Home Foot Care Legislation Gains Momentum Toward Passage in RI

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

A Physician’s Guide to Living Life Fully, Not Just Longer, with Dr. Ed Iannuccilli

Published in RINewsToday on October 12, 2025

Over two weeks ago, over 300 advocates, providers, and older adults gathered at the Senior Agenda Coalition of Rhode Island’s (SACRI) 16th Annual Conference and Expo, “Navigating Choppy Waters – Shelter from the Storm,” held at Rhode on the Pawtuxets in Cranston.

The Sept. 25 event featured a thought-provoking keynote address by Dr. Ed Iannuccilli, state legislative updates, unveiling a new award to recognize two advocates, along with a panel discussion exploring critical topics facing older adults.

“This conference, by all measure, was a tremendous success,” said Carol Anne Costa, Executive Director of the Senior Agenda Coalition of RI, noting that the new venue, the topics, the engagement of the audience was reflected in the energy in the room.

“We are collecting survey responses an the feedback has been overwhelmingly positive,” says Costa noting that people are craving the opportunities to reconnect in person and in conversation. “If our vision for this conference helped to achieve that, it’s a win,” she said. 

___

Simple Tips on Aging Gracefully

 Dr. Ed Iannuccilli, a highly respected retired board-certified internist and gastroenterologist and the author of six published books, delivered an impassioned 31-minute keynote shifting the tone from legislation and program updates.  He offered common-sense advice on aging gracefully and called for changes in the state’s health care system to restore compassion and personal connection.

Looking back to the early days of his medical practice, Iannuccilli—who practiced medicine for over 30 years—recalled a conversation with a lively, healthy 80-year-old woman.

“In the innocence of my youth, I said admiringly, ‘At 80, you’re in marvelous condition. You don’t need to worry—age is just a number.’”

“She looked at me, twirled her ring, straightened her smock, squinted, pursed her lips, and said, ‘Young man, I have the number. Don’t you ever tell anyone that again,’” he said.

“And I never did,” he added. “It was an early lesson. As Oscar Wilde said, ‘With age comes wisdom, but sometimes wisdom comes with winters.’ Well, I have the winters now. I have the number. And I’m pleased to say that no one has dared call it just a number again,” said the Bristol resident.

As for reducing the stress of growing old, Iannuccilli shared: “I try to do happy things, avoid too much news, meet friends, and accept loss and mistakes with a spiritual shovel. No one’s judging anymore—history is history.”

He advised, “Don’t make living a long life your goal; living fully, is. If you’re at an age milestone—don’t panic. Laugh more. Call a friend. As Mark Twain said, ‘Don’t complain about growing old; it’s a privilege denied to many.’”

Iannuccilli said he stays curious, reads, writes, and keeps his mind active. “I even take piano lessons. I don’t need to go on a space mission; I’m already on a planet full of adventure,” he joked.

 He also emphasized that longevity and good health are tied to human connection. “Be a helper. Call a friend. Drive someone to a doctor’s appointment. Volunteer at a pantry. Fred Rogers’ mother was right—‘Look for the helpers.’ Better yet—be one,” urged Iannuccilli.

Navigating a Broken Health Care System

“We use words like quality, efficiency, deliverables, and outcomes—but what people want is access and comfort,” Iannuccilli observed. But, fewer long-term physician-patient relationships, financial barriers at every turn, and isolation among older adults all reflect systemic changes in today’s healthcare system, says Iannuccili.

According to Iannuccili, costs for care, medication, nursing homes, and even vaccines are rising. Too many seniors live alone and disconnected.

“When someone is sick, they want to be comforted. They want someone who listens and helps them navigate an increasingly impersonal system,” he says. 

Today it’s [often] a long phone queue, a chatbot, or a portal that needs a password and two-step verification,” he said. “You wait on hold and think, ‘This is my health I’m calling about, not my cable bill.’ We’ve lost the personal touch.”

