Published in RINewsToday on April 13, 2026
Through the efforts of aging advocates and older Rhode Islanders, the House last week followed the Senate’s lead in passing legislation that would allow certified foot care nurses to provide routine foot care to homebound patients. Under the legislative proposal, nurses must receive proper training and certification and demonstrate clinical competency.
At press time, the two chambers must still reconcile and pass identical versions of the bill before the legislation can be sent to the governor for signature.
On April 7, the Senate unanimously passed S. 2116A, introduced by Sen. Lori Urso, to expand access to routine foot care for homebound patients. Two days later, the House followed suit, passing Rep. Jennifer Boylan’s H 7029A by a vote of 65–0.
The sponsors—Rep. Boylan (D-Dist. 66, Barrington and Riverside) and Sen. Urso (D-Dist. 8, Pawtucket) —say the legislation addresses a critical need for basic, preventive foot care in the home. Many elderly and disabled patients require assistance with services such as toenail care and treatment of corns and calluses, yet are often unable to access care outside the home, including visits to a podiatrist.
Under the legislation, nurses must demonstrate knowledge and clinical competency in foot and nail structure and function, common foot conditions, and appropriate care techniques. They must also be certified by a national professional organization, such as the American Foot Care Nurses Association (AFCNA), or an equivalent approved by the Rhode Island Department of Health. Additionally, two of the required 10 continuing education hours per certification period must focus specifically on foot care. In addition to CEUS, 30 hours of training with a podiatrist are required for certification.
“This bill is about expanding access for vulnerable Rhode Islanders who currently have no safe options for routine foot care,” said Sen. Urso. “While this care may seem simple to some, for others it is difficult or even impossible to perform safely on their own.” She noted that similarly trained nurses already provide this care in most other states, including Massachusetts, whose regulations served as a model for the legislation.
Urso also pointed to the state’s aging demographics. “With the City of Pawtucket joining the AARP Age-Friendly initiative, along with several other Rhode Island communities, it is imperative that we support residents who wish to age in place,” she said. “Rhode Island has more residents over age 65 than under age 20, and initiatives like this help meet their needs.”
Rep. Boylan emphasized the broader issue of healthcare access. While many Rhode Islanders are aware of shortages in primary care and specialty providers, she said, fewer realize that essential services like in-home foot care are largely unavailable. This gap leaves many older adults without safe options.
“It’s especially dangerous for individuals with diabetes, who are prone to infections and other foot problems that can lead to serious complications or even death,” Boylan said.
Strong Backing from Leadership and Advocates
House and Senate leadership, along with aging advocates, say the proposal addresses a longstanding gap in home- and community-based care.
“This legislation will provide a lifeline for vulnerable Rhode Islanders who rely on in-home health services and currently face significant barriers to receiving basic but essential foot care,” said Senate President Valarie J. Lawson. She described the bill as a common-sense solution that improves the quality of life for both patients and caregivers.
House Speaker K. Joseph Shekarchi called the measure a practical response to a widespread problem. “As someone with diabetes, I understand the serious risks associated with a lack of routine care. This bill helps protect the health and safety of Rhode Islanders,” he said.
Tina McDonald, a registered nurse licensed in both Rhode Island and Massachusetts who is certified in foot care, testified in support of H. 7029A. With 12 years of experience in foot care nursing, she argued that there is a significant unmet need among homebound elderly and chronically ill residents who can no longer visit a podiatrist’s office.
“It’s not a question of doctor versus nurse. It is a matter of nurse versus no one,” McDonald told House lawmakers, warning that podiatrists are not filling this gap in care.
Addressing the primary opposition from podiatrists, she clarified that nurses would not be practicing medicine but instead addressing a “self-care deficit” within the established nursing scope of practice.
During her testimony, McDonald emphasized that nurses are highly trained in assessment, infection control, and wound care.
Carol Anne Costa, executive director of the Senior Agenda Coalition of Rhode Island (SACRI), said the legislation would benefit homebound and mobility-challenged residents and their caregivers.
“SACRI was proud to testify in strong support of this bill,” she said. “It represents a vital step toward ensuring that older adults have the care and support they need to age safely and with dignity in their communities.”
Costa noted that allowing trained nurses to provide limited foot care services at home supports both family caregivers and broader home- and community-based care systems. “Those needing these services are often older adults or individuals with disabilities who face mobility challenges, making it difficult to access care outside the home,” she said.
She added that aging and underlying health conditions can make nail care more difficult and increase the importance of proper foot care.
Catherine Taylor, AARP Rhode Island State Director, echoed those concerns. “Access to in-home foot care is critical for older adults facing mobility, vision, or chronic health challenges,” she said. “Without regular care, minor issues can progress into infections, pain, or mobility limitations that increase fall risk and lead to more serious conditions. Home-based care supports prevention, early detection, and aging in place.”
“The bill would provide relief not only to patients, but also to families and caregivers who are often forced to choose between going without care or attempting to provide it themselves,” Taylor added.
Mary Lou Moran, director of the Pawtucket Division of Senior Services at the Leon Mathieu Senior Center, highlighted the local impact.
“This bill removes unnecessary barriers to essential preventive care and helps close a significant service gap,” she said. “Many individuals we serve cannot safely perform their own foot care and face transportation, mobility, or financial challenges accessing clinic-based services.”
Moran added that regulated, in-home care provided by qualified nurses can help prevent avoidable complications, reduce healthcare costs, and improve quality of life.
Podiatry Association Flags Concerns
Following House passage of H 7029A, the Rhode Island Podiatric Medical Association (RIPMA) issued a statement acknowledging improvements in the bill while raising concerns.
“This issue has always been about ensuring patients can access care from certified and credentialed providers,” the statement read. “We appreciate the inclusion of language requiring nurses to be certified by an accredited organization approved by the Department of Health.”
The organization noted that the bill could benefit truly homebound patients by reducing the risk of self-injury, but emphasized that it is not a substitute for physician care. Patients who can access a podiatrist (in the home or office)—especially those with underlying medical conditions—should continue to receive regular professional treatment.
RIPMA also cited studies showing that Medicare patients with diabetes who receive podiatric care experience fewer hospitalizations and amputations. The group expressed interest in collaborating with certified nurses to ensure safe, appropriate care.
At the same time, Past RIPMA President Dr. Michael Reuter, DPM, FACFAS, voiced concerns about the legislation’s broader impact.
“The legislation aims to solve a problem, but I am concerned it may create new ones,” he said.
Reuter, a board-certified podiatric foot and ankle surgeon in Rhode Island, criticized the absence of a Rhode Island Department of Health recommendation requiring collaboration between nurses and podiatrists. He said such coordination is essential to ensure timely referrals when needed.
“I hope the Department of Health establishes strong safeguards and oversight for providers entering vulnerable patients’ homes,” he said.
He also noted potential cost implications. “Patients will have to pay out of pocket for these services, whereas visits to a podiatrist—whether in-office or through a home visit—are covered by insurance,” he said.
Here is the link to the Feb. 10th House Committee on Health and Human Services on H 7029 A, go to House Committee on Health & Human Services – RISE: 2-10-2026
Here is the link to the March 3rd Senate Committee on Health and Human Services on S. 2116 A, go to Senate Committee on Health & Human Services: 3-3-2026
