2025 -- H 6088 SUBSTITUTE A AS AMENDED

========

LC002394/SUB A/3

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2025

____________

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- NURSES

     Introduced By: Representatives Boylan, Cotter, Fogarty, Hopkins, Stewart, Potter,

     Date Introduced: March 14, 2025

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

     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 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 must 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 extremity;

     (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;

     (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 must be focused on foot care.

LC002394/SUB A/3 - 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.

     SECTION 2. This act shall take effect upon passage.

========

LC002394/SUB A/3

========

LC002394/SUB A/3 - Page 3 of 4

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- NURSES

***

     This act would permit a nurse who has the appropriate knowledge and who can demonstrate

clinical competency, to be able to provide home services foot care, which would include routine

foot and nail care, as well as implementing a plan of footcare that includes hygiene and the

shortening of toe and finger nails. A nurse providing in-home foot care would ensure that two (2)

hours of continuing education out of the ten (10) hours required per certification period would be

focused on foot care.

     This act would take effect upon passage.

========

LC002394/SUB A/3

========

LC002394/SUB A/3 - Page 4 of 4