Category guide
TB Testing & Occupational Health Requirements for Home Care Workers, by State
Last reviewed: July 24, 2026
Most states require some form of TB screening for home care workers, but the rules diverge sharply — from screening before any client contact with annual updates, to recommendation-only frameworks. Everywhere, the OSHA Bloodborne Pathogens Standard adds an exposure control plan and a free hepatitis B vaccine offer.
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Reviewed quarterly by Vitable Health.
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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Every state at a glance
| State | TB screening | Workers’ comp |
|---|---|---|
| Alabama | No specific rule | 5+ employees |
| Alaska | Required | From 1st employee |
| Arizona | Required | From 1st employee |
| Arkansas | Required | 3+ employees |
| California | Required | From 1st employee |
| Colorado | Recommended | From 1st employee |
| Connecticut | Required | From 1st employee |
| Delaware | Required | From 1st employee |
| District of Columbia | Required | From 1st employee |
| Florida | Health statement | Non-construction 4+; construction 1+ |
| Georgia | Required | 3+ employees |
| Hawaii | Required | From 1st employee |
| Idaho | No specific rule | From 1st employee |
| Illinois | Health statement | From 1st employee |
| Indiana | Required | From 1st employee |
| Iowa | No specific rule | From 1st employee |
| Kansas | Required | Payroll over $20,000/yr |
| Kentucky | Required | From 1st employee |
| Louisiana | Health statement | From 1st employee |
| Maine | No specific rule | From 1st employee |
| Maryland | Required | From 1st employee |
| Massachusetts | No specific rule | From 1st employee |
| Michigan | No specific rule | 3+ employees (or 1 at 35+ hrs/wk for 13 wks) |
| Minnesota | Required | From 1st employee |
| Mississippi | Required | 5+ employees |
| Missouri | No specific rule | 5+ employees (construction: 1+) |
| Montana | Required | From 1st employee |
| Nebraska | Health statement | From 1st employee |
| Nevada | Required | From 1st employee |
| New Hampshire | Required | From 1st employee |
| New Jersey | Required | From 1st employee |
| New Mexico | Required | 3+ employees |
| New York | Required | From 1st employee |
| North Carolina | Required | 3+ employees |
| North Dakota | No specific rule | From 1st employee (WSI state fund) |
| Ohio | No specific rule | From 1st employee (BWC state fund) |
| Oklahoma | Required | From 1st employee |
| Oregon | Required | From 1st employee |
| Pennsylvania | Required | From 1st employee |
| Rhode Island | Required | From 1st employee |
| South Carolina | Required | 4+ employees |
| South Dakota | No specific rule | Optional (not required by law) |
| Tennessee | Health statement | 5+ employees (construction: 1+) |
| Texas | Recommended | Optional (nonsubscriber system) |
| Utah | Required | From 1st employee |
| Vermont | No specific rule | From 1st employee |
| Virginia | No specific rule | 3+ employees (more than two) |
| Washington | Required | From 1st employee (state fund) |
| West Virginia | No specific rule | From 1st employee |
| Wisconsin | Required | 3+ employees, or $500+ payroll in a quarter |
| Wyoming | Health statement | From 1st employee (state fund) |
Click any state for the full requirements with citations.