House hearing spotlights bill to let certified foot‑care nurses provide in‑home nail and routine care

Providence — Representative Boylan introduced H 7029 on Tuesday, a bill that would allow certified foot‑care nurses to provide routine foot and nail care — including nail trimming — in patients’ homes and directs the Department of Health to set “fair and reasonable” license and renewal fees for those providers.

The sponsor said the measure is intended to close an access gap for homebound Rhode Islanders, citing a veteran in her district who has gone without foot care: “People in Rhode Island should have the right to basic foot and nail care in their homes,” Boylan said, adding that a similar measure passed the House in 2025.

Supporters included foot‑care practitioners, aging‑services advocates and AARP Rhode Island, who described cases in which people with limited mobility or cognitive challenges were unable to reach podiatrists and resorted to salons or family members for nail care. AARP representative Matt Neto told the committee that lack of in‑home options can lead to falls and infections and that nurses sometimes are the only available providers for homebound patients.

Tina McDonald, a registered nurse who practices foot care in Massachusetts, testified that certified foot‑care nurses “do not practice medicine,” obtain consent, provide routine hygiene‑level services and refer higher‑risk patients to physicians. McDonald described certification training as involving both didactic hours and supervised hands‑on practice and said she would be willing to work under a physician’s order if the Committee required it: “If they wanted us to get a physician’s order I said it's another step…yes we can do that,” she told members.

Podiatrists and their association offered qualified support but urged regulation rather than statute. Jason Martisean of the Rhode Island Podiatric Medical Association said podiatrists agree homebound patients need care but argued the Department of Health is the proper venue for setting certification, oversight and sterility standards. Dr. Crystal Lepore, a practicing podiatrist, said regulators should ensure adequate instrument sterilization and training so that caregivers can identify pathology that requires medical intervention.

Several committee members noted that two state agencies — BHDDH and the Department of Veterans Affairs — submitted support, while the Department of Health provided suggested edits and indicated it favored amendments. Rep. Kislak told the committee she was troubled that the regulations have not been issued previously and that legislation may be a pragmatic way to resolve a longstanding barrier.

The committee limited public testimony to preserve time; multiple public commenters described personal or family need for in‑home foot care. Tina McDonald and other witnesses emphasized that certified nurses can fill a gap for people who otherwise receive no care.

The Committee did not take final action on the bill at the hearing; earlier in the evening committee members voted 9–1 to hold all calendar bills for further study, a procedural motion the chair described as not indicating a position on the merits. The bill is expected to be revised to reconcile DOH recommendations on certification, training and reporting before further consideration.

Next steps: the Committee will circulate DOH suggested edits and has asked stakeholders to submit written clarifications on training, referral pathways and certification standards.