training, and licensee’s or registrant’s name. 

    (b)  A self-attestation by the licensee or registrant that includes the date of the training, the provider’s name, the title of the training, and licensee’s or registrant’s name.