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Still some uncertainty as Montana hospitals prepare for federal vaccine mandate

Benefis Health System hospital in Great Falls
Posted at 7:42 PM, Feb 11, 2022
and last updated 2022-02-14 13:03:38-05

HELENA — Starting Monday, February 14, 2022, the federal government is planning to enforce a COVID vaccination mandate for workers at hospitals and other healthcare facilities - including those in Montana. However, a lot of uncertainty remains ahead of the deadline.

Last fall, federal authorities announced a vaccine mandate for hospitals, clinics, and other certified healthcare facilities that receive funding from Medicare or Medicaid. Montana was one of a number of states that challenged the rule in court, pointing to potential negative impacts on labor shortages and hospital operations – particularly in rural areas. In January, however, the U.S. Supreme Court allowed the mandate to stand.

The Centers for Medicare & Medicaid Services has announced different deadlines for different states. In Montana, by February 14, affected facilities will have to show they have a plan for ensuring their staff get vaccinated, and all employees will have to receive at least a first dose, unless they have filed a religious or medical exemption. Health care workers would need to be fully vaccinated by March 15.

Rich Rasmussen, president and CEO of the Montana Hospital Association, says providers started preparing for this months ago, and they’re ready: “Our members are completely confident that they’ll meet the requirements of the CMS vaccine requirement,” he said.

On Thursday, Governor Greg Gianforte published an open letter to healthcare workers. After praising their work and dedication, he said the U.S. Supreme Court’s decision left legal questions unanswered, and the state would continue to challenge the mandate.

“In the meantime, however, I urge those of you who are unvaccinated to consider using the religious and medical exemption processes that your employers are required to offer, as well as talk to your colleagues or personal health care provider about getting vaccinated,” the letter said.

Gianforte also included a standard form, created by the Montana Department of Public Health & Human Services, for employees to claim a religious exemption.

Rasmussen said the MHA has offered its providers a toolkit that included a similar template. He said he sees the governor’s letter as going along with their efforts to limit the mandate’s impact on their work force.

“The total focus among everyone here is to ensure that not a single community in our state will be disrupted by this vaccine mandate,” he said. “We want to make sure that if you’re in an automobile accident, you’ll have the full complement of services to treat you; if you’re going to deliver a baby, you’ll have the full complement of services to be able to treat you.”

Rasmussen said the exemption process is similar to how hospitals have handled flu vaccines in the past.

While the mandate is set to go into effect Monday, that could still be affected by late court action. After the Supreme Court’s ruling, Montana Attorney General Austin Knudsen and 15 other state attorneys general filed an additional legal complaint, seeking to stop enforcement. In that filing, they argued the federal rationale didn’t take into account the evolving circumstances of COVID. They noted the delta variant has been largely replaced by the omicron variant, which appears more transmissible even among vaccinated people.

Knudsen’s office told MTN that case is now before the 5th Circuit Court of Appeals, and some last-minute filings are scheduled over the weekend, so there may still be time for a decision before the February 14 deadline.

Rasmussen said they’re aware of the possibility of court intervention, but that stopping and starting can be disruptive for their operations.

“Here we are, a couple days out before that deadline, and the anecdotal information we’ve received from our members is that they’re ready to go,” he said. “A disruption in that just does create some encumbrances that we’d rather not have.”

DPHHS has posted extensive guidance related to the vaccine mandate on its website.


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