The short answer Wyoming's home health licensing rules require agencies to have employee-health policies and to document that each employee is free of communicable diseases that could put clients at risk, but no TB test is named, making this a health-statement state. Home health is enumerated as extrahazardous, so state-fund workers' comp is mandatory from the first employee.
What Wyoming requires
Wyoming
TB screening: health statement only. Wyoming DOH Home Health Agency rules, Chapter 9, Section 5, require the agency to develop employee-health policies identifying communicable diseases that could put clients at risk and to document that each employee is free of such communicable diseases; no TB test or risk-assessment method is prescribed.
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WDH TB posture. The WDH TB program tells health care facilities to review CDC guidance and licensing policies and follow the most stringent guidance; a recommendation, not a mandate.
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Workers' comp mandatory (extrahazardous). Wyo. Stat. 27-14-108 enumerates ambulatory health care services (which includes home health care) as extrahazardous, so coverage through the monopolistic state fund is required for all workers from the first employee.
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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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