S T A T E   O F   N E W   Y O R K
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                                 9293--A

                          I N  A S S E M B L Y

                            February 14, 2012
                               ___________

Introduced by M. of A. PRETLOW, LATIMER, CASTRO -- Multi-Sponsored by --
  M.  of  A.  RA,  WALTER  -- 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, the public health law, and the civil
  practice law and rules, in relation to the podiatric scope of practice

  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
677 of the laws of 1996, 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 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 THOU-
SAND  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 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.

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

                                                           LBD02760-07-2

A. 9293--A                          2

  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 ISSU-
ANCE  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 PODIA-
TRISTS 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 TIBIOTALO-
CALCANNEAL 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 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. The education law is amended by adding two new sections 7009 and
7010 to read as follows:
  S 7009. PODIATRIC ANKLE SURGERY PRIVILEGES. 1. FOR ISSUANCE OF A PRIV-
ILEGE TO PERFORM PODIATRIC STANDARD 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. 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

A. 9293--A                          3

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  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. 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
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. 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  PRIVILEGE  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 REGISTRATION SHALL
BE TWO HUNDRED TEN DOLLARS. THE  REGISTRATION  PERIOD  FOR  A  PRIVILEGE
HOLDER  SHALL  BE  COTERMINOUS  WITH HIS OR HER REGISTRATION AS A PODIA-
TRIST.
  S 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-

A. 9293--A                          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 PODIATRIC
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  CERTIF-
ICATION 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 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. 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 3. Paragraph (i) of subdivision 1 of section  230-d  of  the  public
health  law,  as added by chapter 365 of the laws of 2007, is amended to
read as follows:
  (i) "Licensee" shall mean an individual licensed or otherwise  author-
ized  under  [articles] ARTICLE one hundred thirty-one [or], one hundred
thirty-one-B, INDIVIDUALS 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 the education
law.
  S 4. Section 2995-d of the public health law is amended  by  adding  a
new subdivision 4-a to read as follows:
  4-A.  IN COOPERATION WITH THE EDUCATION DEPARTMENT, ESTABLISH A HEALTH
CARE PRACTITIONER DATABASE RELATING TO PODIATRISTS. SUCH DATABASE  SHALL
INCLUDE INFORMATION SIMILAR TO THE PHYSICIAN PROFILES ESTABLISHED PURSU-
ANT  TO  SECTION  TWENTY-NINE  HUNDRED  NINETY-FIVE-A OF THIS TITLE. THE
DATABASE SHALL BE CAPABLE OF PRESENTING RELEVANT MEDICAL  AND  TREATMENT

A. 9293--A                          5

INFORMATION  IN A FORMAT THAT IS EASILY UNDERSTOOD BY AND MADE AVAILABLE
TO THE GENERAL PUBLIC.
  S 5. Paragraph 1 of subdivision (d) of section 3101 of the civil prac-
tice  law and rules is amended by adding a new subparagraph (iv) to read
as follows:
  (IV) IN AN ACTION FOR PODIATRIC MEDICAL MALPRACTICE, A  PHYSICIAN  MAY
BE CALLED AS AN EXPERT WITNESS AT TRIAL.
  S  6.  This  act shall take effect eighteen months after it shall have
become a law. Effective  immediately,  the  addition,  amendment  and/or
repeal of any rule or regulation necessary for the implementation of the
provisions of this act on its effective date is authorized to be made on
or before such effective date.