Voting & Cognitive Impairments

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Assisting Cognitively Impaired Individuals with Voting: A Quick Guide 

Difficulties in communication can occur when assisting a voter who has a cognitive impairment. The techniques and tips described  in this guide will help make sure that your communication is as effective as possible and within the limits of  assistance permitted by election laws. 

The American Bar Association Commission on Law and Aging, with funding from the Albert and Elaine Borchard Foundation Center on Law and Aging and the Greenwall Foundation, is conducting a project to identify, publicize, and catalyze policy and practice strategies nationwide that promote proper access to the polls by persons with cognitive impairments and protect against the fraudulent manipulation of the vote of this population.

The project, Accommodating Cognitive Impairments in Voting: Shaping Clinically and Ethically Sound Institutional and Public Policy, will accomplish these goals by:

• Surveying state election policies and activities addressing accommodations for persons with cognitive impairment in order to identify promising practices;
• Developing an easily accessible clearinghouse of information and resources on the subject;
• Identifying and describing the experiences in the November 2008 election of those election boards that provide direct outreach and support to residents of long-term care facilities and publishing a report of the findings;
• Supporting and evaluating a demonstration project of "mobile polling" in Vermont and publishing the evaluation in a peer-reviewed journal.

This website accomplishes the second goal of the project by developing an easily accessible clearinghouse of information and resources on the subject, including findings from the first, third and fourth goals of the project.

Clearinghouse Materials

• Summary of Promising Practices
• Materials Sorted by State
• Materials Sorted by Type

ABA Legislative Policies on Voting

• Voting by Persons with Disabilities

Articles

• Bringing the Vote to Residents of Long-Term Care Facilities: A Study of the Benefits and Challenges of Mobile Polling, by Jason Karlawish, Charlie Sabatino, Deborah Markowitz, Jonathan Rubright, Ellen Klem, and Robert F. Boruch, 10 Election L. J. 1, 2011.
• More Help Is Needed for Persons with Cognitive and Other Brain Impairments, Especially Those in Long-term Care Facilities, Who Want to Vote, by Ellen Klem, 31 Bifocal 3, Jan. - Feb. 2010
• Voting Rights of Older Adults with Cognitive Impairments, by Jennifer Mathis, Clearinghouse Review Journal of Poverty Law and Policy, September – October 2008 (292-300)
• Who Has the Capacity to Vote? by Charles P. Sabatino and Sally Hurme, Experience, Vol. 19, No. 1, 23-29 2009
• The Capacity to Vote of Persons With Alzheimer’s Disease, by Paul S. Appelbaum, Richard J. Bonnie and Jason H. Karlawish, Am. J. Psychiatry 162:11, November 2005
• Policy Statement on voting by persons with dementia residing in long-term care facilities, by Jason Karlawish, Paul S. Appelbaum, Richard Bonnie, Pamela Karlan and Steve McConnell, Alzheimer’s & Dementia 2 (2006) 243-245.
• Identifying the Barriers and Challenges to Voting by Residents in Nursing Homes and Assisted Living Settings by Jason H. T. Karlawish, Richard J. Bonnie, Paul S. Appelbaum, Rosalie A. Kane, Constantine G. Lyketsos, Pamela S. Karlan, Bryan D. James, Charles Sabatino, Thomas Lawrence, David Knopman. Journal of Aging & Social Policy, Vol. 20(1) 2008.

Bazelon Center for Mental Health Law Materials

• Bazelon Center for Mental Health Law, Voting Website
• Voting Rights of Older Adults with Cognitive Impairments, Jennifer Mathis
• People with Mental Disabilities Have the Right to Vote
• Providing Help to Voters with Disabilities: What You Should Know
• Vote. It’s your right.

Congressional Hearings

• United States Senate, Special Committee on Aging, Older Voters: Opportunities and Challenges in the 2008 Elections, January 31, 2008 (232-page pdf)
• S. Hrg. Rep. No. 110-483 (2008)

Election Assistance Commission Materials

• United States Election Assistance Commission Website
• Quick Start Management Guide on Elderly and Disabled Voters in Long Term Care Facilities

Government Accountability Office (GAO) Materials

• Government Accountability Office (GAO) Study: Voting Access for Voters with Disabilities and the Elderly—Election 2008
• Elections: States, Territories, and the District Are Taking a Range of Important Steps to Manage Their Varied Voting System Environments

National Citizens' Coalition for Nursing Home Reform

• N.A., Module 5: Residential Facilities for Groups Homes for Individual Resident Care A Look at Alzheimer’s, N.D. 
• N.A., Module 5: Communication, N.D.

