Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid 600 Washington Street Boston, MA 02111 www.mass.gov/masshealth Eligibility Operations Memo 09-15 September 1, 2009 TO: MassHealth Eligibility Operations Staff FROM: Russ Kulp, Director, MassHealth Operations RE: MassHealth and the National Voter Registration Act and the Help America Vote Act Introduction The National Voter Registration Act (NVRA) of 1993, signed into law by President William J. Clinton, declares that the right of U.S. citizens to vote is a fundamental right and it is the duty of federal, state, and local governments to promote the exercise of that right. The Help America Vote Act of 2002, signed into law by President George W. Bush, was implemented in an effort to improve voting across the country and in response to the problems that arose in the 2000 presidential election. One of the areas impacted by this law is voter registration. This memo outlines the procedures MassHealth and its agents use to ensure that individuals are offered the opportunity to register to vote. It also covers the forms associated with the voter registration process, how those forms are forwarded to the appropriate local election officials, and how MassHealth maintains the records. Voter Registration As the state Medicaid agency, MassHealth is required to have a process to implement voter registration and maintain records for verification of the process. MassHealth workers and its agents are responsible for offering voter registration to persons who are at the office for initial application for services, recertification, renewal, or change of address. While MassHealth workers and agents are required to provide the same degree of help as offered with a MassHealth application or review form, in no way should they ever force an individual to complete the documentation or persuade him or her into making any voting choices, such as party affiliation. Additionally, no statements or actions by MassHealth or its agents should lead the individual to believe his or her decision about voter registration will have a bearing on the availability of services. (continued on next page) Voter Eligibility The effective date of the voter registration is the date that the Official Massachusetts Voter Registration Form (also called the voter registration affidavit) was completed at a MassHealth, or its agents’, office. However, neither MassHealth nor its agents is responsible for determining an individual’s eligibility for voter registration. The local election official determines the registration status and mails an Acknowledgement Notice to every applicant with information that may include registration status and the location of the polling place. Registration Material Each MassHealth office and any of its agents who deal directly with the public must have the following voter registration material: * Massachusetts General Law (M.G.L.) chapter 56, sections 7, 8, and 9 — must be displayed where voter registration is offered; * MassHealth instructions sheet; * Declination Forms; and * Massachusetts Official Voter Registration Forms (voter registration affidavits). Posting Requirement A copy of M.G.L. chapter 56, sections 7, 8, and 9 must be posted at all MassHealth offices and its agents’ offices where voter registration is offered (see Attachment 1). MassHealth Instruction Sheet MassHealth will provide an instruction sheet to all of its offices and agents acting on behalf of MassHealth (see Attachment 2). Declination Form The Declination Form is required by the NVRA and must be offered to every individual who applies in person for services, recertification, renewal, or a change of address. It provides a way for MassHealth to maintain records and prove that the individual was given the opportunity to register to vote. It is not a public record and, therefore, MassHealth will not forward any of these forms to the Secretary of the Commonwealth. However, for accountability, MassHealth must keep these forms for 22 months before destroying. Part A: This part of the form remains attached to the tablet for accountability purposes. It lists the initial voter registration question. It offers the individual choices about voter registration, such as if he or she would like to register or is already registered. If the individual needs to change a registered name, address, or party enrollment, he or she should answer “Yes.” How the individual responds to this question determines if the voter registration process continues or not. (continued on next page) Declination Form (cont.) Part B: This is the agency record. It remains attached to the tablet and may be useful as a way for MassHealth and its agents to accumulate data and provide information for a public record of a voter registration event. It does not record the name of the applicant, but does record the response to the question in Part A. Part C: This is the applicant copy. It is detached and given to every individual who applies in person for services, recertification, renewal, or a change of address and who completes Part A. The Declination Form is attached to this memo. Voter Registration Forms The Massachusetts Official Voter Registration Form (also called the voter registration affidavit) is completed when an individual wants to register to vote or change a name, address, or party enrollment. MassHealth must enter the code BBA in the Agency Designation Code section in the lower right of the form. This code, unknown to the local election office, masks the identity of the agency submitting the form. When completed, the individual receives the second (yellow) sheet (including the hinge and receipt) along with part C of the Declination Form. This sheet is the only proof that the individual has registered to vote until the local election official receives the original copy from MassHealth. Although not a requirement for voting, it may be advisable for the MassHealth worker to advise the individual to take the copy of the voter registration form to the polling place