The New York State Senate

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

                                  4835

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                             April 25, 2013
                               ___________

Introduced  by  Sen.  LIBOUS -- read twice and ordered printed, and when
  printed to be committed to the Committee on Higher Education

AN ACT to amend the education  law,  in  relation  to  making  technical
  changes  to  the  scope  of  the  practice  of podiatry; and to repeal
  certain provisions of the public health law and the civil practice law
  and rules relating thereto

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

  Section  1.  Section  7001 of the education law, as amended by chapter
438 of the laws of 2012, is amended to read as follows:
  S 7001. Definition of practice of podiatry. 1.  The  practice  of  the
profession of podiatry is defined as diagnosing, treating, operating and
prescribing for any disease, injury, deformity or other condition of the
foot,  and  may  include  performing physical evaluations in conjunction
with the provision of podiatric treatment. 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  ARE wounds relating, originating or in the course of treatment
of [a wound on] the foot within the podiatric scope of  practice.  Wound
care  shall  not,  however,  extend  beyond [to] 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  privilege to perform podiatric standard ankle surgery or advanced
ankle surgery in accordance with section seven  thousand  nine  of  this
article;  PROVIDED,  HOWEVER,  THAT SUCH PRIVILEGE SHALL NOT BE REQUIRED
FOR THE DIAGNOSING, TREATING, OPERATING  OR  PRESCRIBING  FOR  CUTANEOUS
CONDITIONS  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"

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10560-01-3

S. 4835                             2

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  OF
THE  TIBIA  AND  FIBULA,  insertion or removal of external fixation pins
into or from the tibial diaphysis at or below the level of the myotendi-
nous junction of the triceps surae, and insertion and removal of  retro-
grade  tibiotalocalcanneal  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.  [Podia-
trists licensed to practice, but not authorized to prescribe or adminis-
ter narcotics prior to the effective date of this subdivision, may do so
only after certification by the department in accordance with the quali-
fications  established  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 anes-
thesia 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.
  3. A. THE DEPARTMENT SHALL CONDUCT A STUDY  TO  DETERMINE  WHETHER  TO
MAKE  AVAILABLE TO THE PUBLIC PROFILES ON PODIATRISTS WHO  HAVE OBTAINED
AN ISSUANCE OF PRIVILEGE TO PERFORM PODIATRIC STANDARD OR ADVANCED ANKLE
SURGERY PURSUANT TO SUBDIVISIONS ONE AND TWO OF SECTION  SEVEN  THOUSAND
NINE  OF THIS ARTICLE. SUCH STUDY SHALL INCLUDE CONSIDERATION OF WHETHER
IT WOULD BE APPROPRIATE AND FEASIBLE FOR THE DEPARTMENT TO MAKE PUBLICLY
AVAILABLE PROFILES FOR SUCH PODIATRISTS IN A MANNER SIMILAR TO PHYSICIAN
PROFILES MADE AVAILABLE ON THE DEPARTMENT OF HEALTH'S WEBSITE IN ACCORD-
ANCE WITH SECTION TWENTY-NINE HUNDRED NINETY-FIVE-A OF THE PUBLIC HEALTH
LAW. THE DEPARTMENT SHALL CONSULT  WITH  THE  DEPARTMENT  OF  HEALTH  AS
NECESSARY  ON  MATTERS  RELATED  TO  THE  OPERATION OF THE DEPARTMENT OF
HEALTH'S PHYSICIAN PROFILES ESTABLISHED PURSUANT TO SECTION  TWENTY-NINE
HUNDRED NINETY-FIVE-A OF THE PUBLIC HEALTH LAW IN CONDUCTING ITS STUDY.
  B. IF THE DEPARTMENT DETERMINES THAT MAKING PODIATRIST PROFILES AVAIL-
ABLE  IS  APPROPRIATE  AND  FEASIBLE, THE DEPARTMENT, AFTER CONSULTATION
WITH THE DEPARTMENT OF HEALTH, SHALL OUTLINE IN SUCH STUDY AND APPROPRI-
ATE AND COST EFFECTIVE METHOD OF  PRESENTING  RELEVANT  AND  APPROPRIATE
PODIATRIC  PROFILING  INFORMATION  TO THE GENERAL PUBLIC. THE DEPARTMENT
SHALL SUBMIT SUCH STUDY TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF  THE
SENATE,  THE  SPEAKER OF THE ASSEMBLY, THE MINORITY LEADER OF THE SENATE

S. 4835                             3

AND THE MINORITY LEADER OF THE ASSEMBLY ON OR BEFORE NOVEMBER FIRST, TWO
THOUSAND SIXTEEN.
  C.  IF THE DEPARTMENT MAKES PODIATRIST PROFILES AVAILABLE AS SET FORTH
IN PARAGRAPH B OF THIS  SUBDIVISION,  THE  DEPARTMENT  OF  HEALTH  SHALL
INCLUDE  ON  ITS  WEBSITE  CONTAINING THE PHYSICIAN PROFILES ESTABLISHED
PURSUANT TO SECTION TWENTY-NINE  HUNDRED  NINETY-FIVE-A  OF  THE  PUBLIC
HEALTH  LAW  A LINK TO THE WEBSITE ON WHICH SUCH PODIATRIST PROFILES MAY
BE ACCESSED AND A STATEMENT DESCRIBING THE PURPOSE OF SUCH LINK.
  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
  (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-

S. 4835                             4

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. Such permits shall author-
ize the performance of podiatric advanced ankle surgery only  under  the
[direct  personal] supervision of a licensed podiatrist holding a podia-
tric advanced ankle surgery privilege issued pursuant to subdivision two
of section seven thousand  nine  of  this  article  or  of  a  physician
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.
  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 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. Subdivision 4-a of section 2995-d of the  public  health  law  is
REPEALED.
  S  5.  Subparagraph  (iv) of paragraph 1 of subdivision (d) of section
3101 of the civil practice law and rules is REPEALED.
  S 6. This act shall take effect on the  same  date  and  in  the  same
manner as chapter 438 of the laws of 2012 takes effect.

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

                                 4835--A

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                             April 25, 2013
                               ___________

Introduced  by  Sen.  LIBOUS -- read twice and ordered printed, and when
  printed to be committed  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. Section 7001 of the education law, as  amended  by  chapter
438 of the laws of 2012, is amended to read as follows:
  S  7001.  Definition  of  practice of podiatry. 1. The practice of the
profession of podiatry is defined as diagnosing, 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 physical evaluations in conjunction with  the
provision  of podiatric treatment. For the purposes of wound care howev-
er, 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  relat-
ing,  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  podia-
tric  scope of practice. Wound care shall not, however, extend beyond to
the level ending at the distal tibial tuberosity. The practice of podia-
try 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 privilege to perform podiatric standard  ankle
surgery or advanced ankle surgery in accordance with section seven thou-
sand  nine of this article; PROVIDED, HOWEVER, THAT SUCH PRIVILEGE SHALL
NOT BE REQUIRED FOR THE DIAGNOSING, TREATING, OPERATING  OR  PRESCRIBING

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10560-02-3

S. 4835--A                          2

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
  (ii) have graduated on or after June first, two thousand  six  from  a
three-year  residency program in podiatric medicine and surgery that was

S. 4835--A                          3

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. Such permits shall author-
ize the performance of podiatric advanced ankle surgery only  under  the
[direct  personal] supervision of a licensed podiatrist holding a podia-
tric advanced ankle surgery privilege issued pursuant to subdivision two
of section seven thousand  nine  of  this  article  or  of  a  physician
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.
  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

S. 4835--A                          4

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.