Montana lawmakers are at odds with the state health department over a package of sweeping changes to child care licensing rules that includes a controversial provision allowing religious exemptions for routine immunizations for children and workers.
Both Republican and Democratic lawmakers on the Interim Children, Families, Health and Human Services Committee voted Jan. 18 to renew their informal opposition to proposed child care licensing rules, which the committee has blocked since November. The vote blocks the state Department of Health and Human Services from adopting the rules until at least March, when committee members say they will discuss a formal objection that could delay approval of the rules until spring 2025.
Committee members renewed their protest after complaining that health department officials had not contacted them to discuss revisions to the proposal.
“It’s really, really disappointing to see some necessary rule changes that providers in our communities are really asking for, along with other rule changes that are burdensome and unnecessary,” Democratic Rep. SJ Howell, the committee’s vice chairman, said during the hearing. . “I hope we can find a way forward.”
Health department leaders have not decided on a course of action, spokesman Jon Ebelt said in an email.
“We expected the interim committee to expand its informal objection to the child care rule package, and we continue to consider options,” Ebelt said. “Increasing access to affordable, high-quality child care for Montana’s hard-working families remains of the utmost importance to us.”
Child care providers are frustrated by the delay in what they say are necessary changes to child care licensing rules. The package will simplify the licensing process, reduce paperwork required of providers and parents, and create a new type of license for providers operating outside school hours, among other changes. Rachel Wanderscheid, the director of the Montana Afterschool Alliance, told the commission that the rules have been in place for at least three years and that the commission should let them go forward.
“They’re good for providers, they’re good for families,” he said. “There are two different areas of contention, but I’d say overall — 95 percent — they’re great.”
The most controversial provision of the 97-page rule package would require large child care facilities to enroll children who, for religious reasons, have not been vaccinated. Montana, like 44 other states, already allows religious exemptions from vaccination requirements for school-aged children. But that proposal would add a religious exemption to vaccination requirements for younger children in the state.
Health care advocates worry that if more parents request vaccine exemptions, community immunity levels to preventable infectious diseases such as measles and whooping cough will decline and lead to outbreaks.
The health department’s proposal would also eliminate the requirement that child care facilities send home infected and unvaccinated children and staff when someone at the facility becomes ill with a vaccine-preventable disease.
Health department officials originally proposed the vaccine rules in 2022. The committee blocked the proposal then as well. In response, the department said it would not enforce the ban on religious exemptions.
In November, KFF Health News was the first to report that health department officials had incorporated the 45-page exemption into the draft licensing rules. Department officials said at the time that the package of rules was necessary to align with laws passed by the Legislature in 2021 and 2023. One law, the Montana Religious Freedom Restoration Act, generally prohibits the state from violating the right of an individual to practice religion. Another act prohibits vaccination discrimination.
Mississippi began allowing similar exemptions for schools and child care centers in July after a court ruled that the state’s lack of a religious exemption violated the US Constitution’s free exercise clause. But other states, including California, New York, Connecticut and Maine, have removed religious exemption policies over the past decade.
The American Academy of Pediatrics has called for the elimination of nonmedical vaccine exemptions, arguing that they are “inappropriate for individual, public health, and ethical reasons,” according to a 2016 policy statement.
The Montana health department has the option to wait for legislative committee objections and adopt the rule. An informal objection by the commission may be renewed for up to six months, after which the department may implement the rule. In this case, this renewal option will expire in April.
But if the committee votes to file a formal objection, the rule could be blocked until the end of the next legislative session, in the spring of 2025, said Maddie Krezowski, attorney for the Legislature. That would give lawmakers a chance to tackle the law governing the rule during the session.
The commission could also file its formal objection with the secretary of state to be published with the adoption of the rule, setting up implications for any legal challenges that follow. The burden of proof in court would shift from anyone potentially suing the health department to the department itself, Krezowski said.
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