There is a dispute between Montana lawmakers and the state’s Department of Health over a package of far-reaching changes to child care licensing rules, including a controversial provision allowing exemptions from routine vaccinations for children and workers for religious reasons.
Both Republican and Democratic lawmakers on the Interim Committee on Children, Families, Health, and Human Services voted on June 18 to renew their informal objection to the proposed child care licensing rules that the committee has been blocking since November. The vote prevents the state’s Department of Public Health and Human Services from adopting the rules until at least March. Committee members then said they will discuss a formal objection that could delay the adoption of the rules until spring 2025.
Committee members renewed their objection after complaining that health department officials did not contact them to discuss revisions to the proposal.
„It’s really quite frustrating to see some necessary rule changes that providers in our communities are really demanding, along with other rule changes that are burdensome and unnecessary,“ said Democratic Representative SJ Howell, deputy committee chair, during the hearing. „I hope we can find a way forward.“
Health department officials have not yet decided on a course of action, said spokesman Jon Ebelt in an email.
„We assumed the interim committee would expand its informal objections to our child care rules package, and we continue to weigh options,“ said Ebelt. „Improving access to affordable, high-quality child care for hard-working families in Montana remains a top priority for us.“
Child care providers are frustrated by the delay in what they believe are urgently needed changes to the child care licensing rules. The package would, among other things, streamline the licensing process, reduce paperwork for providers and parents, and create a new type of license for providers operating outside of school hours. Rachel Wanderscheid, director of the Montana Afterschool Alliance, told the committee that the rules have been in the works for at least three years and urged the committee to move them forward.
„They’re good for providers, they’re good for families,“ she said. „There are a couple of different sticking points, but I would say overall – 95% – they’re great.“
The most controversial provision of the 97-page rule package is that large child care facilities must admit children who have not been vaccinated for religious reasons. Montana, like 44 other states, already allows religious exemptions from vaccination requirements for school-aged children. However, this proposal would add a religious exemption to vaccination requirements for younger children in the state.
Healthcare advocates fear that community immunity to preventable infectious diseases such as measles and whooping cough will decrease and lead to outbreaks if more parents seek a vaccine exemption.
The health department originally proposed the vaccination rules in 2022. At that time, the committee also blocked the proposal. In response, the department stated it would not enforce the ban on religious exemptions.
In November, KFF Health News first reported that health department officials had inserted the exemption onto 45 pages of the draft licensing rules. At that time, department officials stated that the rule package was necessary to align it with laws passed by the legislature in 2021 and 2023. One law, the Montana Religious Freedom Restoration Act, generally prohibits the state from violating a person’s right to religious exercise. Another law prohibits discrimination based on vaccination status.
Mississippi began allowing similar exemptions for schools and daycares in July after a court ruled that the lack of a religious exemption provision in the state violated the U.S. Constitution’s free exercise clause. But other states, including California, New York, Connecticut, and Maine, have abolished religious exemption guidelines in the past decade.
The American Academy of Pediatrics has called for the abolition of non-medical vaccine exemptions, arguing that they are „inappropriate for individual, public health, and ethical reasons,“ in a 2016 policy statement. The Montana Department of Health has the option to wait for the legislature committee’s objections and adopt the rule. An informal objection from the committee can be extended for up to six months, after which the department can implement the regulation. In this case, this extension option would expire in April.
If the committee votes to file a formal objection, the regulation could be blocked until the end of the next legislative session in spring 2025, said Maddie Krezowski, a legislative lawyer. This would give legislators the opportunity to address the law underlying the regulation during the session.
The committee could also file its formal objection with the Secretary of State, which would impact any legal challenges that may arise. The burden of proof in court would shift from anyone potentially suing the health department to the department itself, said Krezowski.