The New York State Senate

                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 7108--A

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                               May 1, 2013
                               ___________

Introduced by M. of A. PRETLOW, SIMANOWITZ, WALTER -- Multi-Sponsored by
  --  M.  of A. CURRAN, RA -- read once and referred to the Committee on
  Higher  Education  --  committee  discharged,  bill  amended,  ordered
  reprinted as amended and recommitted to said committee

AN  ACT  to  amend  the  education  law, in relation to making technical
  changes to the scope of the practice of podiatry

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1. Subdivisions 1 and 2 of section 7001 of the education law,
subdivision 1 as amended by chapter 23 of the laws of 2013 and  subdivi-
sion  2  as  amended  by chapter 438 of the laws of 2012, are amended to
read as follows:
  1. The practice of the profession of podiatry is defined  as  diagnos-
ing,  treating,  operating  and  prescribing  for  any  disease, injury,
deformity or other condition of  the  foot,  THE  DIAGNOSING,  TREATING,
OPERATING  OR  PRESCRIBING  FOR CUTANEOUS CONDITIONS OF THE ANKLE TO THE
LEVEL OF THE DISTAL TIBIAL TUBEROSITY, and may include performing  phys-
ical  evaluations  in conjunction with the provision of podiatric treat-
ment. For the purposes of wound care however, the practice  of  podiatry
shall include the treatment of such wounds if they are [contiguous with]
RELATED  TO  A CONDITION OF THE FOOT OR ANKLE TO THE LEVEL OF THE DISTAL
TIBIAL TUBEROSITY OR ARE wounds relating, originating or in  the  course
of  treatment  of  [a  wound  on]  the foot OR ANKLE TO THE LEVEL OF THE
DISTAL TIBIAL TUBEROSITY within the podiatric scope of  practice.  Wound
care  shall  not,  however, extend beyond the level ending at the distal
tibial tuberosity. The practice of podiatry may also include diagnosing,
treating, operating and prescribing for any disease,  injury,  deformity
or  other  condition  of  the ankle and soft tissue of the leg below the
tibial tuberosity if the podiatrist has obtained an issuance of a privi-
lege to perform podiatric  standard  ankle  surgery  or  advanced  ankle
surgery  in accordance with section seven thousand nine of this article;

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10646-02-3

A. 7108--A                          2

PROVIDED, HOWEVER, THAT SUCH PRIVILEGE SHALL NOT  BE  REQUIRED  FOR  THE
DIAGNOSING,  TREATING, OPERATING OR PRESCRIBING FOR CUTANEOUS CONDITIONS
OR WOUND CARE TO THE LEVEL OF THE DISTAL TIBIAL TUBEROSITY OF THE ANKLE.
Podiatrists  may treat traumatic open wound fractures only in hospitals,
as defined in article twenty-eight of the public  health  law.  For  the
purposes  of  this  article,  the  term  "ankle" shall be defined as the
distal metaphysis and epiphysis of the tibia and fibula,  the  articular
cartilage  of  the  distal  tibia  and distal fibula, the ligaments that
connect the distal metaphysis and epiphysis of the tibia and fibula  and
talus,  and  the  portions of skin, subcutaneous tissue, facia, muscles,
tendons, ligaments and nerves at or below the level of the  myotendinous
junction of the triceps surae.
  2. The practice of podiatry shall not include treating any part of the
human  body  other than the foot, nor treating fractures of the malleoli
or cutting operations upon the malleoli unless the podiatrist obtains an
issuance of a privilege to perform podiatric standard ankle  surgery  or
podiatric  advanced ankle surgery OR UNLESS OTHERWISE PROVIDED IN SUBDI-
VISION ONE OF THIS SECTION. Podiatrists who have obtained an issuance of
a privilege to perform podiatric  standard  ankle  surgery  may  perform
surgery  on  the  ankle which may include soft tissue and osseous proce-
dures except those procedures specifically  authorized  for  podiatrists
who have obtained an issuance of a privilege for advanced ankle surgery.
Podiatrists  who  have  obtained  an  issuance of a privilege to perform
podiatric advanced ankle surgery may perform surgery on the ankle  which
may  include  ankle  fracture fixation, ankle fusion, ankle arthroscopy,
insertion or removal of external fixation pins into or from  the  tibial
diaphysis  at  or  below  the  level of the myotendinous junction of the
triceps surae, and insertion and removal of retrograde  tibiotalocalcan-
neal  intramedullary  rods  and  locking  screws  up to the level of the
myotendinous junction of the triceps surae, but  does  not  include  the
surgical  treatment of complications within the tibial diaphysis related
to the use of such external fixation pins. Podiatrists licensed to prac-
tice, but not authorized to prescribe or administer narcotics  prior  to
the  effective  date  of  this subdivision, may do so only after certif-
ication by the department in accordance with the  qualifications  estab-
lished  by  the  commissioner.  The  practice  of podiatry shall include
administering only local anesthetics for therapeutic purposes as well as
for anesthesia and treatment under general  anesthesia  administered  by
authorized  persons.  The practice of podiatry by any licensee shall not
include partial or total ankle replacements nor the treatment  of  pilon
fractures.
  S  2.  Subdivision 1 of section 7009 of the education law, as added by
chapter 438 of the laws of 2012, is amended to read as follows:
  1. For issuance of a privilege to  perform  podiatric  standard  ankle
surgery,  as that term is used in subdivision two of section seven thou-
sand one of this article, the  applicant  shall  fulfill  the  following
requirements:
  a. Application: file an application with the department;
  b. License: be licensed as a podiatrist in the state;
  c. Training and certification: either:
  (i)  have  graduated  on  or after June first, two thousand six from a
three-year residency program in podiatric medicine and surgery that  was
accredited by an accrediting agency acceptable to the department, and be
certified  in  FOOT  SURGERY  OR  IN  reconstructive  rearfoot and ankle
surgery by a national certifying board  having  certification  standards
acceptable to the department; or

