The November 2020 election looms on the horizon. With only two weeks to go, efforts are ramping up nationwide to get people to the polls. But one group may be left behind: seniors and people with disabilities. Due to COVID-19 restrictions at skilled nursing and residential care facilities combined with a lack of in-person polling places statewide, it’s possible that hundreds of thousands of people’s voting rights could be at stake.
There are 1,200 skilled nursing centers and 8,000 residential care facilities across the state of California. They house people with physical and mental disabilities, and seniors who may have developed age-related disabilities later in life. In San Francisco there are more than 50 of these facilities, housing thousands of residents of voting age. Laguna Honda, one of the largest, has an average population of 780 residents.
Historically, voting while residing at one of these centers wasn’t a huge hurdle. Residential care facilities, in particular, were often turned into polling places, opening their doors to the wider neighborhood. If you lived in one, often the commute to the poll consisted simply of taking an elevator down to the lobby, where trained polling staff could assist you in casting your vote.
Due to COVID-19, however, the majority of in-person polling places are not opening up this November. Instead, every registered voter in the state of California has been sent a mail-in ballot. And while it may seem easier — the ballot is delivered to you! — for people with disabilities, it can present a whole range of barriers.
“My stepfather spent basically the whole day having to figure out how to make sure my mom voted,” says a woman named Jamie, who called into a webinar on voting in residential care homes hosted by the San Francisco-based advocacy organization Senior and Disability Action. “It was a whole ordeal because the nursing home did not facilitate that at all. My mom, being the strong voter that she is, wanted to make sure that she got her ballot cast, but she had to be incredibly proactive in that process.”
Mike Dark, a staff attorney of the California Advocate for Nursing Home Reforms, was on the same call. He is concerned about the fact that many facilities are still not allowing any visitors, or are locking people out if they leave. Many residents of these centers receive their mail elsewhere, and so would need a friend or family member to deliver it to them. Others require assistance in reading or filling in the bubbles of their ballots. With visitors banned, they’re left with little to support in exercising their right to vote.
Dark says that there are federal and state laws in place to protect the voting rights of these residents — but they’re rarely enforced. The Voting Rights Act specifically states that any voter who needs assistance because of a disability may be given assistance by a person of the voter’s choice. An Oct. 5 memo from the Centers for Medicare and Medicaid Patients states that “nursing homes must have a plan to support residents’ right to vote.”
But putting that in practice during a pandemic is not easy. With the lack of visitors, “a lot of the solutions we are talking about involve staff,” Dark says. “Certified nursing assistants work for very little money, and they see 10, 12, 15 residents an hour. If you add on top of that that they need to help people register, assist people with their ballots, then part of the pushback is going to be that they just don’t have time to do that. In thinking through practical solutions, it seems like getting outside assistance into facilities safely, with good PPE, is going to have to be part of the solution.”
Luckily, some of San Francisco’s residential care centers are already on the case. Laguna Honda has historically been a polling place, and has even had Department of Elections staff come in to show residents how to use the voting machines. But due to the pandemic, residents are voting by mail this year.
“At Laguna Honda we take very seriously the right to vote, and support our residents in exercising this right, if they so choose,” says Zoe Harris, a spokesperson at the residential care facility. “Over 400 of our residents are registered to vote and many have already cast their ballots in the 2020 election.”
The casting of ballots at Laguna Honda has been accomplished through the support of social workers and activity therapists. “They proactively provide residents with the opportunity to register to vote and, when ballots arrive, are an important resource in distributing ballots, and depending on the preferences and needs of each resident, supporting to read the voter guide, and complete and return ballots,” Harris says.
It may require some extra work this year, but Michelle Bishop, the voter access and engagement manager and the National Disability Rights Network, says that supporting residents of care homes’ right to vote is “absolutely a civil rights issue.”
“When you talk about people living in residential care facilities, this becomes a disability justice issue,” Bishop says. “We’re also very much talking about racial and ethnic justice. We know that the percentage of racial minorities in assisted care facilities has been increasing in the last decade. It’s also an economic justice issue.”
And in San Francisco, there are several ballot measures that could have strong impacts on seniors and people with disabilities. Proposition A would authorize The City to borrow $600 million to fund the acquisition and development of affordable housing. Statewide, Proposition 14 would fund stem cell research. And Proposition 20, which would alter the state’s parole standards, could also have an outsized impact on people with disabilities; those in state and federal prisons are three times more likely to have a disability than those who are not incarcerated.
“This election in particular — above all other things — is a referendum on how well we are handling a public health crisis, which has been a catastrophe for people who live in long-term care,” Dark says. “The rights of people who live in long-term care to vote on those issues is especially important to protect.”
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