The short answer Arkansas requires TB screening of home health agency workers through the State Board of Health's TB control rules, which expressly define home health agencies as related medical facilities whose patient-contact employees must receive TB screening (now risk-based per CDC 2019). Workers' comp is mandatory at 3 or more employees.
What Arkansas requires
Arkansas
TB screening required (TB control rules). The Arkansas Department of Health Rules Pertaining to Control of Communicable Diseases (Tuberculosis) define related medical facility or service to include home health agencies and require each employee or health worker with patient contact to receive tuberculosis screening.
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Home health licensing chapter. The Arkansas State Board of Health Rules for Home Health Agencies govern licensure and require personnel records for each employee.
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CDC-aligned update. ADH updated its TB screening rules for health care workers to CDC's 2019 approach: baseline individual risk assessment plus symptom evaluation and IGRA/TST, with no routine serial testing absent exposure.
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Workers' comp at 3+ employees. Arkansas employers with three or more employees must carry workers' compensation coverage (construction: 2 or more; certain subcontractors: 1).
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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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