Unless you are one of those folks who live totally off the grid and have little to no access to the modern world, you should know by now that 2024 is a big year in politics. BIG.
If you are an eligible voter, an American citizen, and a person who believes that your vote matters, there is probably not much that will stop you from voting in this year's presidential election.
More than 1.4 million people live in Nursing Homes in the United States. That's about 4% of the US population. Another 2% live in Assisted Living Facilities. A total of 6% of our nation's population live in long-term care communities where they depend on assistance 24 hours a day for, at a minimum, basic things like meals, medication assistance, and transportation. The dependence on others makes these individuals more susceptible to being taken advantage of in many ways, including voting.
This post is probably going to be a little lengthier than most. But it's going to outline some crucial things about voting and voter rights for individuals living in long-term care communities, voter fraud, the responsibilities of the facility in ensuring that each individual has access to the polls, and what facility staff cannot do to assist residents. The NCCCC hosted a webinar in August with Laura Williams, National Training Coordinator for the Center for Vulnerable Voters. The information included in this blog post was provided during that training and is also available on their website.
Who Can Vote?
Long-Term Care residents are guaranteed rights, including their right to vote, under federal regulation:
§483.10(b) - Residents residing in long-term care communities have the right as a resident of that facility and as a citizen of the United States to vote,
§483.10(b)(1) - The facility must ensure that the resident can exercise his or her rights without interference, coercion, discrimination, or reprisal from the facility,
§483.10(b)(2) - The resident has the right to be free of interference, coercion, discrimination, and reprisal from the facility in exercising his or her rights and to be supported by the facility in the exercise of his or her rights
Elderly and disabled adults living in long-term care facilities have the right to vote under the federal Voting Accessibility for the Elderly and Handicapped Act of 1984.
Individuals living in these facilities are often registered to vote in another county. You can assist them with registering to vote in their current county of residence by going to Register And Vote in Your State | U.S. Election Assistance Commission (eac.gov). All states have different election requirements.
All individuals have the right to their own personal and private voting preferences. This includes individuals who may need assistance completing their ballots, accommodations to vote, and transportation to and from the polls. It is illegal to provide your opinion or tell someone who they should vote for.
All individuals have the right to an absentee or mail in ballot. Procedures for voting by mail/absentee vary by state to state. However, every state must provide seniors with an absentee or mail-in ballot when requested. For more information you can go to the U.S. Government website.
Risks
As previously stated, individuals who are dependent on others for their daily care needs are more susceptible to being taken advantage of. In the case of voting and elections, this can be done in many ways by individuals attempting to sway election results. Vote suppression, coercion, theft and ballot harvesting are terms that facility staff should be familiar with, as many of these illegal practices are punishable as felonies.
Vote Suppression - strategy used to influence the outcome of an election by
discouraging and/or preventing specific groups of people from voting.
Vote Coercion - use of intimidation or fear of reprisal to secure a vote for a
specific candidate
Vote Theft - completing and submitting a ballot on behalf of an individual without his/her authorization
Ballot Harvesting - non-secure method of collecting absentee ballots during an
election with the intent of dropping them off at election offices or polling places. Ballot harvesting is illegal in some states, including NC. N.C. Gen. Stat. § 163-231(b)(1).
There are instances where family members and staff submit ballots on behalf of individuals who are not capable of making an informed decision for themselves about who to vote for. This is ILLEGAL.
If an individual is not able to express the desire to vote, cannot tell you who is running in the election, and cannot tell you his/her own name, they do not need to be given a voter ballot. Additionally, residents should not be provided a suggestion or recommendation of who to vote for or told who to vote for.
Long-term care community Administrators should carefully monitor activity in their facility during this time to minimize risks of illegal activity related to voting. It is the responsibility of the Administrator to ensure residents are protected by educating staff and monitoring their activities in your facility. This includes but is not limited to:
Allowing outside groups to come in and assist residents with completing voter ballots
Requests for absentee ballots for residents with dementia or cognitive impairments
Any assistance being provided to residents by facility staff or family members that are not legal guardians to residents with completing ballots. Unmonitored assistance should not be allowed.
Staff training by qualified individuals, such as NCBOE employees or MAT team members, is encouraged to ensure that everyone understands his/her role. The Center for Vulnerable Voters provides an excellent one-page guide for long-term care facility administrator responsibilities. Pages 11-12 of the Residential Facility and Skilled Nursing Home Staff Training Guide, also provided by the Center for Vulnerable Voters outlines facility Administrator responsibilities.
Best Practices
In North Carolina it is a Class 1 felony for any person who is an "owner, manager, director, employee, or other person" affiliated with a "hospital, clinic, nursing home, or rest home.... to mark the voter's absentee ballot or assist such voter in marking an absentee ballot," or even to assist a voter in completing an absentee ballot application or serve as a witness. NC General Statute § 163‑226.3(a)(4)
It is important to note that under Section 208 of the federal Voting Rights Act of 1965, a voter may be given assistance by a person of the voter's choice (other than the voter's employer, employer's agent, officer, or agent of the voter's union). 52 USC §10508. A qualifying disability, under federal law, is a "physical or mental impairment that substantially limits one or more major life activities." 42 U.S. Code § 12102. It is important to note that the individual must be able to choose the person who is providing assistance. If he/she is unable to make this request, assistance will not be able to be provided.
Multipartisan Assistance Teams (MAT) are teams that are composed of members, employees and/or volunteers of the county Board of Elections. These individuals are trained and authorized to assist voters with absentee ballots. Under NC General Statute §163-226.3(a)(4), a MAT must consist of at least two registered voters of the county belonging to each of the two major political parties. A nursing home resident is only allowed to request voting assistance from another person (near relative or verifiable legal guardian) if a MAT is not available within seven calendar days of a request for assistance.
MATs are professionally trained and familiar with state and federal rules concerning absentee voting. It is recommended you contact your county Board of Elections office and request MAT assistance as soon as possible for the residents in your facility who plan to absentee vote in the up-coming election.
The Senior Citizens Bill of Rights Pocket Guide should be made available to all residents of your long-term care community.
The Protect Vulnerable Voters Training Guide should be made available to staff and family members of long-term care residents.
For more information or questions, please contact the Center for Vulnerable Voters.
Much of the information for this post was provided by Laura Williams from the CVV. The handouts, guides, etc. are available on the Center for Vulnerable Voters website. Special thanks for allowing us to share!
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