Bill Sponsors
Boylan, McGaw, Potter, Donovan, Fogarty, Speakman, Azzinaro, Kislak, Bennett, and Hopkins
Committee
House Health & Human Services
Summary
Select
This legislation establishes specific regulations for nurses providing foot care services in patients' homes. It defines the scope of "home services foot care" to include assessments, nail trimming, and treating corns or calluses, while excluding services in hospitals or nursing homes. The bill mandates that nurses performing these services demonstrate competency in foot anatomy and infection control and requires them to dedicate two hours of their continuing education specifically to foot care. Additionally, it exempts nurses who strictly provide this service from certain facility licensing and "certificate of need" requirements, allowing them to practice more independently under Department of Health oversight.
Sponsor
Analysis
Pros for Progressives
- Expands access to essential healthcare services for vulnerable populations, particularly the elderly and disabled who wish to age in place rather than in institutional settings.
- Lowers barriers to entry for nurses, potentially creating more flexible employment opportunities and allowing for a more responsive community healthcare workforce.
- Ensures dignity and safety for home-bound patients by mandating specific competency standards and infection control protocols for foot care.
Cons for Progressives
- Exempts providers from broader home nursing care agency regulations, which could potentially reduce the level of oversight compared to fully licensed agencies.
- May encourage a "gig economy" model of healthcare delivery that lacks the benefits and worker protections associated with traditional agency employment.
- Does not mandate insurance coverage for these services, potentially leaving low-income patients to pay out-of-pocket for necessary care.
Pros for Conservatives
- Reduces government bureaucracy by exempting specific independent nurses from burdensome Certificate of Need laws and full home nursing agency licensing requirements.
- Promotes economic freedom and entrepreneurship by allowing nurses to operate independent practices without the overhead of a large agency structure.
- Encourages free-market competition in the healthcare sector, which may drive down costs and improve service options for consumers.
Cons for Conservatives
- Empowers the Department of Health to set new license and renewal fees, creating a potential revenue stream for the government at the expense of private practitioners.
- Imposes specific government mandates on professional training by dictating how nurses must allocate their continuing education hours.
- Expands regulatory language defining "client education," thereby increasing government involvement in the patient-provider relationship.
Constitutional Concerns
None Likely
Impact Overview
Groups Affected
- Nurses
- Home care patients
- Elderly residents
- Department of Health
- Assisted living residents
Towns Affected
All
Cost to Taxpayers
None
Revenue Generated
Amount unknown
BillBuddy Impact Ratings
Importance
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Freedom Impact
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Public Services
How much the bill is likely to impact one or more public services.
Regulatory
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Clarity of Bill Language
How clear the language of the bill is. Higher ambiguity equals a lower score.
Enforcement Provisions
Measures enforcement provisions and penalties for non-compliance (if applicable).
Environmental Impact
Impact the bill will have on the environment, positive or negative.
Privacy Impact
Impact the bill is likely to have on the privacy of individuals.
Bill Status
Current Status
Held
Comm Passed
Floor Passed
Law
History
• 01/09/2026 Introduced, referred to House Health & Human Services
Bill Text
SECTION 1. Chapter 5-34 of the General Laws entitled "Nurses" is hereby amended by adding thereto the following section:
5-34-51. Foot care.
(a) The purpose of this section is to recognize and promote the rights of home care patients and clients to receive safe, appropriate, and high quality foot care and services in a timely manner with consideration, dignity, respect, and privacy, consistent with the provisions of § 23-17.16-5.
(b) As used in this section, the following terms shall have the following meanings unless the context clearly indicates otherwise:
(1) “Client education” includes, but is not limited to, the following:
(i) Self-care, hygiene, and health habits;
(ii) Appropriate footwear;
(iii) Nutrition;
(iv) Exercise;
(v) Compliance with medical regime; and
(vi) Reporting changes and problems to the patient’s podiatrist if one is provided or identified by the client.
(2) “Home services” means services provided in an individual’s private residential space or dwelling. It includes houses, apartments, condominiums, or other buildings where people live independently or with limited personal assistance, such as an assisted living facility. It does not include facilities such as long-term care nursing homes, hospitals or other facilities or in-patient units where twenty-four (24) hour clinical care is available, nor does it include commercial or public spaces or the common/community areas of multi-unit dwellings such as apartment buildings, condominiums, or senior centers.
(c) Nurses who provide home services foot care shall have theoretical knowledge of and demonstrate clinical competency in:
(1) Foot and lower extremity anatomy and physiology;
(2) Structure and function of the foot and nail;
(3) Common foot pathology and related nursing interventions;
(4) Changes in the foot due to age and chronic diseases;
(5) Nursing assessment of the foot and lower extremities;
(6) Use of instruments used in nursing foot care; and
(7) Infection control.