“Be patient with emerging artificial intelligence,” Iannuccilli added. “With proper tuning, it can increase efficiency, help pair patients with the right provider, contain costs, and even promote equity. But nothing—nothing—will ever replace personal care.”

Patients are now called consumers, he said, a term he dislikes. “You’re not a consumer—you’re a patient. The word comes from the Latin patiens—one who suffers. It deserves respect.”

Recognizing Rhode Island’s Health Care Assets

Iannuccilli called for Rhode Islanders to stop focusing on negatives, like the bridge, and instead recognize their access to high-quality health care facilities.

“Within 20 miles you can reach some of the nation’s best hospitals—Rhode Island Hospital, Women & Infants, Hasbro Children’s, Butler, Bradley, Kent, South County, Newport, Miriam, Roger Williams, and Fatima,” he said.

According to Iannuccilli, the state’s health care system—from Brown University to URI—is “extraordinary,” featuring world-class nursing programs, physician assistant schools, and a top pharmacy school.

He believes Rhode Island can become a national model for universal access to health care.

“If we can assume our trash will be collected, our children educated, and our homes protected by firefighters, why can’t we assume access to health care for everyone?” he asked. “We have the talent. We have the infrastructure. What we need is the will.”

With a growing shortage of primary care physicians, Iannuccilli called for the creation of a medical school at the University of Rhode Island dedicated solely to training primary care physicians.

He concluded by issuing a call to action: “Let’s make Rhode Island the envy of the nation—a state where health care works for everyone, where education, research, and delivery come together. We can do better. We must do better. And guess what? We don’t have a choice.”

SACRI Recognition

At the conference, Costa recognized the advocacy of Ray Gagne Jr. for his advocacy work as Senior Organizer at RI Organizing Project and Sister Norma Fleming, RSM, for her direct work with adults with disabilities at ReFocus, Inc. by presenting them with the inaugural Marjorie Waters Award for Service. Honoring the legacy of Marjorie Waters—a Rhode Island College graduate, former Director of Information Technology for a Tribal Nation, Six Sigma Process Excellence Coach in the finance industry, and Executive Director of Providence’s Westminster Senior Center—the award celebrates her dedication as a lifelong community activist.

Legislative Greetings, and a Look to the Future

House Speaker K. Joseph Shekarchi (D-Dist. 23, Warwick) brought greetings from the House, emphasizing his strong commitment to supporting the state’s growing older population.

“As long as I’m Speaker of this House and I’m in Rhode Island government, you will have a friend in state government,” he pledged to the attending advocates and older adults.

The Warwick lawmaker shared how his 99-year-old father, who is battling Alzheimer’s and has mobility issues, has given him a personal understanding of older Rhode Islanders’ desire to remain at home—insight that has shaped his aging policy agenda.

Shekarchi highlighted several recent legislative successes, including the expansion of the Medicare Savings Program after 14 years of advocacy, which will save low-income beneficiaries over $2,000 annually. He also cited the state’s Accessory Dwelling Unit (ADU) Law, which allows in-law apartments or “granny flats” (in the colloquial), to help residents age in place in their homes.

Senate President Rep. Lauren Carson (D-Dist. 75, Newport), also detailed her legislative work on behalf of older Rhode Islanders. As Chair of the House Study Commission on Aging, she announced her intention to introduce legislation to make the commission permanent to help guide the state’s aging policy.

Another planned bill for next year would replace the term “senior citizen” with “older Rhode Islander” in state law to promote a more positive view of aging.

Maria Cimini, Director of the State’s Office of Healthy Aging, stressed that the guiding principle of her office’s work was to ensure older Rhode Islanders had the “choice to age as they wished” with dignity and independence.

She pointed out a significant demographic shift, noting that Rhode Island now had more people over 65 than under 18. “We are all aging. My goal is to be sure that Rhode Island is a great place to grow up and grow old,” she says.

