The short answer Florida's home health rule (Fla. Admin. Code R. 59A-8.0095) requires, before patient contact, a licensed-practitioner statement that the worker is in reasonably good health and appears free from signs or symptoms of a communicable disease; no TB test is prescribed. Workers' comp: construction 1+, non-construction 4+ employees.
What Florida requires
Florida
Communicable-disease statement. 59A-8.0095 requires, prior to patient contact, that employees and contractors submit a statement from an MD/DO, PA, APRN, or supervised RN that they are in reasonably good health and appear free from apparent signs or symptoms of communicable disease; no TB test is specified.
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Chapter. 59A-8 (Minimum Standards for Home Health Agencies) is administered by AHCA.
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Workers' comp thresholds. FL DFS Division of Workers' Compensation: non-construction industry triggers coverage at 4 or more employees (including corporate officers/LLC members unless exempt), construction at 1 or more, and agriculture at 6 regular or 12 seasonal workers.
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Contractor liability. Contractors must verify subcontractors' workers' comp coverage; uninsured subs' workers become the contractor's responsibility.
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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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