Bill Sponsors
Urso, McKenney, Ciccone, Murray, Valverde, Bell, Vargas, Lawson, and de la Cruz
Committee
Senate Health & Human Services
Summary
Select
This legislation amends the Rhode Island General Laws regarding nurses to specifically address the provision of foot care services in home settings. It defines "home services" and establishes competency requirements for nurses providing valid foot care, including knowledge of anatomy, pathology, and infection control. The bill outlines the specific scope of care, such as nail trimming and callus smoothing, and mandates that nurses providing these services complete specific continuing education focused on foot care. Furthermore, it exempts nurses who strictly provide home foot care from certain broader facility licensing requirements and authorizes the Department of Health to set relevant fees.
Sponsor
Analysis
Pros for Progressives
- Increases access to essential hygiene and preventative health services for elderly and disabled individuals who are homebound, potentially preventing more serious medical complications.
- Ensures a higher standard of care and dignity for patients by mandating specific clinical competencies and training for nurses performing these intimate services.
- Lowers barriers to practice for nurses by exempting them from onerous facility licensing requirements, allowing for a more flexible workforce to meet community needs.
Cons for Progressives
- By exempting these providers from certain licensing regulations (Sections 23-15-2 and 23-17-42), there is a potential risk of reduced oversight compared to fully licensed home nursing care providers.
- The bill does not mandate insurance coverage for these services, which may result in out-of-pocket costs that low-income patients cannot afford.
- The definition of "home services" explicitly excludes community areas in multi-unit dwellings like senior centers, potentially limiting the ability to provide efficient group care to low-income seniors in shared housing.
Pros for Conservatives
- Reduces government red tape by exempting specific nurses from the heavy regulatory burden and certificate of need requirements found in Sections 23-15-2 and 23-17-42.
- Encourages private enterprise and independent practice by allowing nurses to operate small, specialized businesses without the overhead of a full home care agency.
- Promotes individual responsibility by including "client education" on hygiene, diet, and exercise as a mandatory component of the care provided.
Cons for Conservatives
- Expands government bureaucracy by creating new statutory definitions and specific regulatory mandates for a niche medical service.
- Grants the Department of Health broad authority to determine and levy new license and renewal fees on nurses.
- Imposes specific continuing education mandates, dictating how professionals must allocate their training hours rather than leaving it to professional discretion.
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
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Public Services
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Regulatory
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Clarity of Bill Language
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Environmental Impact
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Privacy Impact
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Bill Status
Current Status
Held
Comm Passed
Floor Passed
Law
History
• 01/16/2026 Introduced, referred to Senate Health and 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. LC003721 - 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. LC003721 - 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.