A panel discussion followed the keynote, covering practical aspects of end-of-life planning, including legal documents such as wills and trusts, funeral pre-planning, financial planning for dependents with disabilities, suicide prevention, and the role of the long-term care ombudsman.

To watch SACRI’s Sept. 25th program, go to https://capitoltvri.cablecast.tv/show/11543?site=1

New Detailed Aging Report Will Help Officials, Policymakers

Published in RINewsToday on May 17,2025


By Herb Weiss

In an era of tightening budgets and shrinking federal and state resources for aging programs, legislators, service providers, and advocates now have access to vital data that can help identify and address the unmet needs of older adults in their communities.

Just over a week ago, the Gerontology Institute at the University of Massachusetts Boston released the latest Healthy Aging Data Reports (HADR), funded by the Point32Health Foundation. These reports offer a comprehensive, neighborhood-level view of aging in America—insights often unavailable from other sources.

Rhode Island’s updated report, released on May 1, 2025, follows previous editions published in 2016 and 2020. This year’s release also includes updates for Connecticut, Massachusetts, and New Hampshire, and introduces a first-time report for Maine. The HADR team is now expanding its reach to additional regions, including parts of the Deep South (such as Mississippi) and the West (including Wyoming).

“This is what’s magical about our report: we provide data at very local levels,” says Dr. Elizabeth Dugan, principal investigator and associate professor of gerontology at UMass Boston. “That empowers local advocates, helps policymakers make smarter investments, and allows philanthropists to assess the impact of their contributions,” she says.

The Rhode Island report features 41 community profiles—covering each city and town, along with two neighborhoods in Providence. Drawing on data from the U.S. Census Bureau, Medicare Summary Beneficiary Files, the CDC’s Behavioral Risk Factor Surveillance System, and state health departments, the report highlights disparities that may be hidden in broader state- or county-level statistics.

“What’s powerful about this approach is that we can observe health outcomes that vary dramatically even within a 10-minute walk in the same city,” adds Dugan.

Spotlight on Rhode Island

Several key findings emerged from the 2025 Rhode Island report:

  • Health: Rhode Island ranks highest in New England for rates of high cholesterol, diabetes, hypertension, ischemic heart disease and peripheral hearth disease, stroke, multiple chronic conditions (four or more), and anxiety disorders.
  • Gender Disparities: Women experience anxiety and depression at rates 15% higher than men and are also more likely to suffer from Alzheimer’s disease, schizophrenia, and PTSD.
  • Housing: Roughly 39% of older renters spend more than 35% of their income on housing. Additionally, 46% of Rhode Islanders aged 65 and older report annual incomes under $50,000.

“The Rhode Island Healthy Aging Data Reports are invaluable,” says Maureen Maigret, Policy Advisor for the Senior Agenda Coalition of Rhode Island and a member of several state aging commissions. “They provide essential data down to the ZIP code level, which is useful for legislative testimony, policy recommendations, program planning, and grant writing.”

With Rhode Island’s older adult population rising from 16.5% in 2020 to 18% in 2025, this data is more critical than ever. “The report shows how age and racial diversity vary widely across communities,” Maigret says, noting that in some smaller towns, older adults now make up over 30% of the population.

Maigret notes that availability of localized data helps municipalities develop comprehensive plans and adopt age-friendly strategies. Interactive maps within the report allow comparisons with state averages, making it easier to target resources where they are most needed.

The report also reveals demographic shifts, including a rise in the Hispanic older adult population—from 4.9% in 2020 to 5.9% in 2025. “There are significant racial and ethnic disparities in health outcomes,” says Maigret. “Black and Hispanic older adults are more likely to be dually eligible for Medicare and Medicaid and to be enrolled in Medicare managed care,” she says.

As lawmakers navigate complex budget negotiations and potential changes to federal programs such as the Administration for Community Living, Medicaid, and the CDC, Maigret stresses the importance of leveraging this data in decision-making.

