From NC Health News: How do you vote if you live in a nursing home? It can be complicated.

Voters in Buncombe County drop off their absentee ballots at a temporary station set up by the county Board of Elections outside their office in Asheville. Photo by Hannah Critchfield, courtesy of North Carolina Health News

By Rose Hoban, North Carolina Health News

At 84, Jay Leavitt has been voting for about six and a half decades.

Despite being quadriplegic, he’s politically active and astute and knows many of the candidates near his home in Polk County.

“Just before I went into the hospital, in February, I went to a meet the candidates’ event, and the standing room only,” Leavitt said recently. “And as I came in, all people were yelling, ‘Hi, Jay. Hi, Jay.’”

Now Leavitt has become an ardent advocate for providing better access to voting for North Carolina’s thousands of residents in long-term care facilities and skilled nursing homes.

His own voting plans have been upended this year, not only because of his hospitalization in another state in the middle of the coronavirus pandemic. North Carolina election law, which has been the subject of many lawsuits over the past decade by voter rights advocates, adds challenges to voting in nursing homes and long-term care facilities trying to keep residents safe by restricting visitors.

Leavitt’s challenges started earlier this year when he developed a severe bed sore on his buttocks that landed him first in the hospital, then in a long-term acute care hospital in South Carolina. Now he’s trying to get back to North Carolina, but with the restrictions created by COVID and the fact that he’s a Medicaid patient requiring a lot of hands-on care, Leavitt is having difficulty finding a decent nursing home that will welcome him.

So in an election year when there is much enthusiasm about getting out the vote, he’s stuck in a facility in another state, where he can’t mark an absentee ballot himself because of his quadriplegia. North Carolina voting law prohibits staff there from helping him, but to cast an absentee ballot he needs someone to assist him and attest as a witness that the vote was his.

Leavitt has not been able to get someone from his county board of elections’ multipartisan assistance team (MAT) to cross the Polk County border into South Carolina to help him with his ballot or be a witness for him.

These MATs, as they’re commonly called, consist of volunteers from each of the major parties who go out together to nursing homes, assisted living centers, group homes and other care facilities to facilitate voting for residents.

North Carolina is one of only two states where the law prevents facility staff from assisting with voting in any way. Here, it’s illegal even for a staff member to do so much as drop a completed absentee ballot in the mail.

“It is so fraught,” said Corye Dunn, an attorney from Disability Rights North Carolina who is working to help people in such facilities vote. “Facilities’ staff are fearful about facilitating voting in any way, right? I mean, if you see ‘it is a felony,’ right, you kind of stop there.”

Alternatively, a “near relative” can help out with voting and witnessing a ballot, but with restrictions on visitation in many of the state’s facilities because of COVID-19, that’s happening less frequently.

Many of these rules are in the process of being litigated. One voter, Walter Hutchins, won a ruling this summer in a federal court case in which he claimed state law imposed an “undue burden on the right to vote.”  The judge in the case issued a narrow decision that applied only to Hutchins, allowing nursing home staff to assist him, but leaving other long-term care residents in the state without the same opportunity.

“It’s very troubling,” Dunn said. “To think that thousands of people in our state who have historically been regular and committed voters could be disenfranchised because our desire to prevent the spread of infection stands in tension with our state policy on absentee voting procedure.”

Help is available

This is where MATs come in. Facilities contact their county’s board of elections to send teams out to their facility to assist first with filling out an application for an absentee ballot, and then later to help people vote.

As with so many other things this year, the pandemic has complicated this process. COVID-19 has stalked the hallways of many residential care facilities, claiming the lives of more than 1,850 people, 51 percent of North Carolina’s 3,634 deaths from the disease.

The state Department of Health and Human Services has made recommendations on how the MATs should protect themselves and long term care residents they’re serving.

“There’s more fear,” said Kristin Mavromatis, who coordinates MATs for the Mecklenburg County Board of Elections.

In such a large county, Mavromatis and her team have worked ahead. Back in January, they went to all the facilities in the county to help them make requests.

“So anyone that was already there, we did their annual requests, which means they would have already gotten their presidential ballot,” she said.

By law, those teams need to be balanced between volunteers who are Republicans and Democrats.

“We have a list of Republicans and a list of Democrats,” Mavromatis said. “When we talk to the facility to schedule it, we try to determine how many we need, and then we just make sure it’s equal. Meaning let’s say we need 10 people, I have to have five and five.”

She said the volunteers are mostly retirees, stay-at-home moms, and others who only need a couple of hours at a shot to do the work.

Not every county has managed to recruit these volunteers. In Davidson County, elections board director Ruth Huneycutt said they’ve been unable to form any MATs to go into the nursing and adult care homes in the county, leaving as many as 1,400 people potentially without a means for casting a ballot.

