NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A2217A
SPONSOR: Pretlow TITLE OF BILL:
An act to amend the education law, in relation to modernizing the scope
of the practice of podiatry
PURPOSE OR GENERAL IDEA OF BILL:
To correct certain errors within chapter 438 of the laws of 2012 relat-
ing to the podiatric scope of practice.
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 Amends section 7001 of the education law to acknowledge exist-
ing authority of licensed podiatrists to diagnose and treat conditions
affecting the skin of the foot and to extend that authority to condi-
tions affecting the skin of the ankle, as well, consistent with recently
§ 2. Amends section 7009 of the education law as added by chapter 438 of
the laws of 2012 and outlines requirements that applicants must fulfill
in order to get a license, as well as the duration and registration.
Also outlines fees to be paid to the department for the issuance of a
privilege to perform ankle surgery.
§ 3. Amends section 7010 of the education law relating to the privilege
to perform podiatric advanced ankle surgery, to include certification in
foot surgery and foot and ankle surgery within categories of certif-
ication required for issuance of such privilege. Amends section 7010 of
the education law relating to the issuance of ankle surgery permits to
clarify that the supervision required. with respect to such permits may
be provided by a duly qualified licensed podiatrist or physician in the
immediate area of the procedure or otherwise with the approval of the
hospital's orthopedic or surgery department chair.
§ 4. Effective date
JUSTIFICATION:
Chapter 438 of the laws of 2012 reflected several years of negotiations
and discussions among interested parties to allow the podiatric scope of
practice to be aligned with current educational and clinical standards
which included diagnosis and treatment of ailments of the ankle. Certain
provisions of the chapter, however, required technical amendments and
further refinement. The legislative proposals reflect these refinements
and technical corrections.
PRIOR LEGISLATIVE HISTORY:
2023 01/25/23 A2217 referred to higher education
2021-2022 A2294 referred to higher education
2019-2020 A6185 referred to education
06/05/18 held for consideration in higher education
2014-14 referred to higher education new bill
01/07/15 referred to higher education
06/15/15 amend and recommit to higher education
06/15/15 print number 719a
01/06/16 referred to higher education
03/09/16 amend and recommit to higher education
03/09/16 print number 719b
FISCAL IMPLICATIONS:
None
EFFECTIVE DATE:
This act shall take effect on the one hundred twentieth day 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 this act on its effective date are authorized to be made and
completed on or before such effective date.
STATE OF NEW YORK
________________________________________________________________________
2217--A
2023-2024 Regular Sessions
IN ASSEMBLY
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:
1 Section 1. Section 7001 of the education law, as amended by chapter
2 438 of the laws of 2012, subdivision 1 as amended and subdivision 3 as
3 added by chapter 23 of the laws of 2013, is amended to read as follows:
4 § 7001. Definition of practice of podiatry. 1. The practice of the
5 profession of podiatry is defined as diagnosing, treating, operating and
6 prescribing for any disease, injury, deformity or other condition of and
7 affecting the foot, ankle, skin and the soft tissue of the leg below the
8 tibial tuberosity, unless otherwise provided, and may include performing
9 physical evaluations in conjunction with the provision of podiatric
10 treatment. [For the purposes of wound care however, the practice of
11 podiatry shall include the treatment of such wounds if they are contig-
12 uous with wounds relating, originating or in the course of treatment of
13 a wound on the foot within the podiatric scope of practice.] The prac-
14 tice of podiatry shall not include the following treatments or proce-
15 dures performed above the level of the malleoli, unless otherwise
16 provided: the treatment of melanoma; performance of mohs surgery; muscle
17 flaps or microvascular anastamoses. Wound care shall not[, however,]
18 extend beyond the level ending at the distal tibial tuberosity. [The
19 practice of podiatry may also include diagnosing, treating, operating
20 and prescribing for any disease, injury, deformity or other condition of
21 the ankle and soft tissue of the leg below the tibial tuberosity if the
22 podiatrist has obtained an issuance of a privilege to perform podiatric
23 standard ankle surgery or advanced ankle surgery in accordance with
24 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
1 traumatic open wound fractures only in hospitals, as defined in article
2 twenty-eight of the public health law. For the purposes of this article,
3 the term "ankle" shall be defined as the distal [metaphysis and epiphy-
4 sis of the] tibia and fibula[, the articular] and related cartilage [of
5 the distal tibia and distal fibula, the ligaments that connect the
6 distal metaphysis and epiphysis of the tibia and fibula and talus,] and
7 ligaments and the portions of skin, subcutaneous tissue, facia, muscles,
8 tendons, ligaments and nerves at or below the level of the myotendinous
9 junction of the triceps surae.
