Senate Bill S2544B

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2544
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 23, 2023
                                ___________
 
 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 AND AFFECTING the foot AND ANKLE AND THE
 SOFT  TISSUE  OF  THE  LEG BELOW THE TIBIAL TUBEROSITY, UNLESS OTHERWISE
 PROVIDED BY THIS SECTION, and may  include  performing  physical  evalu-
 ations  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 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.] Podiatrists may treat traumatic  open  wound
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07111-01-3
              

 S. 2544                             2
 
 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.   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 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 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.  The  opening  paragraph of section 7010 of the education law is
 designated subdivision 1 and subdivision 2, as added by chapter  438  of
 the laws of 2012, is amended to read as follows:
   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
 S. 2544                             3
 
 certifying  board  having  certification  standards  acceptable  to  the
 department.
   § 3. This act shall take effect immediately.

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2544--A
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 23, 2023
                                ___________
 
 Introduced  by  Sen. JACKSON -- 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 modernizing 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, subdivision 1 as amended and subdivision 3 as
 added by chapter 23 of the laws of 2013, is amended to read as follows:
   § 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 AND
 AFFECTING the foot, ANKLE, SKIN AND THE SOFT TISSUE OF THE LEG BELOW THE
 TIBIAL TUBEROSITY, UNLESS OTHERWISE PROVIDED, 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 contig-
 uous with wounds relating, originating or in the course of treatment  of
 a  wound  on the foot within the podiatric scope of practice.] THE PRAC-
 TICE OF PODIATRY SHALL NOT INCLUDE THE FOLLOWING  TREATMENTS  OR  PROCE-
 DURES  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  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

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07111-08-3
              

 S. 2544--A                          2

 section seven thousand nine of  this  article.]  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 epiphy-
 sis of the] tibia and fibula[, the articular] AND RELATED 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
 LIGAMENTS 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.]  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 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 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.
   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 a 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  accordance  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 depart-
 ment 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
 available is appropriate and feasible, the department,  after  consulta-
 tion  with  the  department  of  health,  shall outline in such study an
 appropriate and cost effective method of presenting relevant and  appro-
 S. 2544--A                          3
 
 priate  podiatric  profiling  information  to  the  general  public. The
 department shall submit such study to the governor, the temporary presi-
 dent of the senate, the speaker of the assembly, the minority leader  of
 the senate 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.
   § 2. Section 7009 of the education law, as added by chapter 438 of the
 laws of 2012, is amended to read as follows:
   §  7009. [Podiatric ankle] ANKLE surgery privileges. 1.  [For issuance
 of a privilege to perform podiatric standard ankle surgery, as that term
 is used in subdivision two of section seven thousand one of  this  arti-
 cle, 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  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
 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.
   2.]  For issuance of a privilege to perform [podiatric advanced] ankle
 surgery, as that term is used in  [subdivision  two  of]  section  seven
 thousand  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. Experience 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,  be
 certified  in  reconstructive  rearfoot  and ankle surgery by a national
 S. 2544--A                          4
 
 certifying  board  having  certification  standards  acceptable  to  the
 department,  and  provide  documentation  that  he or she has acceptable
 training and experience in advanced midfoot, rearfoot and  ankle  proce-
 dures that has been approved by the department; or
   (ii)  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 advanced midfoot, rearfoot and ankle proce-
 dures 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  advanced]  ankle
 surgery.
   [3.]  2.  Duration and registration of privileges.  A privilege issued
 under this section shall be valid for the life  of  the  holder,  unless
 revoked,  annulled,  or suspended by the board of regents. Such a privi-
 lege shall be subject to the same oversight and disciplinary  provisions
 as  licenses  issued  under this title. The holder of a privilege issued
 under this section shall register with the  department  as  a  privilege
 holder in the same manner and subject to the same provisions as required
 of  a licensee pursuant to section six thousand five hundred two of this
 title, provided that, at the time of each  registration,  the  privilege
 holder  shall  certify that he or she continues to meet the requirements
 for the privilege set forth in this section. The fee for such  registra-
 tion  shall  be  two  hundred ten dollars. The registration period for a
 privilege holder shall be coterminous with his or her registration as  a
 podiatrist.
   § 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. [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.] 1. A limited permit to perform [podiatric advanced] ankle surgery,
 as  described in [subdivision two of] section seven thousand one of this
 article, 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
 thousand  nine  of this article in order to authorize such podiatrist to
 obtain the training and  experience  required  for  the  issuance  of  a
 [podiatric  advanced]  ankle  surgery privilege pursuant to [subdivision
 S. 2544--A                          5

 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 THE PURPOSES OF THIS SUBDIVI-
 SION.    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 priv-
 ilege  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.] 2. For the purposes of this  section,  [direct  personal]  super-
 vision  means  supervision  of  procedures  based  on instructions given
 directly by the supervising podiatrist or physician who remains  in  the
 immediate  area where the procedures are being performed, authorizes the
 procedures and evaluates the procedures performed by the holder  of  the
 limited permit.
   [4.] 3. 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.]  4. 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.] 5. 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 on the one hundred twentieth day after
 it shall have become a law. Effective immediately, the addition,  amend-
 ment and/or repeal of any rule or regulation necessary for the implemen-
 tation  of  this act on its effective date are authorized to be made and
 completed on or before such effective date.