Presby Votes

From left: Alyson Cole, Emily Hollander, Leah Rethy, Thomas Riley, MD, Zachary Mankoff, and Judd Flesch, MD

Think back to the 2016 general election… Regardless of your politics, like many American voters, you may have been counting down the days, ready to cast your ballot and show off your “I Voted” sticker long before the frenzied campaign season came to an end. Now imagine that the night before Election Day, you ended up hospitalized. You couldn’t have anticipated needing an absentee ballot the week before, so was it too late? Had you really watched all of those dramatic debates for nothing?

The answer to both is fortunately “no,” but the process can be complicated – and especially difficult from the confines of a hospital bed. U.S. elections generally tend to have low voter turnout with poor health and disability often cited as reasons for abstaining, so it’s vital to take steps to ensure a hospital visit doesn't bar someone from participating in the political process. That’s why a multidisciplinary group of staff, students, and volunteers at Penn Presbyterian Medical Center – dubbed “Presby Votes” – has been working hard to ensure that patients interested in voting don’t lose their chance, whether in dramatic presidential races or local elections.

“The Presby Votes initiative is a great example of our clinicians and student volunteers enriching the patient experience,” said Alyson Cole, chief patient experience officer and associate executive director of PPMC. “It demonstrates a special, personal connection that goes beyond the bedside relationship by helping our patients use their voices and exercise their civic duties.”

The May Pennsylvania primary election marked the third round of inpatient voting supported by Presby Votes, which is led by Judd Flesch, MD, an assistant professor of Clinical Medicine and residency program director for Internal Medicine, with help from civically-minded, community-focused students in the Perelman School of Medicine and Penn Law. While the 2016 general election was a last-minute push, the group’s approach has become increasingly structured and strategic.

“We were initially going from room to room to ask patients if they were interested in participating, but that was time-intensive and could be confusing if patients switched rooms,” Flesch explained. “We wanted to develop a more organized approach. For the most recent election, we disseminated the info through the staff so patients could talk to their care team about their options, and we also advertised on the hospital televisions and through flyers. Patients could either call or text their name and room number, and our volunteers would connect with them and go over the process.” 

After receiving a patient’s consent and confirming their eligibility to vote, the medical students assist them in understanding and filling out their application. While the process is straightforward for patients submitting a “normal” absentee ballot by the 5:00 p.m. deadline one week prior to the election, as it gets closer to Election Day, challenges arise. There are two types of emergency ballot applications in Pennsylvania – “regular” emergency and “last minute” emergency – and the process becomes more complex as the clock ticks down toward the polls opening. Both require the certification of a physician and must be notarized, but last-minute emergency ballot applications also require judicial approval by an elections judge.

That’s where the student volunteers from Penn Law come in. They are tasked with delivering the applications to City Hall, acting as an authorized representative in front of a judge for any last-minute emergency ballot applications, bringing the approved ballots back to the hospital, and then returning to City Hall with the patients’ completed ballots.

Currently Presby Votes can only support voters registered in Philadelphia County given the time sensitive process and the labor intensive racing between City Hall and PPMC. However, as the team continues working out the kinks through future elections – including the upcoming November midterms – they hope to gradually add other nearby counties in both Pennsylvania and New Jersey so they can empower as many hospitalized patients as possible and ensure their interests are represented in the polls.

“The patient response has been great. Patients hospitalized around Election Day often don’t know there is still a way for them to vote, so they’ve been very grateful for the opportunity, especially during the 2016 election,” said Dorothy Charles, a fourth year medical student, organizer of the student activist group White Coats for Black Lives, and an early leader of the Presby Votes initiative. “Even if they’re registered in Delaware or New Jersey, we still heard from them that they were really happy this program exists. The enthusiasm has been really encouraging.”

After helping patients exercise their voting rights for three elections, the Presby Votes team is looking forward to developing the program based on the experiences of the volunteers and the patient feedback they’ve received. As Flesch notes, “Presby Votes is a pilot program, but as it evolves and as we write a recipe for efficiency, we hope to expand it to the other Penn Medicine locations, as well as other institutions.”

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