10 2. [The practice of podiatry shall not include treating any part of
11 the human body other than the foot, nor treating fractures of the
12 malleoli or cutting operations upon the malleoli unless the podiatrist
13 obtains an issuance of a privilege to perform podiatric standard ankle
14 surgery or podiatric advanced ankle surgery.] Podiatrists who have
15 obtained an issuance of a privilege to perform [podiatric standard]
16 ankle surgery may perform surgery on the ankle which may include soft
17 tissue and osseous procedures except those procedures specifically
18 authorized for podiatrists who have obtained an issuance of a privilege
19 for advanced ankle surgery. Podiatrists who have obtained an issuance of
20 a privilege to perform podiatric advanced ankle surgery may perform
21 surgery on the ankle which may include ankle fracture fixation, ankle
22 fusion, [ankle arthroscopy,] insertion or removal of external fixation
23 pins into or from the tibial diaphysis at or below the level of the
24 myotendinous junction of the triceps surae, and insertion and removal of
25 retrograde tibiotalocalcanneal intramedullary rods and locking screws up
26 to the level of the myotendinous junction of the triceps surae, but does
27 not include the surgical treatment of complications within the tibial
28 diaphysis related to the use of such external fixation pins. Podiatrists
29 licensed to practice, but not authorized to prescribe or administer
30 narcotics prior to the effective date of this subdivision, may do so
31 only after certification by the department in accordance with the quali-
32 fications established by the commissioner. The practice of podiatry
33 shall include administering only local anesthetics for therapeutic
34 purposes as well as for anesthesia and treatment under general anes-
35 thesia administered by authorized persons. The practice of podiatry by
36 any licensee shall not include [partial or total ankle replacements nor]
37 the treatment of pilon fractures.
38 3. (a) The department shall conduct a study to determine whether to
39 make available to the public profiles on podiatrists who have obtained
40 an issuance of a privilege to perform [podiatric standard or advanced]
41 ankle surgery pursuant to [subdivisions one and two of] section seven
42 thousand nine of this article. Such study shall include consideration of
43 whether it would be appropriate and feasible for the department to make
44 publicly available profiles for such podiatrists in a manner similar to
45 physician profiles made available on the department of health's website
46 in accordance with section twenty-nine hundred ninety-five-a of the
47 public health law. The department shall consult with the department of
48 health as necessary on matters related to the operation of the depart-
49 ment of health's physician profiles established pursuant to section
50 twenty-nine hundred ninety-five-a of the public health law in conducting
51 its study.
52 (b) If the department determines that making podiatrist profiles
53 available is appropriate and feasible, the department, after consulta-
54 tion with the department of health, shall outline in such study an
55 appropriate and cost effective method of presenting relevant and appro-
56 priate podiatric profiling information to the general public. The
A. 2217--A 3
1 department shall submit such study to the governor, the temporary presi-
2 dent of the senate, the speaker of the assembly, the minority leader of
3 the senate and the minority leader of the assembly on or before November
4 first, two thousand sixteen.
5 (c) If the department makes podiatrist profiles available as set forth
6 in paragraph (b) of this subdivision, the department of health shall
7 include on its website containing the physician profiles established
8 pursuant to section twenty-nine hundred ninety-five-a of the public
9 health law a link to the website on which such podiatrist profiles may
10 be accessed and a statement describing the purpose of such link.
