TB Testing & Occupational Health Rules for Home Care Workers in Louisiana

Annual health screening (licensing); no TB test named. LAC 48:I.9119 requires each home health agency's personnel policies and each personnel file to include an annual employee health screening in accordance with current local, federal, and state laws; no TB test or screening method is specified in the home health licensing chapter. Source ↗

Sanitary Code TB rule does not reach home health. LAC 51:II.503's baseline requirement to show freedom from communicable TB (negative TST or FDA-approved blood assay, or chest X-ray/physician statement) applies to direct-patient-care staff of hospitals and nursing homes (including ICF-DDs) requiring LDH licensing and of LDH-OPH parish health units and outpatient facilities — home health agencies are not among the covered settings for baseline testing. Only the provisions for staff with positive tests or latent TB history (treatment/physician statement, annual symptom screens) and annual TB education apply to LDH-licensed medical facilities more broadly. Source ↗

Workplace violence (Act 461 of 2022). La. R.S. 40:2199.11 through .19 require LDH-licensed regulated entities, including home health agencies, to maintain a workplace violence prevention plan, provide annual interactive training to direct-care workers, post signage, report incidents, and not retaliate against reporters. Source ↗

Workers' comp from 1st employee. Louisiana Workforce Commission: employers must carry workers' compensation even with only one employee (part-time, full-time, temporary, or seasonal), covered from the first day of employment. Source ↗

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. Source ↗

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. Source ↗

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. Source ↗

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. Source ↗