The short answer Virginia's home care organization licensing chapter (12VAC5-381) contains no TB screening requirement; the requirement instead lives on the Medicaid side, where personal care aides and consumer-directed attendants serving waiver individuals must receive TB screening under 12VAC30-120-930. Workers' comp is required at more than two employees.
What Virginia requires
Virginia
Licensing chapter: no TB rule. 12VAC5-381-200 (Personnel practices) covers staffing, credentialing, background checks, and records with no TB or health screening, and 12VAC5-381-260 (Infection control) requires an infection-risk-reduction program and OSHA bloodborne pathogens compliance but no worker TB screening.
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TB rule lives in Medicaid regs. 12VAC30-120-930(J) requires personal care aides and consumer-directed attendants serving CCC Plus waiver individuals to receive tuberculosis screening as specified in the criteria used by VDH.
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VDH screening criteria. VDH's TB screening/testing page and TB Risk Assessment Form 512 are the referenced criteria for Medicaid waiver aide/attendant screening.
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Workers' comp at more than two employees. Virginia Workers' Compensation Commission: businesses with more than two employees (full- or part-time) regularly in service must carry coverage; subcontractor workers count toward the threshold.
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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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