Getting In the Vote: The Nursing Home Challenge

Ensuring that residents of long-term care facilities can exercise their right to vote has been fraught with challenges, even prior to the pandemic. Many residents need assistance with some or all aspects of voting and have relied upon support from long-term care facility staff, family, friends and community programs, as well as outside volunteers, to help them.

With the impact of COVID-19, however, many of those supports are not as available this year. We are at great risk of excluding significant numbers of residents from voting in the 2020 election.

As communities shut down due to COVID-19, severe restrictions on access and visitation in long-term care facilities were put into place. Despite many states reopening businesses and resuming services, the process has been much slower in long-term care facilities because of the outsize impact of COVID-19 on residents and staff. Visitors onsite at long-term care facilities primarily have been restricted to families and long-term care ombudsmen.

Responsibility to Help Residents Exercise Their Right to Vote

Long-term care facilities have a responsibility to assist residents in exercising their rights, including their right to vote. Such assistance often includes helping them to register to vote, to obtain an absentee or mail-in ballot, to get to the polls or to fill out and return ballots. There are a significant number of residents, however, who rely upon outside support for voting assistance, either because they are not getting the help they need from their facility, or because of restrictions on who can provide that assistance to them.

In some states, state law prohibits nursing home staff from helping residents fill out their ballots. However, many community-based voter assistance programs, which would otherwise go into nursing homes to help residents vote, have indicated that due to COVID-19 they will not be doing so this year. Furthermore, while nursing homes have in previous years served as polling sites, allowing many residents to remain in the building to cast their vote, for this election, many of these sites are being relocated away from nursing homes. So how to address these issues and help facilitate voting for residents of long-term care facilities?

  1. Identify and collaborate with community programs that traditionally provide assistance and information to persons with disabilities—including long-term care facility residents—around voting. Many state disability rights networks, or protection and advocacy programs, actively provide help. Additionally, long-term care ombudsman programs also have provided information and advocacy for residents who wish to vote.
  2. Ensure that residents, families and long-term care facilities have the information they need about voting options, polling places, early voting availability, obtaining mail-in ballots and deadlines for requesting and mailing in a ballot. Right now, as the weather is still warm, in many states outdoor and window visits are being held. Voter registration programs could coordinate with long-term care facilities about having an outside table available where residents can be helped to register to vote or request a mail-in ballot.
  3. Facilities can assign a non-clinical staff person or volunteer to assist residents in registering to vote or requesting a mail-in ballot. Because many long-term care facilities across the country have obtained additional computers, tablets or other electronic devices to help residents connect virtually with families, those devices can be used to help residents request mail-in ballots online.
  4. Review state policies around voting, including early voting and who is permitted to provide assistance to residents around voting and determine if additional flexibility is necessary. Advocate for changes that are more inclusive, such as permitting a resident to select someone they trust in the facility, a staff person, a family member (if visits are permitted leading up the election day) or even another resident, to provide assistance; or offering additional hours for individuals who need special assistance or support.
  5. Explore the availability of mobile polling locations in the community. Implement protocols for social distancing and cleaning machines between votes.
  6. For residents who wish to go to their community polling site to cast their ballot, work with them to facilitate access safely. What options are available for safe transportation? Do they have a mask or other face covering and access to hand sanitizer? Ensure they understand the need for social distancing, and whether they will be required to quarantine for a set period of time when they return to the nursing home.

As we think about how we will vote in the election this year, we must include options for long-term care facility residents to cast their ballots as well.

Lori Smetanka, J.D., is the executive director of the National Consumer Voice for Quality Long-term Care in Washington, DC.