11 § 2. Section 7009 of the education law, as added by chapter 438 of the
12 laws of 2012, is amended to read as follows:
13 § 7009. [Podiatric ankle] Ankle surgery privileges. 1. [For issuance
14 of a privilege to perform podiatric standard ankle surgery, as that term
15 is used in subdivision two of section seven thousand one of this arti-
16 cle, the applicant shall fulfill the following requirements:
17 a. Application: file an application with the department;
18 b. License: be licensed as a podiatrist in the state;
19 c. Training and certification: either:
20 (i) have graduated on or after June first, two thousand six from a
21 three-year residency program in podiatric medicine and surgery that was
22 accredited by an accrediting agency acceptable to the department, and be
23 certified in reconstructive rearfoot and ankle surgery by a national
24 certifying board having certification standards acceptable to the
25 department; or
26 (ii) have graduated on or after June first, two thousand six from a
27 three-year residency program in podiatric medicine and surgery that was
28 accredited by an accrediting agency acceptable to the department, be
29 board qualified but not yet certified in reconstructive rearfoot and
30 ankle surgery by a national certifying board having certification stand-
31 ards acceptable to the department, and provide documentation that he or
32 she has acceptable training and experience in standard or advance
33 midfoot, rearfoot and ankle procedures that has been approved by the
34 department; or
35 (iii) have graduated before June first, two thousand six from a two-
36 year residency program in podiatric medicine and surgery that was
37 accredited by an accrediting agency acceptable to the department, be
38 certified in reconstructive rearfoot and ankle surgery by a national
39 certifying board having certification standards acceptable to the
40 department, and provide documentation that he or she has acceptable
41 training and experience in standard or advanced midfoot, rearfoot and
42 ankle procedures that has been approved by the department;
43 d. Fees: pay a fee to the department of two hundred twenty dollars for
44 the issuance of a privilege to perform podiatric standard ankle surgery.
45 2.] For issuance of a privilege to perform [podiatric advanced] ankle
46 surgery, as that term is used in [subdivision two of] section seven
47 thousand one of this article, the applicant shall fulfill the following
48 requirements:
49 a. Application: file an application with the department;
50 b. License: be licensed as a podiatrist in the state;
51 c. Experience and certification: either:
52 (i) have graduated on or after June first, two thousand six from a
53 three-year residency program in podiatric medicine and surgery that was
54 accredited by an accrediting agency acceptable to the department, be
55 certified in reconstructive rearfoot and ankle surgery by a national
56 certifying board having certification standards acceptable to the
A. 2217--A 4
1 department, and provide documentation that he or she has acceptable
2 training and experience in advanced midfoot, rearfoot and ankle proce-
3 dures that has been approved by the department; or
4 (ii) have graduated before June first, two thousand six from a two-
5 year residency program in podiatric medicine and surgery that was
6 accredited by an accrediting agency acceptable to the department, be
7 certified in reconstructive rearfoot and ankle surgery, by a national
8 certifying board having certification standards acceptable to the
9 department, and provide documentation that he or she has acceptable
10 training and experience in advanced midfoot, rearfoot and ankle proce-
11 dures that has been approved by the department.
12 d. Fees: pay a fee to the department of two hundred twenty dollars for
13 the issuance of a privilege to perform [podiatric advanced] ankle
14 surgery.
15 [3.] 2. Duration and registration of privileges. A privilege issued
16 under this section shall be valid for the life of the holder, unless
17 revoked, annulled, or suspended by the board of regents. Such a privi-
18 lege shall be subject to the same oversight and disciplinary provisions
19 as licenses issued under this title. The holder of a privilege issued
20 under this section shall register with the department as a privilege
21 holder in the same manner and subject to the same provisions as required
22 of a licensee pursuant to section six thousand five hundred two of this
23 title, provided that, at the time of each registration, the privilege
24 holder shall certify that he or she continues to meet the requirements
25 for the privilege set forth in this section. The fee for such registra-
26 tion shall be two hundred ten dollars. The registration period for a
27 privilege holder shall be coterminous with his or her registration as a
28 podiatrist.