the first time he or she votes. Information to help individuals complete the voter registration form ? Section 1 through 3 — self-explanatory ? Section 4 — must not provide a post office box ? Sections 5 and 6 — self-explanatory ? Section 7 — identification number o federal law requires a valid and current Massachusetts driver’s license number to register to vote; or o if no license, the last four digits of the social security number; or o if neither, “None” must be entered in the box ? Sections 8 and 9 — self-explanatory o Note: It is not MassHealth’s responsibility to explain or help the individual chose the party enrollment. ? Section 10 — if never registered to vote, leave this section blank (continued on next page) Voter Registration Forms (cont.) ? Section 11 — if physically unable to complete the form, the assisting person must complete the form and sign it and then record his or her name on the form. A telephone number is optional ? Sections 12 through 14 — self-explanatory ? Agency Designation Code — enter the code BBA MassHealth offices and its agents must mail the Voter Registration Form to the appropriate city or town local election official within five calendar days of the completion of the form. The mailing addresses for each city and town are listed on the Massachusetts City and Town Directory page of the Massachusetts Election Division Web site at www.sec.state.ma.us/ele/eleclk/clkidx.htm. The Massachusetts Official Voter Registration Form is attached to this memo. Record Keeping Each MassHealth office and its agents will develop and implement a system for maintaining the Declination Forms (Parts A and B) for the required 22 months and mailing the Voter Registration Forms to the appropriate local election official. Attachments The following attachments are included with this memo: * Attachment 1 — Massachusetts General Law (M.G.L.) chapter 56, sections 7, 8, and 9; * Attachment 2 — MassHealth instructions sheet; * Attachment 3 — Declination Form; and * Attachment 4 — Massachusetts Official Voter Registration Form (voter registration affidavit). Questions If you have any questions about this memo, please have your MEC designee contact the Policy Hotline. EOM 09-15 September 1, 2009 Attachment 1 The following information must be posted at MassHealth offices and the offices of agents acting on behalf of MassHealth where voter registration is offered. Massachusetts General Law Chapter 56. VIOLATIONS OF ELECTION LAWS PENALTIES FOR OFFENCES CONCERNING ASSESSMENT, LISTING, AND REGISTRATION OF VOTERS Chapter 56: Section 7. Aiding or abetting false affidavits or oaths Section 7. Whoever aids or abets a person in knowingly or wilfully making a false affidavit, taking a false oath or signing a false certificate relative to the qualifications of any person for listing or registration shall be punished by a fine of not more than one thousand dollars or by imprisonment for not more than one year. Chapter 56: Section 8. Illegal registration Section 8. Whoever causes or attempts to cause his name to be registered, knowing that he is not a qualified voter in the place of such registration or attempted registration; whoever registers or attempts to register under a name other than his own; whoever represents or attempts to represent himself as some other person to an election commissioner, registrar or assistant registrar; whoever gives a false answer to an election commissioner, registrar, or assistant registrar respecting any matter relating to his registration or his right to vote; whoever otherwise illegally registers or attempts to register; or whoever aids or abets any other person in doing any of the acts above mentioned, shall be punished by a fine of not more than ten thousand dollars or by imprisonment for not more than five years, or both. Chapter 56: Section 9. Misconduct at registration Section 9. Whoever refuses to obey the lawful orders or directions of an election commissioner, a registrar or assistant registrar, or interrupts or disturbs the proceedings at any registration shall be punished by a fine of not more than one hundred dollars. EOM 09-15 September 1, 2009 Attachment 2 Basic Instruction Sheet for MassHealth and its Agents Acting on Behalf of MassHealth This process provides an opportunity to register to vote or change name, address, or party enrollment for voter registration purposes to all individuals who are at the office to apply for: * service/benefits; * recertification; * renewal; or * change of address. Staff must provide the same degree of help as offered with MassHealth applications or renewal forms. Staff must not force an individual to complete the documentation or persuade him or her into making voting choices. Staff must not make any statements or take any actions that would lead the individual to believe his or her decision about whether to register to vote will have a bearing on the availability of services. Staff must ask the following question to everyone who meets the above criteria: “If you are not registered to vote where you live now and you are eligible to register to vote, would you like to apply to register to vote here today?” Staff must offer the Declination Form. Declination Form Part A: Subsequent actions depend on the responses on this part. If the answer is * yes o offer the two-part Massachusetts Official Voter Registration Form * no o voter registration activity ends * already registered where I live now o voter registration activity ends * no response o voter registration activity ends * no signature o individual is considered to have decided not to register to vote at this time o voter registration activity ends Do not detach this section from the tablet. Part B: Complete this section for accountability purposes. Do not detach this section from the tablet. Part B does not record the name of the applicant, but is used to collect data indicating how an individual answered the voter registration question on Part A. Part C: Detach and give every individual this part of the