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H7029AHealthcare: Licensing & Accreditation

Businesses and Professions - Nurses

This bill sets certification, education, and practice requirements for registered nurses providing foot care in patients' private homes.

Signed into law65 Yea0 Nay10 Not voting
Population
Affected
15
Email Legislator
Introduced Jan 9, 2026Committee House Health & Human Services

Plain-English Summary

This bill establishes rules for registered nurses who provide foot care services to patients in their private homes. It requires these nurses to hold specific national certifications and demonstrate competency in foot anatomy, disease impacts, and infection control. The bill outlines what foot care includes, such as assessing medical history, checking circulation, trimming nails, and educating patients. It also mandates that two hours of a nurse's required continuing education be dedicated to foot care. Nurses providing only these services are exempt from certain other home care licensing requirements, and the health department will set their licensing fees.

For younger readers

This bill makes rules for specially trained nurses who visit people's homes to help take care of their feet. It says these nurses must pass special tests to prove they know how to safely check for foot problems, trim toenails, and teach people how to keep their feet healthy. The bill lists exactly what the nurses are allowed to do and requires them to keep learning about foot care every year. It also says the state health department will decide how much these nurses must pay for their official permission to do this job.

Who & Where It Applies

Impacted groups
Registered nursesHome care patientsElderly individualsDiabetic patientsDepartment of Health
Impacted communities
All

Constitutional & Fiscal Check

None Likely. The bill regulates the medical profession and establishes licensing and practice standards for nurses providing in-home foot care. States have broad police powers to regulate public health and safety, including medical licensing and scope of practice, which does not typically implicate First, Fourth, or Fourteenth Amendment rights.

Estimated cost
None
Estimated revenue
Amount unknown

Bill Analysis

Both viewpoints
For Progressives
  • Expands access to specialized healthcare services directly in patients' homes, which heavily benefits elderly or disabled individuals who may have mobility issues and rely on community-based care.
  • Ensures high quality and safety standards for vulnerable patients by requiring nurses providing these services to be licensed registered nurses with specific national certifications and documented clinical competency.
  • Reduces bureaucratic barriers for independent nurses by exempting them from broader home healthcare facility licensing requirements, potentially increasing the availability of these specialized community health workers.
  • The creation of new, specific licensing and renewal fees determined by the health department could create a financial barrier for nurses wanting to provide these services, reducing the potential workforce.
  • By explicitly excluding public spaces, senior centers, and common areas of multi-unit dwellings, the bill limits where vulnerable populations, such as the unhoused or low-income seniors in community living, can receive these services.
  • Relying on private home care services rather than integrating these specialized foot care treatments into a broader, universally funded public healthcare framework may leave out those who cannot afford private in-home care.
For Conservatives
  • Decreases government regulation on independent practitioners by exempting nurses who solely provide in-home foot care from the more burdensome and costly licensing requirements typically applied to large home nursing care providers.
  • Promotes free-market healthcare solutions by allowing specialized nurses to offer services directly to consumers in their private residences, fostering small business growth and individual entrepreneurship.
  • Focuses on preventative care and patient self-reliance by mandating that nurses provide client education on self-care, hygiene, and nutrition, potentially reducing the need for more expensive government-funded medical interventions later.
  • Imposes new, specific state mandates regarding continuing education and requires national certifications, which adds regulatory red tape to nurses who are already licensed registered nurses.
  • Grants the department of health broad, unchecked authority to determine and impose new license and renewal fees on these specialized nurses, essentially acting as an additional tax on their practice.
  • Restricts personal and business freedom by strictly dictating where these services can be provided, explicitly banning them from being performed in commercial spaces or the common areas of senior centers and apartment buildings.

Votes

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Full Bill Text

2 versions
Changes to existing Rhode Island law · 62 additions

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 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.