“We’ve talked to the parties, we’ve talked to the facilities, we’ve done about everything we can do,” Huneycutt said. “The parties have not been participating in it at all, now they’re starting to get interested in it.”

She said she hopes to have something by the end of the week.

Strictly non-partisan

Once a care facility resident gets their ballot in the mail, then the MAT members come back to help people to get it marked as per the voter’s wishes. Usually, they set up in a common area, such as a dining room to meet with voters. This year, while the weather has still been warm, many of those meetings are happening outside, if a resident is healthy enough to be out of their room.

“And then their voters come one at a time with their ballots and their two MAT members assist them with whatever they are needing them to do,” said Kaylor Robertson who coordinates MATs in Orange County.

The teams’ members help if residents require any assistance, say if they can’t see or read the ballot well, or if their handwriting is too shaky to fill in the ovals. There’s no restriction on whether or how a cognitively impaired voter may cast a ballot.

“If you are inattentive, you may vote, even if you don’t care about policies, but really choose candidates on the basis of their appearance,” Dunn said. “There is no test for when a voter is making a decision on the right basis.”

MAT members may have to sit through a voter maligning their favorite candidate.

“We just nod and smile, nod and smile,” said Robertson. “They are instructed, and we are very clear that there has to be no discussions of any kind of political nature because we are completely non-partisan, our only job is to administer elections.”

The team members are also there to witness the resident signing their ballot because it’s illegal for any staff members at a care facility to even witness that a person filled out their own ballot. Elections officials said that if a resident’s ability to sign has deteriorated, the resident only needs to be able to make a mark.

All of this has been made more complicated by COVID-19. This work is done with everyone wearing masks, and for MAT members, personal protective equipment such as gloves or gowns.

It’s been a special challenge when there is a facility with a COVID-19 outbreak and no one from outside is allowed in. That could mean recruiting helpers from inside the facility.

“You’re just gonna have to come up with a creative way to get them a witness,” said Karen Hebb, from the Henderson County Board of Elections. “We suggested to them if they had another resident there that was mobile, and would like to help other people, they could suggest that they just go and help people when they needed it.”

Hebb has gone so far as to provide one-time-use pens for voters. Her board had a dry run for the presidential election back in June when there was a runoff race for their congressional seat.

“We were able to see what worked and what didn’t work then,” she said.

In years past, many facilities would send out their activity van to bring people to the polls, said Robertson.

“They come and they vote and then they go have lunch and it’s a big outing for them,” Robertson said. “We love having them do that and them getting out of the facility and having a chance to interact, and actually come to the polling place.”

That will also be more complicated this year with COVID-19.

“All of our poll workers will be required to wear PPE on election day and our early voting anyway, we have a huge amount of safety precautions in place for voting this year,” she said.

Lots of absentee ballots already

Already, the county elections boards are seeing huge numbers of people requesting and dropping off their absentee ballots, with demand for mail-in ballots at five, six or seven times the usual rate.

“We’ve had four, or five, six hundred people a day come in through our lobby,” said Hebb, from Henderson County, where in prior years, maybe a hundred people came to drop off ballots.

“They’re deciding just to bring them in, so they know that we’ve received it and then that reassures them and they don’t have to think about it anymore,” she said.

At early and regular voting sites, trained poll workers can help people with disabilities vote.

For those who can’t make it to an election site, Dunn is worried, especially about the witnessing procedure. Family members or “near relatives” can request absentee ballots and be a witness for a remote voter. There have been some instances of family members witnessing the vote through a care facility window but Dunn said she hears stories all the time about voters having difficulties.

This spring, Karen Brinson-Bell, executive director of the state Board of Elections,  made recommendations to lawmakers on ways to facilitate voting during the pandemic. Her memo cited difficulties faced by people in residential care facilities and suggested easing up on restrictions around witnessing during the pandemic and paying for the postage for ballots.

Lawmakers passed a 2020 elections bill in May that required one witness for absentee ballots. Gov. Roy Cooper signed it into law.

Lawsuits were filed in federal and state court challenging some of the measures. A recent settlement to litigation pending in state court that was supported unanimously by Democrats and Republicans on the elections board now is being challenged by Republicans in federal court.

Meanwhile, many North Carolinians already are casting absentee ballots.

For Disability Rights’ Dunn, what she’s seen this year with the difficulties in absentee voting has persuaded her to cast her own vote in person.

“I have seen just how easy it is to screw up an absentee ballot, and there are lots of ways to do it wrong. I’m not risking that,” Dunn said. “I’m going to make sure I have my ballot, and I’m going to mark it appropriately and I’m going to watch as it goes through the scanner, and I’m gonna get my stickers. Because I just had no idea how many ways it could go wrong.”

This article first appeared on North Carolina Health News and is republished here under a Creative Commons license.


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