29 § 3. Section 7010 of the education law, as added by chapter 438 of the
30 laws of 2012, is amended to read as follows:
31 § 7010. Ankle surgery limited permits. [A limited permit to perform
32 podiatric standard ankle surgery, as described in subdivision two of
33 section seven thousand one of this article, may be issued by the depart-
34 ment to a podiatrist who is licensed pursuant to this article and who
35 has met the residency and board qualification/certification requirements
36 set forth in subdivision one of section seven thousand nine of this
37 article in order to authorize such podiatrist to obtain the training and
38 experience required for the issuance of a podiatric standard ankle
39 surgery privilege pursuant to subdivision one of section seven thousand
40 nine of this article. Such permits shall authorize the performance of
41 podiatric standard ankle surgery only under the direct personal super-
42 vision of a licensed podiatrist holding a podiatric standard ankle
43 surgery privilege or a podiatric advanced ankle surgery privilege issued
44 pursuant to section seven thousand nine of this article or of a physi-
45 cian licensed pursuant to article one hundred thirty-one of this title
46 and certified in orthopedic surgery by a national certifying board
47 having certification standards acceptable to the department.
48 2.] 1. A limited permit to perform [podiatric advanced] ankle surgery,
49 as described in [subdivision two of] section seven thousand one of this
50 article, may be issued by the department to a podiatrist who is licensed
51 pursuant to this article and who has met the residency and board certif-
52 ication requirements set forth in [subdivision two of] section seven
53 thousand nine of this article in order to authorize such podiatrist to
54 obtain the training and experience required for the issuance of a
55 [podiatric advanced] ankle surgery privilege pursuant to [subdivision
56 two of] section seven thousand nine of this article; provided, however,
A. 2217--A 5
1 that board qualification shall be deemed to satisfy the certification
2 requirements set forth in such section for the purposes of this subdivi-
3 sion. Such permits shall authorize the performance of [podiatric
4 advanced] ankle surgery only under the [direct personal] supervision of
5 a licensed podiatrist holding a [podiatric advanced] ankle surgery priv-
6 ilege issued pursuant to [subdivision two of] section seven thousand
7 nine of this article or of a physician licensed pursuant to article one
8 hundred thirty-one of this title and certified in orthopedic surgery by
9 a national certifying board having certification standards acceptable to
10 the department.
11 [3.] 2. For the purposes of this section, [direct personal] super-
12 vision means supervision of procedures based on instructions given
13 directly by the supervising podiatrist or physician who remains in the
14 immediate area where the procedures are being performed, authorizes the
15 procedures and evaluates the procedures performed by the holder of the
16 limited permit.
17 [4.] 3. The holder of a limited permit issued pursuant to this section
18 shall perform [podiatric] ankle surgery only in a hospital or health
19 facility licensed pursuant to article twenty-eight of the public health
20 law and appropriately authorized to provide such surgery.
21 [5.] 4. Limited permits shall be issued for a period of one year, and
22 may be renewed for additional one year periods when necessary to permit
23 the completion of the training and experience required to obtain a
24 [podiatric standard] ankle surgery privilege [or podiatric advanced
25 ankle surgery privilege, as applicable], provided that no permit may be
26 renewed more than four times for each such privilege.
27 [6.] 5. The fee for a limited permit shall be one hundred five dollars
28 and the fee for a renewal shall be fifty dollars.
29 § 4. This act shall take effect on the one hundred twentieth day after
30 it shall have become a law. Effective immediately, the addition, amend-
31 ment and/or repeal of any rule or regulation necessary for the implemen-
32 tation of this act on its effective date are authorized to be made and
33 completed on or before such effective date.
