Nursing home residents need more help voting

Given all the deaths, Mass. should give them a voice

NEARLY 40,000 citizens in nursing homes across Massachusetts have endured months of harrowing conditions under COVID-19, watching as friends and caregivers succumb, victims of the largest concentration of deaths in the state. Given their experiences, they rightly need to express their views by voting in November. Yet it appears that most will face undue hurdles in exercising this fundamental right.

Massachusetts moved swiftly to expand mail-in voting over the summer, and the primaries in September seemed to prove the effectiveness of the system overall, with no reports of voter fraud and high voter participation. But following the vote, it was disclosed that 18,000 ballots were discarded by the state. As the general election nears, we are concerned that the ballots of older citizens and people with disabilities living in nursing homes and similar facilities are most at risk, and that these citizens will not have the support they need to fill them out and submit them.

The challenges are substantial. Some residents do not have their nursing home addresses registered as their primary residence, and with limited visitation rights, family cannot bring their ballots to them. Others may need assistance requesting, filling out, or mailing their ballots. And some may wish to go offsite to vote in person at their local polling station. These things may sound simple and easy to those of us who do not live in nursing homes, but given the protocols in place because of coronavirus, these barriers are now insurmountable for many.

In a nation where the outcome of elections has been decided by a handful of votes, this is no small matter, and it is indeed a nationwide problem.

Advocates are doing their best to counter the effects. In New York state, the Long Term Care Community Coalition has launched a website to provide voting resources to nursing home residents. Likewise, the Autism Self-Advocacy Network has produced essential resources for voters. Here in the Commonwealth, the Massachusetts Senior Care Association has done similar work to keep voters informed.

All of these efforts are admirable. But they require internet literacy and access at time when many residents are unable to visit with loved ones who might assist them. In short, nothing is the same as gaining a firm and clear commitment from government officials that they will take action to ensure equal access to the vote. The current approach relies too heavily on each individual facility knowing and following the rules, and those rules set a low bar.

There is still time for action. Most recently, the federal government has weighed in with the Centers for Medicare & Medicaid Services Memo Reaffirming Nursing Home Residents’ Right to Vote.  And now the Massachusetts Department of Public Health and the Secretary of the Commonwealth must swiftly partner to deliver the resources nursing homes and congregate care facilities need to ensure unimpeded access to the vote. City and town clerks should be checking in with residents, ensuring that facility directors understand the need for compliance with regulations that allow unimpeded access to the vote. These needs have never been more acute.

No group has suffered the ravages of COVID-19 more in this crisis. At least 66 percent of deaths in Massachusetts have been people in nursing homes—more than 6,000 people—accounting for 1 in 6 of the Commonwealth’s nursing home residents. Far from simply being an election about Donald Trump and Joe Biden, they have a direct and very personal interest in voting in this election.

Perhaps, for instance, they are represented by one of dozens of legislators who voted to provide broad legal protections for nursing homes in April, while everyone was still scrambling at high speed to try to stem the spread of the virus. In addition, decisions about Medicaid – which supports more than 60 percent of nursing home residents – are voted on by elected officials. So are regulations that oversee and protect residents and their rights.

Meet the Author

Arlene Germain

Co-founder and policy director, Massachusetts Advocates for Nursing Home Reform
Meet the Author

Alison Weingartner

Executive director, Massachusetts Advocates for Nursing Home Reform
Meet the Author

Alex Green

Adjunct lecturer public policy, Harvard Kennedy School
Meet the Author

Bill Henning

Executive director, Boston Center for Adult Living
Yet nursing home residents need not have any reasons, when all is said and done, to deserve full access to this right. They have the right to vote – even amid a pandemic. And government has the obligation to ensure that right is supported in all reasonable ways – even amid a pandemic. Anything less is disenfranchisement, plain and simple.

Arlene Germain and Alison Weingartner are, respectively, the co-founder/policy director and the executive director of Massachusetts Advocates for Nursing Home Reform. Alex Green is an adjunct lecturer in public policy at the Harvard Kennedy School. Bill Henning is the executive director of the Boston Center for Independent Living.