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A09293 Summary:

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A09293 Floor Votes:

A09293 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         9293--A
 
                   IN ASSEMBLY
 
                                    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:
 
     1    Section  1.  Section  7001 of the education law, as amended by chapter
     2  677 of the laws of 1996, is amended to read as follows:
     3    § 7001. Definition of practice of podiatry. 1.  The  practice  of  the
     4  profession of podiatry is defined as diagnosing, treating, operating and
     5  prescribing for any disease, injury, deformity or other condition of the
     6  foot,  and  may  include  performing physical evaluations in conjunction
     7  with the provision of podiatric treatment.   For the purposes  of  wound
     8  care  however,  the  practice of podiatry shall include the treatment of
     9  such wounds if they are contiguous with wounds relating, originating  or

    10  in  the  course of treatment of a wound on the foot within the podiatric
    11  scope of practice. Wound care shall not, however, extend beyond  to  the
    12  level  ending  at the distal tibial tuberosity. The practice of podiatry
    13  may also include diagnosing, treating, operating and prescribing for any
    14  disease, injury, deformity or other condition  of  the  ankle  and  soft
    15  tissue  of  the  leg  below  the tibial tuberosity if the podiatrist has
    16  obtained an issuance of a privilege to perform podiatric standard  ankle
    17  surgery or advanced ankle surgery in accordance with section seven thou-
    18  sand  nine  of  this article. Podiatrists may treat traumatic open wound
    19  fractures only in hospitals, as defined in article twenty-eight  of  the

    20  public  health law.   For the purposes of this article, the term "ankle"
    21  shall be defined as the distal metaphysis and epiphysis of the tibia and
    22  fibula, the articular cartilage of the distal tibia and  distal  fibula,
    23  the  ligaments  that  connect the distal metaphysis and epiphysis of the
    24  tibia and fibula and talus,  and  the  portions  of  skin,  subcutaneous
    25  tissue,  facia,  muscles,  tendons, ligaments and nerves at or below the
    26  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
 

     1    2. The practice of podiatry shall not include treating any part of the
     2  human body other than the foot, nor treating fractures of  the  malleoli
     3  or cutting operations upon the malleoli unless the podiatrist obtains an
     4  issuance  of  a privilege to perform podiatric standard ankle surgery or
     5  podiatric advanced ankle surgery. Podiatrists who have obtained an issu-
     6  ance  of  a  privilege  to  perform podiatric standard ankle surgery may
     7  perform surgery on the ankle which may include soft tissue  and  osseous
     8  procedures  except  those  procedures specifically authorized for podia-
     9  trists who have obtained an issuance of a privilege for  advanced  ankle
    10  surgery.  Podiatrists  who  have  obtained an issuance of a privilege to

    11  perform podiatric advanced ankle surgery  may  perform  surgery  on  the
    12  ankle  which  may  include  ankle fracture fixation, ankle fusion, ankle
    13  arthroscopy, insertion or removal of external fixation pins into or from
    14  the tibial diaphysis at or below the level of the myotendinous  junction
    15  of the triceps surae, and insertion and removal of retrograde tibiotalo-
    16  calcanneal intramedullary rods and locking screws up to the level of the
    17  myotendinous  junction  of  the  triceps surae, but does not include the
    18  surgical treatment of complications within the tibial diaphysis  related
    19  to  the  use  of  such external fixation pins.   Podiatrists licensed to
    20  practice, but not authorized to prescribe or administer narcotics  prior

    21  to  the effective date of this subdivision, may do so only after certif-
    22  ication by the department in accordance with the  qualifications  estab-
    23  lished  by  the  commissioner.  The  practice  of podiatry shall include
    24  administering only local anesthetics for therapeutic purposes as well as
    25  for anesthesia and treatment under general  anesthesia  administered  by
    26  authorized  persons.  The practice of podiatry by any licensee shall not
    27  include partial or total ankle replacements nor the treatment  of  pilon
    28  fractures.
    29    §  2. The education law is amended by adding two new sections 7009 and
    30  7010 to read as follows:
    31    § 7009. Podiatric ankle surgery privileges. 1. For issuance of a priv-
    32  ilege to perform podiatric standard ankle surgery, as that term is  used

    33  in  subdivision  two  of section seven thousand one of this article, the
    34  applicant shall fulfill the following requirements:
    35    a. Application: file an application with the department;
    36    b. License: be licensed as a podiatrist in the state;
    37    c. Training and certification: either:
    38    (i) have graduated on or after June first, two  thousand  six  from  a
    39  three-year  residency program in podiatric medicine and surgery that was
    40  accredited by an accrediting agency acceptable to the department, and be
    41  certified in reconstructive rearfoot and ankle  surgery  by  a  national
    42  certifying  board  having  certification  standards  acceptable  to  the
    43  department; or
    44    (ii) have graduated on or after June first, two thousand  six  from  a

