The short answer Kansas home health agency licensure rules require a pre-assignment two-step TB skin test per CDC health care worker guidelines plus a health assessment, documented in the personnel file. Kansas ties workers' comp to a $20,000 annual payroll threshold rather than employee count.
What Kansas requires
Kansas
TB rule. K.A.R. 28-51-103(d)(6) requires each employee's personnel health record to include a current two-step tuberculosis skin test following CDC testing guidelines for health care workers, taken before working with clients or patients, plus a pre-work health assessment and reassessment at least every two years (amended effective 5/20/2022).
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2022 regulation overhaul. KDHE published a summary of its 2022 home health agency regulation changes, including the updated TB testing requirement.
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Workers' comp tied to payroll. Kansas Department of Labor: workers' compensation coverage is compulsory for employers with gross annual payroll over $20,000 (all wages counted, in- and out-of-state); certain agricultural employment is exempt.
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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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