Relates to podiatry and the scope of podiatric practice.

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S7800-2011 Actions

• Jun 21, 2012: SUBSTITUTED BY A9293A
• Jun 20, 2012: ORDERED TO THIRD READING CAL.1453
• Jun 19, 2012: REFERRED TO RULES

S7800-2011 Meetings

Rules: Jun 21, 2012

S7800-2011 Calendars

Active List: Jun 21, 2012 , Floor Calendar: Jun 20, 2012 , Floor Calendar: Jun 21, 2012

S7800-2011 Votes

S7800-2011 Memo

BILL NUMBER:S7800

TITLE OF BILL:
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

PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this
bill is to expand
the scope of the practice of podiatry in New York State. Expanding
the scope of podiatric practice in New York will bring it more in
line with the vast majority of other States in the country which
already allow the scope of practice to include the treatment of the
ankle and soft tissue areas associated with the ankle, in addition to
structures of the foot.

SUMMARY OF PROVISIONS:
Section 1: Amends Education Law section 7001 to
expand the scope of practice for podiatry to include, in addition to
the treatment of the foot, conditions of the ankle, and all soft
tissue structures related to the ankle that go up the leg to just
below the knee cap. To limit the scope of practice, Podiatrists may
perform surgical treatments of the rear foot and ankle, but such
treatment may not extend beyond the calf of the leg, unless it is
related to the treatment of the ankle.

The bill revises Education Law section 7001(2) to update the law.
First enacted in 1996 to allow newly licensed or certified
podiatrists to prescribe narcotics related to their treatment of
patients, this provision did not allow formerly licensed podiatrists
to prescribe drugs until they had been certified. After 13 years,
this phase-in period of time between old and new podiatrists is not
needed and is therefore eliminated.

This bill section also adds a new subsection (3) to apply the expanded
scope of practice related to ankle surgery (1) to only newly licensed
podiatrists and (2) to currently licensed podiatrists who have
completed a course of study and are deemed competent by the State
Education Department to practice the new expanded scope of practice.
The bill also authorizes all podiatrists to treat soft tissue
structures related to the ankle. All podiatric schools in this
country, including the New York College of podiatric Medicine, teach
the expanded New York scope of practice (as provided for under this
bill). In fact, by enacting this bill, New York will join at least 38
other states that now allow Podiatrists to treat areas above the foot
to include the ankle, and sometimes up to the knee cap.

Amends Public Health Law section 230-d (1) to include podiatrists of
professions (Physicians, Physician Assistants, and Specialists who are
subject to the rules regarding office based surgery.

Section 3: Amends public Health Law section 2995-d to request the
Department of Health, in cooperation with the Education Department,
to study health care practitioner data related to podiatrists and
determine if the provisions related to physician profiling should be


extended to podiatrists so that the public has additional information
on the quality of care provided by individual podiatrists.

Section 4: Amends the civil practice Laws and Rules section 3101 to
allow a physician to be called as an expert witness in a podiatric
medical malpractice action.

JUSTIFICATION:
New York State, is the home of one of the largest
colleges of podiatric Medicine in the country. Further, there are
only eight other such colleges in the country. However, New York has
one of the most restrictive scope of podiatric practice statutes in
the nation being one of only twelve States that limit the scope of
podiatric medicine to the foot. The other states being, Alabama,
Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Mississippi,
South Carolina, South Dakota, Texas, and Washington.

The NYS Education Department has certified the New York College of
podiatric Medicine to offer degrees in the proposed expanded scope of
podiatric medicine (foot, ankle, and leg). This means that students
who earn degrees from this in-state college, can relocate to the
other 3B states that authorize the practice of podiatric care which
includes not only the foot, but also the ankle, and soft tissues
related to the ankle up to the knee cap.

Two disturbing trends are occurring in New York with regard to the
training and location of new podiatric physicians. First, due to New
York's very restrictive definition of podiatric scope of practice,
those graduating from podiatric medical colleges, on a national
basis, are electing to start their practices in states other than New
York. In 1999, The State Education Department provided 145 new
licenses, in 2000, 127 licenses were issued, in 2001, 69 licenses, in
2002 and in 2003, 81 licenses were issued, and in 2007, only 52
licenses were issued to new Podiatrists. This decrease in the number
of new podiatrists being licensed in New York is beginning to result
in a shortage of those capable of providing podiatric care.