“Despite the growth in our older population and increasing reports of elder abuse, neglect, and substandard nursing home care, the Office of Healthy Aging’s budget has remained relatively flat,” she warns. “With half of its funding coming from the federal government, proposed cuts could seriously undermine vital programs such as the Long-Term Care Ombudsman,” she adds.

The report also shines a light on mental health, showing high rates of depression and anxiety—especially among older women. Maigret believes this supports increased investment in the 988 mental health crisis line and other behavioral health services.

Another notable trend is the continued shift toward Medicare managed care, now covering more than half of Rhode Islanders aged 65 and older. While rates of arthritis and depression have increased, the report also notes a decline in nursing home stays, inpatient admissions, emergency room visits, and several chronic conditions such as diabetes, COPD, hypertension, and heart disease.

Since the 2020 report, communities have taken meaningful steps to support aging in place. “The Village Common of RI has built age-friendly communities that enable older adults to live independently with the care and resources needed to promote health and well-being,” says Maigret. “There are now 11 local villages across 14 communities, supported by trained volunteers who help members stay connected and independent.”

Data Driving Policy and Innovation

Marie E. Cimini, MSW, Director of the Rhode Island Office of Healthy Aging, says the HADR report has broad implications. “As a state agency, we must lead with policies that prioritize inclusion, access, and dignity throughout the aging journey.”

“The report reinforces our commitment to advancing the goals outlined in the RI 2030 Plan, especially around expanding in-home care, supporting workforce development, and strengthening behavioral health services,” Cimini continues. “But it also challenges us to go further—to integrate aging into every aspect of public life and ensure that the voices of older adults inform policy at every level.”

For Meghan Grady, Executive Director of Meals on Wheels of Rhode Island (MOWRI), one of the most important takeaways is the persistence of health disparities, particularly in managing chronic conditions. Grady supports legislation introduced by Sen. Victoria Gu (D-Dist. 38) and Rep. Justine Caldwell (D-Dist. 30) to integrate medically tailored meals into healthcare delivery. “This report validates our advocacy,” she says. “Food is a fundamental part of care, especially for aging populations facing health disparities.”

The HADR report is also proving instrumental for nonprofit organizations. “We use the data in community presentations, grant proposals, and to guide our work in promoting health equity,” says Debra Burton, Executive Director of RI Elder Info. “With so much uncertainty around policy and funding for programs that impact older adults and caregivers, this data helps us identify where changes will have the greatest impact,” she says.

James Connell, Executive Director of Age-Friendly RI, agrees. “The Healthy Aging Data Report is extraordinarily helpful for nonprofits across sectors. I used it to support funding for a home-share program that pairs older homeowners with individuals facing housing insecurity—a creative approach to our state’s housing crisis,” he says.

“The ’25 Healthy Aging Report provides vital indicators of older adult well-being that are essential for policymaking, intentional planning, and program development,” says Connell. “The data highlight serious concerns about the mental and emotional health of our community, with one in three Rhode Islanders experiencing anxiety and/or depression.” Connell also emphasizes the report’s finding that women are disproportionately affected, calling it “a clear call to action for improved screening and more accessible treatment options.”

Greg Shell, Chair of the Point32Health Foundation Board of Directors, emphasizes the value of data in shaping policy. “When we use data to guide our work, we can change policies and practices, engage communities, and highlight what truly matters,” he says. “These reports are essential tools in making New England a better place to grow up and grow old.”

The research team behind the Healthy Aging Data Reports includes: Principal Investigator Elizabeth Dugan, PhD, along with Nina Silverstein, PhD; Qian Song, PhD; Taylor Jansen, PhD; Jay Lee, PhD; Yan-Jhu Su, PhD; Han Lin, PhD; Shan Qu, MS; Tiffany Tang, BS; Jeannine Johnson, PhD; Amanda Cox, MS; and Mengshi Liu.

To access the 2025 Rhode Island Healthy Aging Data Report, visit https://healthyagingdatareports.org/ri/rhode-island-healthy-aging-data-report.