The short answer South Dakota does not license home health agencies at the state level (and does not regulate non-medical home care at all), so there is no TB rule reaching home care workers. Uniquely, South Dakota law does not require any employer to carry workers' compensation insurance; it is elective though strongly recommended.
What South Dakota requires
South Dakota
No home care licensure / no TB rule. SD DOH states South Dakota does not require state licensure for certified home health agencies and that non-medical home health providers are not regulated by the Department of Health, so no TB rule reaches home care workers.
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TB rules cover other settings only. South Dakota's healthcare TB screening rules apply to ambulatory surgery centers, assisted living, hospitals, and nursing facilities; home health/home care is not on the list.
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Workers' comp optional. SD DLR: there is no law in South Dakota requiring any employer to carry workers' compensation insurance, though it is highly recommended; an uninsured employer may be sued in civil court by an injured worker.
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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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