(d) Home services foot care is considered a nursing intervention that includes, but is not limited to, the following components:
(1) Assessing past medical history including diabetes mellitus, peripheral vascular disease or peripheral neuropathy;
(2) Assessing health habits affecting feet and lower extremities (activity level, exercise, obesity, diet, smoking, etc.);
(3) Assessing circulation;
(4) Assessing skin integrity, foot and nail structure;
(5) Assessing pain and methods of relief; and
(6) Implementing a plan of foot care that is consistent with recognized standards of practice that includes:
(i) Hygiene and shortening of toe and finger nails;
(ii) The use of emery boards or pedicure drill with emery disc attachment, to smooth corns or calluses;
(iii) Referring the patient to an appropriate practitioner for further assessment and orders when alterations in skin integrity, foot structure and/or other abnormalities require application of prescribed or over-the-counter treatments/devices;
(iv) Evaluating client response to a plan of care; and
(v) Appropriate client education.
(e) A nurse providing in-home foot care shall ensure that two (2) hours of continuing education out of the ten (10) hours required per certification period shall be focused on foot care. LC003130 - Page 2 of 4
(f) A nurse whose home care services are limited to providing home services foot care pursuant to and as described in this section shall be exempt from the requirements of §§ 23-15-2 and 23-17-42.
(g) The department of health shall determine fair and reasonable license and renewal fees for nurses who provide services pursuant to this section.
SECTION 2. This act shall take effect upon passage.
5-34-51. Foot care.
(a) The purpose of this section is to recognize and promote the rights of home care patients and clients to receive safe, appropriate, and high quality foot care and services in a timely manner with consideration, dignity, respect, and privacy, consistent with the provisions of § 23-17.16-5.
(b) As used in this section, the following terms shall have the following meanings unless the context clearly indicates otherwise:
(1) “Client education” includes, but is not limited to, the following:
(i) Self-care, hygiene, and health habits;
(ii) Appropriate footwear;
(iii) Nutrition;
(iv) Exercise;
(v) Compliance with medical regime; and
(vi) Reporting changes and problems to the patient’s podiatrist if one is provided or identified by the client.
(2) “Home services” means services provided in an individual’s private residential space or dwelling. It includes houses, apartments, condominiums, or other buildings where people live independently or with limited personal assistance, such as an assisted living facility. It does not include facilities such as long-term care nursing homes, hospitals or other facilities or in-patient units where twenty-four (24) hour clinical care is available, nor does it include commercial or public spaces or the common/community areas of multi-unit dwellings such as apartment buildings, condominiums, or senior centers.
(c) Nurses who provide home services foot care shall have theoretical knowledge of and demonstrate clinical competency in:
(1) Foot and lower extremity anatomy and physiology;
(2) Structure and function of the foot and nail;
(3) Common foot pathology and related nursing interventions;
(4) Changes in the foot due to age and chronic diseases;
(5) Nursing assessment of the foot and lower extremities;
(6) Use of instruments used in nursing foot care; and
(7) Infection control.
(d) Home services foot care is considered a nursing intervention that includes, but is not limited to, the following components:
(1) Assessing past medical history including diabetes mellitus, peripheral vascular disease or peripheral neuropathy;
(2) Assessing health habits affecting feet and lower extremities (activity level, exercise, obesity, diet, smoking, etc.);
(3) Assessing circulation;
(4) Assessing skin integrity, foot and nail structure;
(5) Assessing pain and methods of relief; and
(6) Implementing a plan of foot care that is consistent with recognized standards of practice that includes:
(i) Hygiene and shortening of toe and finger nails;
(ii) The use of emery boards or pedicure drill with emery disc attachment, to smooth corns or calluses;
(iii) Referring the patient to an appropriate practitioner for further assessment and orders when alterations in skin integrity, foot structure and/or other abnormalities require application of prescribed or over-the-counter treatments/devices;
(iv) Evaluating client response to a plan of care; and
(v) Appropriate client education.
(e) A nurse providing in-home foot care shall ensure that two (2) hours of continuing education out of the ten (10) hours required per certification period shall be focused on foot care. LC003130 - Page 2 of 4
(f) A nurse whose home care services are limited to providing home services foot care pursuant to and as described in this section shall be exempt from the requirements of §§ 23-15-2 and 23-17-42.
(g) The department of health shall determine fair and reasonable license and renewal fees for nurses who provide services pursuant to this section.
SECTION 2. This act shall take effect upon passage.