November 3, 2020 Election: Voting During the COVID-19 Pandemic

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AFL 20-78 From the California Department of Public Health 

October 5, 2020

TO: Skilled Nursing Facilities

SUBJECT: November 3, 2020 Election: Voting During the COVID-19 Pandemic


Title 42 Code of Federal Regulations section 483.10(b)

Title 22 California Code of Regulations section 72527(a)(7)

Election Code section 3021

All Facilities Letter (AFL) Summary

This AFL reminds skilled nursing facilities (SNFs) to ensure that residents can exercise their right to vote safely in the November 3, 2020 election during the Coronavirus Disease 2019 (COVID-19) pandemic. SNFs are encouraged to work with their local long-term care (LTC) ombudsman and take appropriate precautions.

​As the November 3, 2020 election approaches, the California Department of Public Health (CDPH) would like to remind SNFs of their obligation to assist and encourage residents to exercise their rights as a resident and as a citizen to be free from restraint, interference, coercion, discrimination or reprisal. This includes their right as a citizen to vote safely during the COVID-19 pandemic. Due to the COVID-19 pandemic and in a continued effort to protect the health of all Californians and ensure access to voting, Governor Newsom issued Executive Order N-64-20 (PDF) directing that every Californian who has registered to vote for the November 3, 2020 General Election is to receive a vote-by-mail ballot. Counties will begin mailing vote-by-mail ballots to registered California voters on October 5, 2020. Please note the last day to register to vote in California is October 19, 2020.

CDPH encourages SNFs to ensure that as many residents as possible are able to vote while following Centers for Medicare and Medicaid Services, Centers for Disease Control and Prevention (CDC), and local public health guidance. In an effort to prevent the spread of COVID-19 SNFs may want to consider doing the following:

  • Licensees should let facility residents know of the election and voting timelines and that they are there to help at the request of a resident.
  • Ensure that the privacy and confidentiality of the resident is observed if facility staff provide voting assistance to a resident.
  • Help with registering to vote or updating voter registration.
  • Advising of different ways to vote, such as early voting, voting by mail, or in person. Since some residents may be at higher risk for severe illness from COVID-19, it is highly recommended that residents be encouraged to consider early voting or vote-by-mail. Encourage residents to register early so that they can vote by mail and avoid public polling places. Residents may register to vote online.
  • Assistance with tracking a resident’s ballot.
  • Accessing election materials, which are available in multiple languages, online or receiving them by mail. Have voting materials for residents in their preferred language.
  • Reading election materials or a ballot.
  • Have staff handle ballots as little as possible and wear gloves when handling ballots.
  • Limit nonessential visitors when possible.
  • Post signs prohibiting persons with symptoms from entering the SNF.
  • Warn residents to beware of scams that claim to help them avoid exposure to COVID-19 by assisting them to vote in exchange for a fee and a bank account number.
  • After the close of the period for requesting vote-by-mail ballots, assist residents pursuant to Elections Code section 3021 with a written statement, signed under penalty of perjury that a ballot be delivered to them.

Licensees are also encouraged to contact their County Elections Office for alternative voting methods such as Remote Accessible Vote-by-Mail (RAVBM). This system allows voters to mark their selections using their own compatible technology to vote independently and privately at the facility. Please see the RAVBM FAQs (PDF) fact sheet for more information on how to access and the deadlines for requesting use of this alternative voting method.

For those residents that chose to vote in person:

  • Assist residents in maintaining appropriate social distancing while voting. 
  • Offer scheduled voting or staggered entry to the polling location.
  • Encourage early voting which is available in all counties four (4) days before the election (beginning on Saturday, October 31).
  • Poll workers assisting voters should be provided with personal protective equipment (PPE) consistent with CDC guidelines. 
  • Ensure all residents are informed on November 3 that it is election day.

SNF staff cannot do the following when assisting a resident to vote:

  • Influence a resident’s vote or mark a ballot in any way other than as directed by the resident.
  • Tell anyone how the resident voted.
  • Determine that a resident is mentally incompetent to vote. Only a court of law may determine whether or not a qualified voter is mentally incompetent for the purposes of voting. Existence of a conservatorship does not always mean that a resident is mentally incompetent to vote (California Elections Code Section 2208).
  • Vote by proxy. For example, the staff member knows that in the past the resident has always voted a straight party ticket. Now the resident is unresponsive. The staff member may not vote the resident’s ballot if the staff member is unable to reliably determine how the resident wants to vote.

Another resource to assist with voting is the LTC Ombudsman. The LTC Ombudsman advocate for residents in SNFs. The Ombudsman program and their designated representatives work to resolve individual problems and to effect change to improve quality of care in SNFs. Ombudsman programs support and advocate for all eligible residents’ right to vote, and they are available to assist SNFs to:  

  • Discuss residents’ rights, including the right to vote, with residents, facility staff, and family members/representatives.
  • Provide information about the voting process and relevant dates and deadlines such as when to register, how to register, how to make sure your receive your ballet by mail, how to locate accessible polling places, how to find transportation to polling sites, and how to connect with outside organizations that could assist residents directly.
  • Help residents change their address to the facility address to receive their ballot by mail or ask the resident representative to bring the ballot to the facility if it was mailed to the resident’s home.
  • Remind facility staff about their responsibility to assist residents in exercising their right to vote including finding transportation to polling sites or identifying other ways residents can cast their ballot (e.g., drop box, early voting, mobile polling, becoming a polling site).
  • Create and distribute educational materials about voting rights.
  • Encourage resident councils to invite candidates to their meetings to speak and visit with residents via videoconference or onsite.
  • Investigate complaints regarding residents’ rights and access to information, including the right to vote.

Information about the November 3, 2020 election, including additional voter rights, may be found at the California Secretary of State’s Election 2020 website.


Original signed by Heidi W. Steinecker

Heidi W. Steinecker
Deputy Director