Montana Seeks Exemptions to Vaccine Mandate for Rural Hospitals

Montana state leaders are calling on the Biden Administration to issue exemptions to a nationwide vaccine mandate for healthcare workers. Implementing the vaccine mandate in Montana could worsen access to care, especially those seeking it at rural hospitals, they say.

The Supreme Court recently ruled in favor of the Biden Administration’s vaccine mandate for healthcare workers despite blocking a larger mandate for large, private employers. Montana was one of the states that had challenged the vaccine mandate for healthcare workers. Healthcare facilities now have until March 15th to get their workers fully vaccinated against COVID-19.

“Like many states across the nation, Montana is already facing labor shortages, especially in the healthcare industry, which severely threaten patient access to lifesaving medical care,” US Senator Steve Dainers, Governor Greg Gianforte, and Congressman Matt Rosendale wrote in a letter to HHS leaders on Wednesday.

“Given the Supreme Court’s decision, we are deeply concerned that the vaccine mandate will penalize healthcare entities that simply cannot comply with the mandate due to ongoing workforce challenges. Some Montana facilities cannot afford to lose another healthcare professional, especially when alternative measures can be implemented, such as masking and testing, to protect the safety and health of employees, patients, and visitors from COVID-19,” they wrote.

State leaders asked HHS to consider “unique healthcare access challenges faced by rural states like Montana.” They called for the federal department to exercise discretion by issuing waivers for healthcare facilities facing “dire workforce impact” from the vaccine mandate.

Hospital and health system leaders have shared concerns about internal vaccine mandates and their workforce even though national groups like the American Hospital Association have backed mandates. While many organizations still opted to require immunization among their staff members, others deferred the decision or would not consider a mandate over fears of exacerbating already high levels of turnover.

“I agree fundamentally with what the hospital association is saying and with what other hospital systems are now doing with the mandates, but those systems are in different environments and markets,” Alan Levine, CEO of Tennessee-based Ballad Health, said in a July 2021 call with local news sources.

“If today I said, ‘everybody’s required to take the vaccine or you’re terminated,’ then I have a problem being able to take care of people who show up to our ER with strokes, or chest pains, or medical admissions or surgical admissions,” Levine continued.

Ballad Health also recently requested changes to the national vaccine mandate for healthcare workers because of staffing shortage concerns, according to local news sources. In a comment letter on the mandate obtained by WJHL, Levine said the vaccine mandate “threatens to exacerbate the national shortage of healthcare workers, particularly in rural communities.”

Levine revealed in the comment letter that nursing turnover at the health system reached as high as 27 percent during the initial surge of COVID-19.

The situation is not unfamiliar to rural hospitals. Rural communities have historically faced shortages of qualified healthcare professionals. The COVID-19 pandemic made it even more difficult to attract and retain staff as many professionals made the decision to leave the healthcare field altogether because of the stress and burnout. Other professionals also chose to take on new roles or traveling jobs because of the significant pay bumps.