Second, while the number of-students who have enrolled in the New York
college of podiatric Medicine has been gradually increasing from 85
students to 92 students for class of 2010 to the class of 2013, the
number of New York residents who have elected annually to enroll in
New York's only podiatric college has decreased substantially from 55
students to 32 students. Generally, students tend to enroll in a
college in the State in which they plan to practice. with New York's
very limited scope of practice laws, prospective New York podiatric
students are electing to be trained outside of New York and then
setting up their practices outside of New York. unfortunately, this
trend indicates that in the future, there were will be even fewer
candidates who wish to apply for licensure for podiatric medicine in
New York. This will clearly
exacerbate the current trends that have reduced the number persons
who have wished to become licensed to practice podiatric medicine in
New York.

Under current law, essentially, New York trains podiatrists and then
encourages them to relocate elsewhere to practice because such
graduates cannot practice the full scope of podiatric medicine that


they were taught in New York. Under current rules, students of
podiatric medicine who Intern or are Residents at the NY College of
podiatric Medicine may practice the expanded scope of podiatric
medicine, as contained in this bill, but only while being trained at
the College. After graduation, their practices must be limited to the
foot, and not include the ankle.
Therefore, under current law, podiatric students are able to practice
the expanded scope of practice as contained in this bill, but not
those who have completed their training and are licensed by the State
of New York. This bill would rectify that dichotomy.

Of the 38 states that allow podiatrists to treat the ankle and
portions of the leg above the ankle, 6 States allow podiatrists to
treat the entire leg. Those states are Florida, Georgia, Idaho,
Nevada, New Hampshire, and Vermont. This bill merely expands the
scope of practice for podiatrists so that it more closely mirrors the
scope of practice used in at least 75 percent of all other states in
the nation.

For those who might maintain that podiatrists should not be allowed to
expand their scope of practice, because it will lead to a higher rate
of patient injury, this supposition is not true. The bill sponsor
contacted the Podiatry Insurance Company of America (PICA) and
inquired about the rate of injury by podiatrists who were limited by
their scope of practice to the foot, and those who were authorized to
treat the ankle and above. This insurer, which covers approximately
750 of all podiatrists in the nation, maintained that the loss
experience between those podiatrists who only treat the foot and
those who treat the ankle and above was the same. Hence, expanding
the scope of podiatric practice should not lead to more injuries to
patients.

The underlying goal of this bill is:

1) to ensure that the New York College of podiatric Medicine can
continue to attract a sufficient number of quality students,
particularly New York resident students, to continue to be a leading
medical college in this important area of medical care, and

2) to ensure that podiatric medical colleges in the State of New York
and around the country graduate students, who in the end will want to
choose t.O practice podiatric medicine in this State to provide this
important services to our residents.

LEGISLATIVE HISTORY:
2010: S.2992-B Passed Senate - A.2518-B Referred to Higher Education

FISCAL IMPLICATIONS:
None to the State.

EFFECTIVE DATE:
18 months after it shall have become law.

S7800-2011 Text

                      S T A T E   O F   N E W   Y O R K
  ________________________________________________________________________

                                    7800

                              I N  SENATE

                                June 19, 2012
                                 ___________

  Introduced  by  Sen.  LIBOUS -- read twice and ordered printed, and when
    printed to be committed to the Committee on Rules

  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.
    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

   EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                        [ ] is old law to be omitted.
                                                             LBD16059-08-2

 S. 7800                             2

  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
  CERTIFYING  BOARD  HAVING  CERTIFICATION  STANDARDS  ACCEPTABLE  TO  THE
  DEPARTMENT, AND PROVIDE DOCUMENTATION THAT  HE  OR  SHE  HAS  ACCEPTABLE

 S. 7800                             3

  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-
  VISION OF A LICENSED  PODIATRIST  HOLDING  A  PODIATRIC  STANDARD  ANKLE
  SURGERY PRIVILEGE OR A PODIATRIC ADVANCED ANKLE SURGERY PRIVILEGE ISSUED

 S. 7800                             4

  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
  INFORMATION  IN A FORMAT THAT IS EASILY UNDERSTOOD BY AND MADE AVAILABLE
  TO THE GENERAL PUBLIC.

 S. 7800                             5

    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.