The New York State Senate

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

                                  5395

                       2019-2020 Regular Sessions

                            I N  S E N A T E

                             April 29, 2019
                               ___________

Introduced  by  Sen. JACKSON -- 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

  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 NON-SURGICAL TREATMENT OF
THE ANKLE AND THE ANATOMICAL STRUCTURES OF THE ANKLE,  CUTANEOUS  CONDI-
TIONS AND WOUNDS OF THE ANKLE, and may include performing physical eval-
uations  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 wounds
relating, originating or in the course of treatment of a  wound  on  the
foot  within  the podiatric scope of practice.] 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. 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 SURGICAL TREATMENT
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 podia-
tric standard ankle surgery or advanced ankle surgery in accordance with
section seven thousand nine of this article. Podiatrists may treat trau-

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

                                                           LBD04854-01-9

S. 5395                             2

matic 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 AND ANKLE AS HEREIN PROVIDED, nor treat-
ing 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
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 procedures 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  fixa-
tion 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 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. Podiatrists
licensed to practice, but not  authorized  to  prescribe  or  administer
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.
  § 2. Subparagraph (ii) of paragraph c of 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:
  (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
  § 3. Section 7010 of the education law, as added by chapter 438 of the
laws of 2012, is amended to read as follows:
  §  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

S. 5395                             3

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
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.
  § 4. This act shall take effect immediately.