Bill Sponsors
Urso, McKenney, Ciccone, Murray, Valverde, Bell, Vargas, Lawson, and de la Cruz
Committee
Senate Health & Human Services
Summary
Select
This bill creates new rules for registered nurses who provide foot care services to patients in their private homes or assisted living facilities. It requires these nurses to hold specific national certifications in foot care and demonstrate knowledge of foot anatomy, diseases, and infection control. The bill outlines the specific assessments and treatments these nurses can perform, such as trimming nails and smoothing calluses, and requires them to refer patients to doctors for more serious issues. It also requires two hours of continuing education in foot care and exempts these specific nurses from broader home healthcare agency licensing requirements.
Sponsor
Analysis
Pros for Progressives
- Increases access to specialized healthcare for elderly and disabled individuals who are homebound, allowing them to age in place with dignity and better health outcomes.
- Ensures high-quality care and patient safety by establishing strict certification, competency, and continuing education requirements for home foot care nurses.
- Lowers barriers for individual nurses to provide specialized care by exempting them from burdensome and expensive home nursing care provider licensing requirements, fostering a more accessible healthcare workforce.
Cons for Progressives
- The requirement for additional national certifications and specific continuing education may impose financial burdens on nurses, potentially limiting the number of providers available to lower-income communities.
- Allowing the Department of Health to set new license and renewal fees could increase out-of-pocket costs for nurses, which may be passed on to vulnerable patients in the form of higher service fees.
- Exempting these nurses from broader home care licensing and Certificate of Need requirements might reduce state oversight and regulatory protections designed to ensure equitable healthcare distribution.
Pros for Conservatives
- Reduces bureaucratic red tape by exempting specialized foot care nurses from the state's Certificate of Need and broad home nursing care provider licensing requirements.
- Promotes free-market healthcare solutions by allowing independent nurses to offer private in-home foot care services without needing to establish a fully licensed home healthcare agency.
- Specifies clear, limited scopes of practice for these nurses, ensuring they refer more complex medical issues to specialized physicians rather than overstepping their medical authority.
Cons for Conservatives
- Imposes new state-mandated certification, credentialing, and continuing education requirements on registered nurses who want to provide basic foot care services.
- Grants the Department of Health the authority to create and determine new license and renewal fees, essentially representing a new financial burden on healthcare workers.
- Creates unnecessary government intervention by strictly defining specific tools and procedures allowed, rather than trusting the professional judgment of licensed registered nurses.
Constitutional Concerns
None Likely. This bill regulates the medical profession and establishes licensing and certification standards for nurses providing specialized foot care. States possess broad police powers to regulate healthcare professions to protect public health and safety. There are no obvious free speech, due process, or search and seizure concerns.
Impact Overview
Groups Affected
- Registered nurses
- Homebound patients
- Elderly individuals
- Podiatrists
- Assisted living facility residents
Towns Affected
All
Cost to Taxpayers
None
Revenue Generated
Amount unknown
BillBuddy Impact Ratings
Importance
Measures population affected and overall level of impact.
Freedom Impact
Level of individual freedom impacted by the bill.
Public Services
How much the bill is likely to impact one or more public services.
Regulatory
Estimated regulatory burden imposed on the subject(s) of the bill.
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
• 01/16/2026 Introduced, referred to Senate Health and Human Services
• 02/27/2026 Scheduled for hearing and/or consideration (03/03/2026)
• 03/03/2026 Committee recommended measure be held for further study
• 03/27/2026 Scheduled for consideration (03/31/2026)
• 03/30/2026 Proposed Substitute
• 03/31/2026 Committee recommends passage of Sub A
• 04/02/2026 Placed on Senate Calendar (04/07/2026)
• 04/07/2026 Senate passed Sub A
• 04/08/2026 Referred to House Health & Human Services
• 04/10/2026 Scheduled for consideration (04/14/2026)
• 04/14/2026 Committee recommends passage of Sub A in concurrence
• 04/24/2026 Placed on the House Consent Calendar (04/28/2026)
• 04/28/2026 House passed Sub A in concurrence
• 04/28/2026 Transmitted to Governor
• 04/29/2026 Signed by Governor
• 02/27/2026 Scheduled for hearing and/or consideration (03/03/2026)
• 03/03/2026 Committee recommended measure be held for further study
• 03/27/2026 Scheduled for consideration (03/31/2026)
• 03/30/2026 Proposed Substitute
• 03/31/2026 Committee recommends passage of Sub A
• 04/02/2026 Placed on Senate Calendar (04/07/2026)
• 04/07/2026 Senate passed Sub A
• 04/08/2026 Referred to House Health & Human Services
• 04/10/2026 Scheduled for consideration (04/14/2026)
• 04/14/2026 Committee recommends passage of Sub A in concurrence
• 04/24/2026 Placed on the House Consent Calendar (04/28/2026)
• 04/28/2026 House passed Sub A in concurrence
• 04/28/2026 Transmitted to Governor
• 04/29/2026 Signed by Governor
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.
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 be licensed as a registered nurse and shall be certified and credentialed by a relevant national professional organization including, but not limited to, the American Foot Care Nurses Association or the Wound Ostomy and Continence Nursing Certification Board, or by another substantially equivalent national certifying organization approved by the department of health.
Such nurses shall possess the requisite theoretical knowledge of, and shall demonstrate documented clinical competency in, the following areas, consistent with nationally recognized standards of foot care nursing practice:
(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 LC003721/SUB A - Page 2 of 3 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.
(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 be licensed as a registered nurse and shall be certified and credentialed by a relevant national professional organization including, but not limited to, the American Foot Care Nurses Association or the Wound Ostomy and Continence Nursing Certification Board, or by another substantially equivalent national certifying organization approved by the department of health.
Such nurses shall possess the requisite theoretical knowledge of, and shall demonstrate documented clinical competency in, the following areas, consistent with nationally recognized standards of foot care nursing practice:
(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 LC003721/SUB A - Page 2 of 3 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.
(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.
Changes from S2116A:
The amended bill introduces strict licensure and certification requirements for nurses providing home foot care. It mandates that these providers be licensed registered nurses and hold certification from a recognized national professional organization, such as the American Foot Care Nurses Association. It also requires their clinical competency to align with nationally recognized nursing standards.
- Adds a requirement that nurses providing home foot care must be licensed as registered nurses and certified by a relevant national professional organization (such as the American Foot Care Nurses Association, the Wound Ostomy and Continence Nursing Certification Board, or another approved equivalent).
- Clarifies that these nurses must possess "requisite" theoretical knowledge and "documented" clinical competency.
- Specifies that their knowledge and competency must be "consistent with nationally recognized standards of foot care nursing practice."
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The amended bill introduces strict licensure and certification requirements for nurses providing home foot care. It mandates that these providers be licensed registered nurses and hold certification from a recognized national professional organization, such as the American Foot Care Nurses Association. It also requires their clinical competency to align with nationally recognized nursing standards.
- Adds a requirement that nurses providing home foot care must be licensed as registered nurses and certified by a relevant national professional organization (such as the American Foot Care Nurses Association, the Wound Ostomy and Continence Nursing Certification Board, or another approved equivalent).
- Clarifies that these nurses must possess "requisite" theoretical knowledge and "documented" clinical competency.
- Specifies that their knowledge and competency must be "consistent with nationally recognized standards of foot care nursing practice."
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