The short answer Indiana's home health agency licensing rules require TB evaluation of all staff and contractors with direct patient contact, including a baseline two-step Mantoux TST or QuantiFERON assay. Workers' comp is mandatory from the first employee.
What Indiana requires
Indiana
TB rule. 410 IAC 17-12-1 requires all employees, staff, persons providing care on the agency's behalf, and contractors with direct patient contact to be evaluated for TB; those without prior positive history need a baseline two-step Mantoux TST or a QuantiFERON-TB assay unless a negative TST is documented within the prior 12 months.
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Licensing program. The Indiana Department of Health administers the Home Health Agency Licensing and Certification Program.
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Workers' comp from 1st employee. The Workers' Compensation Board of Indiana requires coverage from the first employee (IC 22-3-2-5).
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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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