Virginia Senate Clerk Susan Schaar, ties a mask on Virginia State Senator Thomas Norment, R-James City County, as they prepare for the reconvene session at the Science Museum of Virginia Wednesday April 22, 2020, in Richmond, Va. The Senate is meeting in a remote location due to COVID-19 social distancing restrictions. (AP Photo/Steve Helber, Pool)

Virginia Senate Clerk Susan Schaar, ties a mask on Virginia State Senator Thomas Norment, R-James City County, as they prepare for the reconvene session at the Science Museum of Virginia Wednesday April 22, 2020, in Richmond, Va. The Senate is meeting in a remote location due to COVID-19 social distancing restrictions. (AP Photo/Steve Helber, Pool)

Kentucky Sen. Gerald Neal had a big decision to make as the legislature gathered at the state Capitol for some important votes amid the coronavirus outbreak.

His dilemma wasn’t simply whether to vote “yes” or “no,” but whether to even enter the state Senate.

At age 74 with diabetes and high-blood pressure, Neal was at high risk of developing life-threatening problems were he to contact the virus that causes the COVID-19 disease. Yet the Kentucky Senate — like most legislative chambers across the country — doesn’t allow remote voting.

“It’s a challenging piece, because you want to carry out your responsibility. People elect you to do that,” said Neal, a Democrat from Louisville. “But at the same time, it defies logic to put yourself in a position that is injurious to your health.”

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Since the coronavirus outbreak led to widespread stay-at-home orders last month, 13 states have adopted some means of remote voting in at least one of their legislative chambers, according to the National Conference of State Legislatures. Those include seven Republican-led legislatures, five Democratic-led ones and the politically split Minnesota Legislature

Some legislatures have stopped meeting entirely.

But others are pressing ahead with in-person sessions, leaving lawmakers to choose between health precautions and their public duty to represent thousands of constituents on budget and policy decisions.

Neal chose to go to the Capitol last week but isolated himself in an office, emerging while wearing a mask only to vote on what he considered the most important issues.

State lawmakers, on average, are significantly older than the general population, which puts them at greater risk for the coronavirus. For many people, the virus causes mild to moderate symptoms such as a fever or cough. But for some, especially older adults and those with existing health problems, it can lead to more severe illnesses and death.

In Missouri, the Republican-led House and Senate adjusted their procedures this month to try to prevent the spread of germs by limiting the number of lawmakers on the floor at the same time. But neither allowed remote voting when lawmakers approved spending billions of dollars in the battle against the coronavirus.

State Sen. Gina Walsh, who had been in voluntary isolation after a family member developed coronavirus symptoms, missed the vote because she decided to remain home.

“This is unprecedented, they’re making history and I really wanted to participate,” said Walsh, a Democrat whose home of St. Louis County leads the state in COVID-19 deaths. “But it wasn’t worth risking harm to others.”

Republican Rep. Jeffrey Messenger, 70, who has cancer, diabetes and high-blood pressure, also stayed away. Messenger said he wished legislative leaders would have let him text his vote from home.

“The technology is there,” Messenger said. “Why they elected not to, I do not know.”

Some of Messenger’s constituents were surprised to learn that he couldn’t vote on their behalf if he didn’t make the 150-mile drive from his hometown of Republic to the Missouri Capitol.

“It sounds like they are penalizing the legislators that are trying to follow the rules” of stay-at-home orders, said Gala Wilson, president of a nonprofit food and clothes bank in Republic.

Some legislatures have gone to great lengths to continue meeting in person. Virginia House members met outside Thursday under tents, spread out at individual tables. Democrats had proposed a rule change that would have let members participate remotely, but Republicans objected, and the measure failed.

When Michigan lawmakers met earlier this month to consider extending a coronavirus emergency declaration, about one-third of the House and Senate members skipped the session. Most of the absentees were from the Detroit area, a virus hot spot where one lawmaker had died.

House Democratic Leader Christine Greig, of suburban Detroit, has unsuccessfully pushed the Republican-led House to authorize remote sessions. She also has expressed frustration that the Legislature is rarely meeting at a time when it typically would be holding regular budget hearings.

“We’re not representing our constituents in the budget process, because we are not equipped as a state for remote participation,” Greig said.

Detroit public schools Superintendent Nikolai Vitti said he fears “dramatic cuts to K-12 education” because of the virus-related economic downturn. For Detroit’s concerns to be heard, he wants lawmakers to get to work on the budget remotely.

“We’ve already held one school board meeting and three committee meetings virtually,” Vitti said. “If a school district can do that, certainly the Legislature can do that.”

Republican legislative leaders in Michigan and Missouri have said conducting business remotely could violate their state constitutions.

Other state legislative chambers have used a variety of technologies for remote voting.

Some, such as the Kentucky House, have allowed distant members to message their intended votes to a colleague in the chamber, who then publicly announces it.

Wisconsin has used live video feeds to link members from afar. Lawmakers have cast votes while sitting in their kitchens, living rooms and home offices, which has caused roll calls to last much longer than usual.

When Minnesota lawmakers met last week, the vast majority of the 134 House members voted by phone. Twenty-one of the 67 senators voted remotely. But some senators urged a return to more regular sessions.

“We are called to be here and to meet. And if by meeting we somehow inadvertently contract COVID-19, so be it. We have courage,” said Republican Sen. Scott Jensen, a physician.

Sen. Scott Dibble, a Democrat, cautioned against that approach, noting he has three medically fragile siblings and a 98-year-old father-in-law.

When the Oklahoma Legislature met this month to pass three budget bills designed to prevent cuts to state agencies, the House had approved rule changes allowing remote voting but the Senate had not.

Sen. Carri Hicks, who has a young son with diabetes, said she wrestled with the decision about whether to attend the Senate session. She opted against it, and missed the votes.

“Folks that cast their ballot for me and the people that I represent ... deserve to have a strong voice for them at the Capitol,” said Hicks, an Oklahoma City Democrat. But “I had to make the difficult decision to prioritize the health of my family and follow the guidelines and expert opinions on protecting our son.”

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Lieb reported from Jefferson City, Missouri.

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Associated Press writers David Eggert in Lansing, Michigan; Steve Karnowski in Minneapolis; Sean Murphy in Oklahoma City; Todd Richmond in Madison, Wisconsin; and Alan Suderman in Richmond, Virginia, contributed to this report.