A. 7108--A                          3

  (ii)  have  graduated  on or after June first, two thousand six from a
three-year residency program in podiatric medicine and surgery that  was
accredited  by  an  accrediting  agency acceptable to the department, be
board qualified but not yet certified in FOOT SURGERY OR IN  reconstruc-
tive  rearfoot  and  ankle surgery by a national certifying board having
certification  standards  acceptable  to  the  department,  and  provide
documentation  that  he or she has acceptable training and experience in
standard or advance midfoot, rearfoot and ankle procedures that has been
approved by the department; or
  (iii) have graduated before June first, two thousand six from  a  two-
year  residency  program  in  podiatric  medicine  and  surgery that was
accredited by an accrediting agency acceptable  to  the  department,  be
certified  in  FOOT SURGERY, FOOT AND ANKLE SURGERY OR IN reconstructive
rearfoot and ankle surgery by a national certifying board having certif-
ication standards acceptable to the department, and  provide  documenta-
tion  that  he or she has acceptable training and experience in standard
or advanced  midfoot,  rearfoot  and  ankle  procedures  that  has  been
approved by the department;
  d. Fees: pay a fee to the department of two hundred twenty dollars for
the issuance of a privilege to perform podiatric standard ankle surgery.
  S 3. Section 7010 of the education law, as added by chapter 438 of the
laws of 2012, is amended to read as follows:
  S  7010. Ankle surgery limited permits. 1. A limited permit to perform
podiatric standard ankle surgery, as described  in  subdivision  two  of
section seven thousand one of this article, may be issued by the depart-
ment  to  a  podiatrist who is licensed pursuant to this article and who
has met the residency and board qualification/certification requirements
set forth in subdivision one of section  seven  thousand  nine  of  this
article in order to authorize such podiatrist to obtain the training and
experience  required  for  the  issuance  of  a podiatric standard ankle
surgery privilege pursuant to subdivision one of section seven  thousand
nine  of  this  article. Such permits shall authorize the performance of
podiatric standard ankle surgery only under the [direct personal] super-
vision of a licensed  podiatrist  holding  a  podiatric  standard  ankle
surgery privilege or a podiatric advanced ankle surgery privilege issued
pursuant  to  section seven thousand nine of this article or of a physi-
cian licensed pursuant to article one hundred thirty-one of  this  title
and  certified  in  orthopedic  surgery  by  a national certifying board
having certification standards acceptable to the department.
  2. A limited permit to perform podiatric advanced  ankle  surgery,  as
described in subdivision two of section seven thousand one of this arti-
cle,  may  be  issued  by the department to a podiatrist who is licensed
pursuant to this article and who has met the residency and board certif-
ication requirements set forth in subdivision two of section seven thou-
sand nine of this article in  order  to  authorize  such  podiatrist  to
obtain the training and experience required for the issuance of a podia-
tric  advanced  ankle  surgery  privilege pursuant to subdivision two of
section seven thousand nine of this  article;  PROVIDED,  HOWEVER,  THAT
BOARD  QUALIFICATION  SHALL  BE  DEEMED  TO  SATISFY  THE  CERTIFICATION
REQUIREMENTS SET FORTH IN SUCH SECTION FOR PURPOSES OF THIS SUBDIVISION.
Such permits shall authorize the performance of podiatric advanced ankle
surgery only under the  [direct  personal]  supervision  of  a  licensed
podiatrist  holding  a podiatric advanced ankle surgery privilege issued
pursuant to subdivision two of section seven thousand nine of this arti-
cle or of a physician licensed pursuant to article one  hundred  thirty-
one  of  this  title  and  certified in orthopedic surgery by a national

A. 7108--A                          4

certifying  board  having  certification  standards  acceptable  to  the
department.
  3.  For  the  purposes  of this section, [direct personal] supervision
means supervision of procedures based on instructions given directly  by
[the  supervising] A LICENSED podiatrist HOLDING A PODIATRIC STANDARD OR
ADVANCED ANKLE SURGERY PRIVILEGE or physician who remains in the immedi-
ate area where the procedures are being performed, authorizes the proce-
dures and evaluates the procedures performed by the holder of the limit-
ed permit OR WITH THE APPROVAL OF THE CHAIR OF THE ORTHOPEDIC OR SURGERY
DEPARTMENT OF THE HOSPITAL AT WHICH THE PROCEDURE WILL BE PERFORMED.
  4. The holder of a limited permit  issued  pursuant  to  this  section
shall  perform  podiatric  ankle  surgery  only  in a hospital or health
facility licensed pursuant to article twenty-eight of the public  health
law and appropriately authorized to provide such surgery.
  5.  Limited  permits shall be issued for a period of one year, and may
be renewed for additional one year periods when necessary to permit  the
completion of the training and experience required to obtain a podiatric
standard  ankle  surgery  privilege  or podiatric advanced ankle surgery
privilege, as applicable, provided that no permit may  be  renewed  more
than four times for each such privilege.
  6.  The fee for a limited permit shall be one hundred five dollars and
the fee for a renewal shall be fifty dollars.
  S 4. This act shall take effect on the  same  date  and  in  the  same
manner as chapter 438 of the laws of 2012 takes effect.