The short answer Oregon's in-home care agency licensing chapter (OAR 333-536) no longer contains its own TB provision, but the statewide communicable disease rule OAR 333-019-0041 requires every health care facility/setting — which covers licensed home health agencies, though generally not non-medical in-home care agencies — to annually assess TB transmission risk and follow CDC/NTCA 2019 recommendations. Workers' comp starts at one subject worker. Oregon's workplace violence law (SB 537) now reaches home health effective Jan. 1, 2026.
What Oregon requires
Oregon
TB screening required. OAR 333-019-0041 requires each health care facility or setting (including home-based health care per the CDC guidelines' covered settings) to formally assess the risk of tuberculosis transmission among staff at least annually and follow CDC 2005 and NTCA/CDC 2019 TB screening recommendations. This reaches licensed (skilled) home health agencies as health care settings; non-medical in-home care agencies licensed under OAR 333-536 are generally not covered.
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Licensing chapter. In-home care agencies are licensed under OAR ch. 333, div. 536; current caregiver-qualification rules contain no TB language after 2023 amendments.
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Workplace violence (SB 537). SB 537 (2025), signed July 17, 2025, amends ORS 654.412 through 654.423 to extend health care workplace-violence requirements (violence pattern assessments, prevention/response plans, expanded harassment/threat definitions) to home health care services entities and hospice; key sections operative Jan. 1, 2026.
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Workers' comp from 1st employee. Employers with one or more subject workers must carry coverage, subject to roughly 30 statutory exceptions at ORS 656.027.
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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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