S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2217
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 25, 2023
                                ___________
 
 Introduced  by M. of A. PRETLOW -- read once and referred to the Commit-
   tee 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
 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
 
              

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07111-01-3
 A. 2217                             2

 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
 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
 ________________________________________________________________________
 
                                  2217--A
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 25, 2023
                                ___________
 
 Introduced  by M. of A. PRETLOW -- read once and referred to the Commit-
   tee 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
 section seven thousand nine of  this  article.]  Podiatrists  may  treat
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07111-07-3
              

 A. 2217--A                          2
 
 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-
 priate podiatric  profiling  information  to  the  general  public.  The
 A. 2217--A                          3
 
 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
 certifying  board  having  certification  standards  acceptable  to  the
 A. 2217--A                          4
 
 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
 two of] section seven thousand nine of this article; PROVIDED,  HOWEVER,
 A. 2217--A                          5
 
 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.