Skip to main content

Elderly Voters: Information on Promising Practices Could Strengthen the Integrity of the Voting Process in Long-term Care Facilities

GAO-10-6 Published: Nov 30, 2009. Publicly Released: Nov 30, 2009.
Jump To:
Skip to Highlights


Voting is fundamental to the U.S. democratic system and federal law provides broad protections for people with disabilities, including older voters. Many long-term care facility residents, who often have physical or cognitive impairments, vote by absentee or early ballot. Concerns have been raised about the extent to which states and localities are helping the increasing number of facility residents exercise their right to vote, especially those requiring voting assistance, who may be subject to undue influence or unauthorized completion of their ballot by facility staff or relatives. Given these concerns, GAO was asked to identify the actions taken to facilitate and protect voting for long-term care facility residents at (1) the state level and (2) the local level. To address these objectives, GAO interviewed federal officials, national organizations, and researchers; reviewed Election Assistance Commission (EAC) guidance on voting in long-term care facilities; surveyed state and local election officials; and visited seven localities in the weeks prior to the November 2008 federal election to observe the voting process in long-term care facilities.

Skip to Recommendations


Recommendations for Executive Action

Agency Affected Recommendation Status
Election Assistance Commission The EAC should work with stakeholders to develop guidance on voting in long-term care facilities. The EAC should also collect and disseminate information on cost-effective promising practices for providing voting access while also ensuring voting integrity.
Closed – Implemented
The Election Assistance Commission (EAC) has produced a full chapter on voting accessibility, which includes information on serving voters in long-term care facilities as part of its Election Management Guidelines. The chapter includes information on mobile voting and an example of one state's mobile voting program. The Election Management Guidelines are used to assist state and local election officials in effectively managing and administering elections and each chapter is vetted by recognized election experts.

Full Report

GAO Contacts

Office of Public Affairs


Absentee votingAid for the disabledElderly personsElectionsEmployeesstate relationsFraudHealth care facilitiesLong-term careNursing homesPeople with disabilitiesReporting requirementsRequirements definitionSkilled nursing facilitiesStrategic planningVotingPolicies and procedures