The short answer North Dakota licenses home health agencies but its licensing chapter contains no worker TB screening requirement. Workers' comp is mandatory for all employers before the first employee is hired, purchased only through the state monopolistic fund (WSI).
What North Dakota requires
North Dakota
TB screening: no rule. NDAC Chapter 33-03-10.1 (Home Health Agencies) covers definitions, licensure, governing body, quality improvement, services, records, and aide training, but contains no employee health or TB screening section.
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Licensing agency. ND HHS Health Facilities Unit administers home health agency licensure.
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Workers' comp (state fund). Coverage is required before hiring the first employee; North Dakota is a monopolistic state where all coverage is purchased through Workforce Safety & Insurance (WSI).
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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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