    45  three-year  residency program in podiatric medicine and surgery that was
    46  accredited by an accrediting agency acceptable  to  the  department,  be
    47  board  qualified  but  not  yet certified in reconstructive rearfoot and
    48  ankle surgery by a national certifying board having certification stand-
    49  ards acceptable to the department, and provide documentation that he  or
    50  she  has  acceptable  training  and  experience  in  standard or advance
    51  midfoot, rearfoot and ankle procedures that has  been  approved  by  the
    52  department; or
    53    (iii)  have  graduated before June first, two thousand six from a two-
    54  year residency program  in  podiatric  medicine  and  surgery  that  was
    55  accredited  by  an  accrediting  agency acceptable to the department, be

    56  certified in reconstructive rearfoot and ankle  surgery  by  a  national
        A. 9293--A                          3
 
     1  certifying  board  having  certification  standards  acceptable  to  the
     2  department, and provide documentation that  he  or  she  has  acceptable
     3  training  and  experience  in standard or advanced midfoot, rearfoot and
     4  ankle procedures that has been approved by the department;
     5    d. Fees: pay a fee to the department of two hundred twenty dollars for
     6  the issuance of a privilege to perform podiatric standard ankle surgery.
     7    2.  For  issuance  of  a privilege to perform podiatric advanced ankle
     8  surgery, as that term is used in subdivision two of section seven  thou-

     9  sand  one  of  this  article,  the applicant shall fulfill the following
    10  requirements:
    11    a. Application: file an application with the department;
    12    b. License: be licensed as a podiatrist in the state;
    13    c. Experience and certification: either:
    14    (i) have graduated on or after June first, two  thousand  six  from  a
    15  three-year  residency program in podiatric medicine and surgery that was
    16  accredited by an accrediting agency acceptable  to  the  department,  be
    17  certified  in  reconstructive  rearfoot  and ankle surgery by a national
    18  certifying  board  having  certification  standards  acceptable  to  the
    19  department,  and  provide  documentation  that  he or she has acceptable

    20  training and experience in advanced midfoot, rearfoot and  ankle  proce-
    21  dures that has been approved by the department; or
    22    (ii)  have  graduated  before June first, two thousand six from a two-
    23  year residency program  in  podiatric  medicine  and  surgery  that  was
    24  accredited  by  an  accrediting  agency acceptable to the department, be
    25  certified in reconstructive rearfoot and ankle surgery,  by  a  national
    26  certifying  board  having  certification  standards  acceptable  to  the
    27  department, and provide documentation that  he  or  she  has  acceptable
    28  training  and  experience in advanced midfoot, rearfoot and ankle proce-
    29  dures that has been approved by the department.
    30    d. Fees: pay a fee to the department of two hundred twenty dollars for

    31  the issuance of a privilege to perform podiatric advanced ankle surgery.
    32    3. Duration and registration of privileges. A privilege  issued  under
    33  this  section shall be valid for the life of the holder, unless revoked,
    34  annulled, or suspended by the board of regents. Such a  privilege  shall
    35  be subject to the same oversight and disciplinary provisions as licenses
    36  issued  under  this  title.  The holder of a privilege issued under this
    37  section shall register with the department as a privilege holder in  the
    38  same manner and subject to the same provisions as required of a licensee
    39  pursuant  to  section  six  thousand  five  hundred  two  of this title,
    40  provided that, at the time of each registration,  the  privilege  holder

    41  shall  certify that he or she continues to meet the requirements for the
    42  privilege set forth in this section. The fee for such registration shall
    43  be two hundred ten dollars. The  registration  period  for  a  privilege
    44  holder  shall  be  coterminous  with his or her registration as a podia-
    45  trist.
    46    § 7010. Ankle surgery limited permits.   A limited permit  to  perform
    47  podiatric  standard  ankle  surgery,  as described in subdivision two of
    48  section seven thousand one of this article, may be issued by the depart-
    49  ment to a podiatrist who is licensed pursuant to this  article  and  who
    50  has met the residency and board qualification/certification requirements
    51  set  forth  in  subdivision  one  of section seven thousand nine of this

