Senate Bill S4600A

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

                                 4600--A

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                             March 30, 2015
                               ___________

Introduced  by  Sens.  LIBOUS, PARKER -- 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. 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  TIBIAL  TUBEROSITY,  and may include performing physical
evaluations in conjunction with the provision  of  podiatric  treatment.
THE  PRACTICE  OF PODIATRY SHALL NOT INCLUDE THE FOLLOWING TREATMENTS OR
PROCEDURES PERFORMED ABOVE THE LEVEL OF THE MALLEOLI,  UNLESS  OTHERWISE
PROVIDED: THE TREATMENT OF MELANOMA; PERFORMANCE OF MOHS SURGERY; MUSCLE
FLAPS  OR  MICROVASCULAR  ANASTAMOSES.  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 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 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

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05334-05-5
              

S. 4600--A                          2

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
FOR CUTANEOUS CONDITIONS OR WOUND CARE TO THE LEVEL OF THE TIBIAL TUBER-
OSITY 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 liga-
ments 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

S. 4600--A                          3

certified  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  reconstructive  rearfoot  and
ankle surgery by a national certifying board having certification stand-
ards  acceptable to the department, and provide documentation that he or
she has acceptable training and  experience  in  standard  or  [advance]
ADVANCED  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  reconstructive  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 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-

S. 4600--A                          4

cle 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  imme-
diate  area  where  the  procedures  are being performed] IS IMMEDIATELY
AVAILABLE TO FURNISH ASSISTANCE AND DIRECTION THROUGHOUT THE PERFORMANCE
OF THE PROCEDURE, authorizes the procedures and evaluates the procedures
performed by the holder of the limited 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 immediately.