The short answer Colorado's home care agency licensing chapter (6 CCR 1011-1, Chapter 26) requires written policies on pre-employment physical evaluations and personnel health but does not mandate a specific TB test; CDPHE's TB program states it does not regulate providers' TB screening and instead recommends the CDC framework. Workers' comp from the first employee.
What Colorado requires
Colorado
No TB mandate; CDC-based recommendation. CDPHE states its TB Program does not regulate private providers' TB screening and testing processes and provides recommendations based on CDC guidance (the 2019 CDC/NTCA approach).
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Licensing chapter. 6 CCR 1011-1, Chapter 26 (Home Care Agencies) requires agencies to establish written policies concerning pre-employment physical evaluations and personnel health, but no TB test is specified.
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CDPHE licensing page. Home care agencies are licensed by CDPHE under its general licensure chapter and Chapter 26.
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Workers' comp from 1st employee. Colorado employers with one or more full- or part-time employees must carry workers' compensation at all times (Division of Workers' Compensation, CDLE); noncompliance fines run $250 to $500 per day.
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The federal baseline (applies in every state)
Federal
No federal TB mandate for home care workers. There is no federal law requiring tuberculosis screening of home care or home health workers; TB screening obligations for this workforce are set by each state's facility licensing law. Federal Medicare Conditions of Participation for home health agencies (42 CFR Part 484) require an infection-prevention program but do not prescribe worker TB testing.
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2019 CDC/NTCA baseline screening standard. The 2019 CDC/National Tuberculosis Controllers Association recommendations for U.S. health care personnel call for a baseline (pre-placement) individual TB risk assessment, symptom evaluation, and a TB test (IGRA or TST) for those without documented prior positive results. Routine annual (serial) testing of health care personnel is no longer recommended absent ongoing exposure; instead facilities should provide annual TB education and symptom screening.
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Positive-result workup. Personnel with a newly positive TB test or TB symptoms should receive a chest X-ray and clinical evaluation to rule out active TB disease; those found to have latent TB infection should be offered and encouraged to complete LTBI treatment per CDC guidance.
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OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030). OSHA's Bloodborne Pathogens Standard applies to home care/home health workers with reasonably anticipated exposure to blood or other potentially infectious materials. Employers must maintain a written exposure control plan, provide annual training, and offer the hepatitis B vaccine series at no cost within 10 working days of assignment to covered workers.
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