News

• Anya Huneke, Vermont launches mobile polling program, NECN, Oct. 23, 2008 (article no longer online)
  
• Dena Potter, Advocates Push For Voting Rights For People w/ Psychiatric Disabilities, Associated Press, Nov. 3, 2008
• Ina Urbina, V.A. to Allow Voter Signup for Veterans at Facilities, New York Times, Sept. 9, 2008
• Mary Pitman Kitch, Democracy Makes House Calls, The Oregonian, Nov. 2, 2008
• Steven Rosenfeld, Department of Veterans Affairs Changes Policy on Helping Wounded Soldiers Register to Vote, AlterNet, May 1, 2008

State Law

• Voting by Residents of Nursing Homes and Assisted Living Facilities: State Law Accommodations
• State Provisions Regarding Voting: Constitutions, Election Laws, and Guardianship Statutes

State Resources

Maryland

• Linda H. Lamone, Administrator, Maryland State Board of Elections, Absentee Ballot and Voter Registration Procedures for Licensed Nursing Homes and Assisted Living Facilities, April 2004
• Maryland State Board of Elections, Licensed Nursing Homes and Assisted Living Facilities: Absentee Ballot & Voter Registration Procedures, June 2006
• Maryland State Board of Elections, Licensed Nursing Homes and Assisted Living Facilities: Absentee Ballot & Voter Registration Procedures, November 2007
• State of Maryland, 2006 Judges Manual, Chapter 5, Sample Letters and Memos, N.D.
• State of Maryland, Absentee Ballot Accounting Form, N.D.
• State of Maryland, Absentee Ballot Log, N.D.
• State of Maryland, Nursing Home & Assisted Living Facility Worksheet, N.D.

Missouri

• Robin Carnahan, Secretary of State, Your Vote, Your Voice, 2008

Nevada

• Nevada Disability Advocacy and Law Center, Nevada’s Protection & Advocacy System for Individuals with Disabilities, Protection & Advocacy for Voting Access (PAVA) Informational Packet, April 2007

Oregon

• League of Women Voters of Oregon, Official 2008 March Primary Voters, Pamphlet, Voters with Disabilities, pgs. 2-3, N.D.
• Mary Shultz, Assistant Director of Elections, Multnomah County, Multnomah County Voter Assistance Team (VAT) November 6, 2007 Special Election October 8, 2007 through November 30, 2007, December 21, 2007
• Mary Shultz, Assistant Director of Elections, Multnomah County, Multnomah County Voter Assistance Team (VAT) May 15, 2007 Special Election April 16 through May 15, 2007, June 3, 2007
• Mary Shultz, Assistant Director of Elections, Multnomah County, Multnomah County Voter Assistance Team (VAT) Abbreviated Report on the November 7, 2006 General Election: Voting Assistance Phase October 11, 2006 through November 7, 2006, February 28, 2007
• Mary Shultz, Assistant Director of Elections, Multnomah County, Multnomah County Voter Assistance Team (VAT) Abbreviated Report on the November 7, 2006 General Election: Registration Assistance Phase June 1, 2006 though October 10, 2006, February 28, 2007
• Mary Shultz, Assistant Director of Elections, Multnomah County, Multnomah County Voter Assistance Team (VAT) Abbreviated Report on the November 7, 2006 General Election, July 12, 2005
• Mary Shultz, Assistant Director of Elections, Multnomah County, Multnomah County Voter Assistance Team (VAT) Abbreviated Report on the November 7, 2006 General Election: Voting Assistance Phase October 11, 2006 through November 7, 2006 (Reflects removal of "No-Sig" phone calls), June 1, 2007
• N.A., Draft: Voting Assistance Program – Summary of Recommendations, N.D.
• N.A., Information Paper on AFB (Alternate Format Ballot), January 2008
• Washington County Elections, Voter Assistance Program Pamphlet, N.D.

Texas

• Comparison of Voter Participation in Long Term Care Facilities in the 2004 and 2008 Presidential Elections
• Carolyn Mounce, Suggestions for facilities to help their residents VOTE! (Draft – Rev. 2, September 1, 2007)

Vermont

• Deborah Markowitz, Secretary of State Releases Results of Mobile Polling Study: Vermont pilot project to expand voter accessibility for elderly, June 4, 2009
• Deborah Markowitz, The Office of the Vermont Secretary of State, Mobile Polling Project, 2008
• Jason Karlawish, Deborah Markowitz and Charlie Sabatino, Bringing voting to long term care facilities: Assessing the benefits of mobile polling, N.D.

Washington

• Kitsap County, Washington, Kitsap County

Symposium Facilitating Voting as People Age: Implications of Cognitive Impairment

• Introduction, Charles P. Sabatino and Edward D. Spurgeon
• Recommendations of the Symposium
• Voting and Cognitive Impairments: An Election Administrator's Perspective, Deborah Markowitz, Vermont Secretary of State
• Voting by Elderly Persons with Cognitive Impairment: Lessons from Other Democratic Nations, Jason H. Karlawish and Richard J. Bonnie
• Framing the Voting Rights Claims of Cognitively Impaired Individuals, Pamela S. Karlan
• Defining and Assessing Capacity to Vote: The Effect of Mental Impairment on the Rights of Voters, Sally Balch Hurme and Paul S. Appelbaum
• Absentee Voting by People with Disabilities: Promoting Access and Integrity, Daniel P. Tokaji and Ruth Colker
• Preserving Voting Rights in Long-Term Care Institutions: Facilitating Resident Voting While Maintaining Election Integrity, Nina A. Kohn
• The Technology of Access: Allowing People of Age to Vote for Themselves, Ted Selker

Websites

• Bazelon Center for Mental Health Law, Voting Website
• Brennan Center for Justice at New York University School of Law, Voting Rights & Elections Website
• National Association of State Election Directors Website
• United States Election Assistance Commission Website

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