    52  article in order to authorize such podiatrist to obtain the training and
    53  experience required for the  issuance  of  a  podiatric  standard  ankle
    54  surgery  privilege pursuant to subdivision one of section seven thousand
    55  nine of this article. Such permits shall authorize  the  performance  of
    56  podiatric  standard  ankle surgery only under the direct personal super-
        A. 9293--A                          4
 
     1  vision of a licensed  podiatrist  holding  a  podiatric  standard  ankle
     2  surgery privilege or a podiatric advanced ankle surgery privilege issued
     3  pursuant  to  section seven thousand nine of this article or of a physi-
     4  cian  licensed  pursuant to article one hundred thirty-one of this title

     5  and certified in orthopedic  surgery  by  a  national  certifying  board
     6  having certification standards acceptable to the department.
     7    2.  A  limited  permit to perform podiatric advanced ankle surgery, as
     8  described in subdivision two of section seven thousand one of this arti-
     9  cle, may be issued by the department to a  podiatrist  who  is  licensed
    10  pursuant to this article and who has met the residency and board certif-
    11  ication requirements set forth in subdivision two of section seven thou-
    12  sand  nine  of  this  article  in  order to authorize such podiatrist to
    13  obtain the training and experience required for the issuance of a podia-
    14  tric advanced ankle surgery privilege pursuant  to  subdivision  two  of

    15  section  seven thousand nine of this article. Such permits shall author-
    16  ize the performance of podiatric advanced ankle surgery only  under  the
    17  direct personal supervision of a licensed podiatrist holding a podiatric
    18  advanced  ankle  surgery privilege issued pursuant to subdivision two of
    19  section seven thousand nine of this article or of a  physician  licensed
    20  pursuant  to  article one hundred thirty-one of this title and certified
    21  in orthopedic surgery by a  national  certifying  board  having  certif-
    22  ication standards acceptable to the department.
    23    3. For the purposes of this section, direct personal supervision means
    24  supervision  of  procedures  based on instructions given directly by the

    25  supervising podiatrist or physician who remains in  the  immediate  area
    26  where  the procedures are being performed, authorizes the procedures and
    27  evaluates the procedures performed by the holder of the limited permit.
    28    4. The holder of a limited permit  issued  pursuant  to  this  section
    29  shall  perform  podiatric  ankle  surgery  only  in a hospital or health
    30  facility licensed pursuant to article twenty-eight of the public  health
    31  law and appropriately authorized to provide such surgery.
    32    5.  Limited  permits shall be issued for a period of one year, and may
    33  be renewed for additional one year periods when necessary to permit  the
    34  completion of the training and experience required to obtain a podiatric

    35  standard  ankle  surgery  privilege  or podiatric advanced ankle surgery
    36  privilege, as applicable, provided that no permit may  be  renewed  more
    37  than four times for each such privilege.
    38    6.  The fee for a limited permit shall be one hundred five dollars and
    39  the fee for a renewal shall be fifty dollars.
    40    § 3. Paragraph (i) of subdivision 1 of section  230-d  of  the  public
    41  health  law,  as added by chapter 365 of the laws of 2007, is amended to
    42  read as follows:
    43    (i) "Licensee" shall mean an individual licensed or otherwise  author-
    44  ized  under  [articles] article one hundred thirty-one [or], one hundred
    45  thirty-one-B, individuals who have obtained an issuance of  a  privilege

    46  to  perform  podiatric  standard  or  advanced ankle surgery pursuant to
    47  subdivisions one and two of section seven thousand nine of the education
    48  law.
    49    § 4. Section 2995-d of the public health law is amended  by  adding  a
    50  new subdivision 4-a to read as follows:
    51    4-a.  In cooperation with the education department, establish a health
    52  care practitioner database relating to podiatrists. Such database  shall
    53  include information similar to the physician profiles established pursu-
    54  ant  to  section  twenty-nine  hundred  ninety-five-a of this title. The
    55  database shall be capable of presenting relevant medical  and  treatment
        A. 9293--A                          5
 
     1  information  in a format that is easily understood by and made available

     2  to the general public.
     3    § 5. Paragraph 1 of subdivision (d) of section 3101 of the civil prac-
     4  tice  law and rules is amended by adding a new subparagraph (iv) to read
     5  as follows:
     6    (iv) In an action for podiatric medical malpractice, a  physician  may
     7  be called as an expert witness at trial.
     8    §  6.  This  act shall take effect eighteen months after it shall have
     9  become a law. Effective  immediately,  the  addition,  amendment  and/or
    10  repeal of any rule or regulation necessary for the implementation of the
    11  provisions of this act on its effective date is authorized to be made on
    12  or before such effective date.