The short answer Idaho ended state licensure of home health agencies effective July 1, 2025 (Streamlined Facilities Licensing and Inspection Act), so there is no state licensing TB rule; Medicare-certified agencies follow only the federal Conditions of Participation. Workers' comp is mandatory from the first employee.
What Idaho requires
Idaho
No state license / no TB rule. Idaho DHW states that effective July 1, 2025, Medicare-certified home health agencies are no longer required to be licensed in Idaho and no new licenses will be issued; the former licensing rules (IDAPA 16.03.07) contained no TB screening mandate.
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Repealing legislation. The 2025 Idaho legislature repealed home health licensure via S1015 (amending Title 39, Chapter 24).
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Workers' comp from 1st employee. Idaho Industrial Commission: employers with one or more full-time, part-time, seasonal, or occasional employees must carry workers' compensation unless specifically 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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