Declination Form. Massachusetts Official Voter Registration Form — used to register to vote or change name, address, or party enrollment for voter registration purposes. MassHealth workers and agents must * ensure person completes all applicable areas and signs form; ? Section 1 through 3 — self-explanatory ? Section 4 — must not provide a post office box ? Sections 5 and 6 — self-explanatory ? Section 7 — identification number o federal law requires a valid and current Massachusetts driver’s license number to register to vote; or o if no license, the last four digits of the social security number; or o if neither, “None” must be entered in the box ? Sections 8 and 9 — self-explanatory o Note: It is not MassHealth’s responsibility to explain or help the individual chose the party enrollment. ? Section 10 — if never registered to vote, leave this section blank ? Section 11 — if physically unable to complete the form, the assisting person must complete the form and sign it and then record his or her name on the form. A telephone number is optional. ? Sections 12 through 14 — self-explanatory * Enter the MassHealth Agency Designation Code — BBA in the red Agency Designation box in the lower right corner of the affidavit; * Detach and give the yellow copy to the individual. * Mail completed affidavits within five calendar days. ? The mailing addresses for each city and town are listed on the Massachusetts City and Town Directory page of the Massachusetts Election Division Web site at www.sec.state.ma.us/ele/eleclk/clkidx.htm EOM 09-15 September 1, 2009 Attachment 3 William Francis Galvin Secretary of the Commonwealth Declination Form PART A If you are not registered to vote where you live now and you are eligible to register to vote would you like to apply to register to vote here today? * Yes * No * Already registered where I live now (If you are registered to vote where you live now and have not changed your address it is not necessary to register to vote again.) Please, sign your name here: Date: _ If you do not check any box, you will be considered to have decided not to register to vote at this time. PART B: Use is optional o Registered to vote 0 Did not register to vote o Already registered where I live now For agency use only: Agency staff signature: Date: _ Tear along this perforated line and give to applicant. PART C I APPLICANT COPY: Please keep this for your personal records. • Applying to register or declining to register to vote will not affect the amount of assistance that you will be provided by this agency. If you would like help filling our the voter registration application form, we will help you. The decision whether to seek or accept help is yours. You may fill our the application form in private. If you believe that someone has interfered with your right to register or to decline to register to vote, your right to privacy in deciding whether to register or in applying to register to vote, or your right to choose your own political party or other political preference, you may file a complaint with the Secretary of the Commonwealth, Elections Division, One Ashburton Place, Room 1705, Boston, MA 02108; telephone 617-727-2828 or toll free 1-800-462-8683. EOM 09-15 September 1, 2009 Attachment 4 To register to vote in Massachusetts you must be: a U.S. citizen, a resident of Massachusetts and at least 18 years old on or before the next election. If you are registering to vote at an agency, the fact that you register or refuse to register to vote will remain confidential and will be used only for voter registration purposes and the office at which you register will remain confidential and be used only for registration purposes. Penalty for Illegal Registration: Fine of not more than $10,000 or imprisonment for not more than five years or both (MGL c56 s8) Massachusetts Official Voter Registration Form William Francis Galvin Secretary of the Commonwealth 1 Check all that apply Are you as Citizen of the United States of America? * Yes * No Will you be 18 years of age or older on or before Election Day? * Yes * No Note: If you checked “no” to either of these questions, no not complete this form. 2 Full name last name first name middle initial Miss Ms. Mrs. Mr. Jr. Sr. II III IV (circle one if appropriate) 3 Former name (if applicable) last name first name middle initial Miss Ms. Mrs. Mr. Jr. Sr. II III IV (circle one if appropriate) 4 Address where you live (street number, street name, rural route number and box number): street number/street name/rural route number and box number apartment number city or town zip code + 4-digit 5 Address where you receive your mail (if different from #4): street number/street name/rural route number and box number apartment number city or town zip code + 4-digit 6 Date of birth: month day year 7 Identification #: license # or last four digits or your Social Security # 8 Telephone (optional): * Check if unlisted ( ) 9 Party enrollment or designation (check one) * Democratic * Republican * Libertarian *No Party (unenrolled) * Political Designation (not a political party): 10 Address at which you were last registered to vote: street number/street name/rural route number and box number/post office box apartment number city or town zip code + 4-digit 11 If the applicant is unable to sign this form, give the name, address and telephone number (optional) of the person helping the applicant: name address telephone number (optional) 12 I hereby swear (affirm) that I am the person named above, that the above information is true, that I AM A CITIZEN OF THE UNITED STATES, that I am not a person under a guardianship which prohibits my registering to vote, that I am not temporarily or permanently disqualified by law from voting because of corrupt practices in respect to elections, that I am not currently incarcerated for a felony conviction, and that I consider this residence to be my home. Signed under the penalty of perjury. 13 Today’s date: month day year 14 Signed (sign your name here) Agency designation