The day before Election Day patients at some hospitals in the University of Pennsylvania Health System get more than just food delivered on their meal trays — they will also get information on how to cast emergency absentee ballots.
At least 38 states offer opportunities for patients to cast ballots if they are in the hospital, and many health systems across the country have helped patients and caregivers get reliable information on how to vote. Voting for inpatients has become even more complicated as many hospitals have restricted visitor policies due to the COVID-19 pandemic.
Dr. Kelly Wong decided shortly before the 2018 midterm election to establish an online resource for patients seeking information about how to vote while hospitalized, which became the Patient Voting initiative.
In this election cycle, medical students and other volunteers with Patient Voting have contacted election officials to ensure the group had accurate information about how voting procedures changed during the COVID-19 pandemic.
They are currently fielding inquiries from caregivers, patients and healthcare professionals on what can be a detailed process.
Timing matters when patients are trying to register for an emergency absentee ballot or dropping off ballots as deadlines are inflexible, said Dr. Alison Hayward, an emergency room physician and assistant professor at Brown University's medical school who is on the board of Patient Voting. Patient Voting's website has a repository of state-by-state requirements.
"If they are trying to vote at eleventh hour, hours count. Offices don't stay open late, and there's not much staffing," Hayward said.
Some states have more complicated processes than others. In North Carolina it's a felony for healthcare workers to help patients vote, and New Jersey limits the number of ballots an individual can drop off for others to three.
Brown's emergency department doesn't allow volunteers to go door-to-door asking patients if they are interested in voting, Hayward said, but they are allowed to distribute business cards and notify providers about voting procedures.
All eyes will be on Pennsylvania as a crucial swing state in the presidential vote count this year, and Penn Medicine has partnered with Patient Voting to augment its civic engagement efforts. The health system's civic engagement programming since 2017 has been spearheaded by Dr. Judd Flesch, an assistant professor of clinical medicine at Penn Medicine, and Aliza Narva, a nurse and director of ethics at the Hospital of the University of Pennsylvania.
Penn Medicine participated in pilot programs of the VotER voter registration program that started at Massachusetts General Hospital, though registration kiosks transitioned to virtual means such as posters and QR codes on the back of health workers' badges as the pandemic altered dynamics in the emergency room. Flesch said Penn Medicine's efforts registered roughly 4,000 people this cycle. Flesch and Narva said that University of Pennsylvania Health System CEO Kevin Mahoney was supportive of the effort.
Penn Medicine's voter registration drive pivoted to providing information about emergency absentee ballots last week, as individuals who were hospitalized after Oct. 27 may be eligible to vote through the process. Medical student volunteers are helping ferry paperwork to Philadelphia City Hall.
"Health professions are civic professions," Narva said. "There has been a tremendous amount of enthusiasm, and everyone has engaged in this process."
Flesch is an intensive-care unit physician, and he said he was struck by how much patients appreciated assistance with voting.
"It was clear that this connection to their own humanity was extremely important to them," Flesch said.
Correction: A prior version of this story misspelled the name of Dr. Judd Flesch.