Legislators unanimously pause rule on religious exemptions for vaccinations at childcare centers

Allowing religious exemptions from vaccination requirements at childcare centers was voted down again by legislators Thursday after the proposal was included in a new rule package from the state health department.

The Children, Families, Health, and Human Services Interim Committee voted unanimously to halt the implementation of a rule package, which included other largely agreed-upon health department updates, because of disagreements over the childcare rule.

“Go look at what an iron lung looks like, what Polio does to people,” said Sen. Chris Friedel, R-Billings. “That alone will make you reconsider when you have a conversation about religious exemptions.”

Attempts to add exemptions for vaccine requirements for children in daycare failed during the 2023 legislative session, as well as the previous interim committee, sparking criticisms that the Department of Public Health and Human Services was attempting to circumvent the legislative process.

Health organizations spoke against the rule, saying it would endanger immunocompromised kids and families. But representatives of some Montana daycare centers spoke in favor of the changes, saying it gave them more flexibility and would expand access for care in the state.

Legislators differed in their arguments against the requirement, but both parties agreed to vote to informally object to the rules, which postpones implementation until the committee meets again.

The rest of the rules package, a total of eight proposals, included permanently expanding telehealth for mental health services allowed during the pandemic, among other changes.

Legislators expressed bipartisan concern over changes to immunization requirements, with Friedel saying it was the only thing giving him pause in the entire rules package.

Rep. SJ Howell, D-Missoula, said they were frustrated at the position the committee was placed in, with a lot of what they saw as good changes in the rest of the rules package.

Rep. Jennifer Carlson, R-Manhattan, made the motion to put the brakes on the rules package and explained she felt the proposed childcare rules were too restrictive for home daycare centers.

“I don’t believe that forcing home daycares into the box of following all of the same rules as a daycare center are appropriate,” Carlson said. “I don’t believe that a home daycare needs eight fire drills every year.”

During public comment representatives from daycare centers applauded the health department for the proposed changes, saying loosening regulatory requirements would lessen administrative burden.

In support of the exemption, Satish Silva, an “early childhood coach” with the nonprofit Child Care Connections, said it’s not unusual for family and group providers to make the decision to go into providing home daycare — oftentimes because of their own family’s needs and immune compromised status.

“If the choice of protecting unimmunized children is not protected, we can expect to see closure of some of our family providers,” she said, adding her prediction of closures would run contrary to the legislature’s desire to increase childcare providers in the state.

Pediatrician and president of the Montana Chapter of the American Academy of Pediatrics Lauren Wilson said the change would compromise the safety of children in childcare in Montana.

“When you cannot vaccinate infants, they can’t be protected,” Wilson said. “Their parents don’t have the option of protecting them, so they rely on knowing what the childcare center’s policies are, and knowing that those are strong policies in order to send their kids in.”

She said the rules would both increase the spread of vaccine-preventable diseases and make it difficult to respond quickly and effectively to outbreaks of disease – increasing the chance entire care centers would have to close.

Wilson also noted the proposed childcare rules overlook the legislative discussions in the 2021 and 2023 session over House Bill 702, which restricted employers from requiring vaccination against COVID-19 but specifically excluded childcare centers, and two bills in 2023 with religious exemption language that died during the session earlier this year.

Sen. Mary Ann Dunwell, D-Helena, said her sister was severely visually impaired for the rest of her life after getting Measles before a vaccine was available. She said she got sick as well, and had rashes all over her body. Measles was declared eradicated in the U.S. for 20 years but has made a resurgence in recent years.

“Nobody wants their infant or child to go through the ordeal that most children back in the ‘50s did,” Dunwell said. “And many did not survive.”

The committee has yet to decide how the rules package will proceed after the objection expires following their next meeting, scheduled on Jan. 18, 2024.