The short answer Arizona's health care institution licensing rules include a dedicated TB screening rule, A.A.C. R9-10-113, which AZDHS confirms applies to licensed home health agencies: baseline evidence of freedom from infectious TB plus annual documentation, consistent with the 2019 CDC/NTCA recommendations. Workers' comp is mandatory from the first employee.
What Arizona requires
Arizona
TB screening rule R9-10-113. A.A.C. R9-10-113 requires baseline documentation (a negative TB test within 12 months before starting, or a clinician statement of freedom from infectious TB for prior positives) and documentation every 12 months thereafter for health care institution personnel.
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Applies to home health agencies. AZDHS's official TB screening regulation summary confirms R9-10-113 covers licensed health care institutions including home health agencies and hospices and requires TB infection-control activities consistent with the CDC/NTCA 2019 recommendations (rule updated effective 2022).
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Workers' comp from 1st employee. Arizona law requires all public and private employers with at least one employee to carry workers' compensation coverage (Industrial Commission of Arizona).
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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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