The short answer Delaware's skilled home health agency licensure regulation (16 Del. Admin. Code 3350, Section 5.0) requires CDC-consistent TB testing: baseline on hire, then per risk assessment, with annual symptom attestations for prior positives. Parallel licensure regs exist for aide-only agencies (3351) and personal assistance services agencies (3345). Workers' comp from the first employee.
What Delaware requires
Delaware
TB testing required. 16 DE Admin. Code 3350 (Skilled Home Health Agencies), Section 5.0, sets minimum TB testing following CDC recommendations, with baseline testing upon hire and thereafter per TB risk assessment; no person with infectious active TB may give care, and prior positives with a negative chest X-ray must complete annual symptom attestations, all kept on file.
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Renumbering note. The former DPH regs were moved to the Division of Health Care Quality series (skilled home health to 3350; aide-only agencies to 3351; non-medical personal assistance services agencies to 3345).
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Workers' comp from 1st employee. Every Delaware employer with one or more employees must carry workers' compensation insurance (farm workers exempt).
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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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Primary sources for this page
- https://regulations.delaware.gov/AdminCode/title16/Department%20of%20Health%20and%20Social%20Services/Division%20of%20Health%20Care%20Quality/3350.shtml
- https://www.law.cornell.edu/regulations/delaware/title-16/department-of-health-and-social-services/division-of-health-care-quality
- https://labor.delaware.gov/divisions/industrial-affairs/workers-comp/
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