Passed away without any documents: why the Stateless Determination Procedure (SDP) applicants have no access to the medical services

Natalia was only 39. In early 2021 she was diagnosed with cancer, yet due to the lack of identity documents, she could not receive vital treatment: she could have neither undergo chemotherapy nor surgery.

Undocumented persons and even people who have applied for the Stateless Determination Procedure (SDP) are not entitled to free medical treatment under the medical guarantee program. Natalia was hospitalized several times in critical conditions, but she did not receive proper treatment, despite the fact that in August 2021, with the help of a lawyer from the CF “Right to Protection” (R2P), she applied for an SDP.

In the spring, Volodymyr Kohan died at the age of 69. This happened before the SDP was established. The lawyer of the R2P has been assisting the man in obtaining Ukrainian citizenship since 2018, but it has not been possible to confirm his citizenship - the legal connection with the Ukrainian state has been lost. The man suffered for many years due to vision loss and other diseases. He did not receive treatment due to a lack of a passport, as well as did not have money to be able to undergo treatment. The man made an appointment to apply for the Stateless Determination Procedure, but unfortunately, he was never able to obtain this document...

Recently, a 59-year-old woman, a beneficiary of the Fund, died. For more than 20 years, she struggled and waited for the introduction of the Stateless Determination Procedure to be adopted, all that while living without any documents, because no country recognized her as a citizen. For a long time, the woman suffered from diabetes, but could not receive medical care and proper examination due to a lack of identity documents. In May 2021, the woman already had the necessary package of documents to apply for an SDP but was never able to apply for the long-awaited procedure.

Due to the lack of citizenship, thousands of people living in Ukraine also do not have identity documents.

Since April 2021, Ukraine has introduced the Stateless Determination Procedure (SDP). Finally, undocumented persons got a chance to change their lives for the better and live without any obstacles.

According to the survey, conducted by the CF “Right to Protection” (R2P) in 2020, 17% of undocumented and/or stateless persons have serious chronic diseases or disabilities. These people are not entitled to free treatment, free examinations, disability, vaccinations, or any other free medical services under the medical guarantee program.

 Why can't stateless applicants be treated free of charge?

Only citizens of Ukraine, foreigners, and stateless persons permanently residing in Ukraine, as well as the refugees and persons in need of complementary protection, can receive free medical care within the framework of the medical guarantee program.

This applies to the following types of medical care:

  •  emergency care;
  •  primary care;
  •  secondary (specialized) medical care;
  •  tertiary (highly specialized) medical care;
  •  palliative care;
  •  medical rehabilitation;
  •  medical care for children under 16;
  •  medical care in connection with pregnancy and childbirth.

Persons with uncertain legal status and/or citizenship, without any identity documents, do not have access to free medical care. Such people can count only on emergency medical care with the subsequent reimbursement of the cost of the provided services. The same applies to people who have applied for an SDP, as well as to the officially recognized stateless persons without a temporary residence permit.

According to the results of the study referred to in the report “Socio-economic rights of a person recognized as stateless in Ukraine and a person who has applied to be recognized as stateless under the statelessness determination procedure”, the R2P concluded that Article 4 of the Law of Ukraine "On the state financial guarantees of medical care" should be amended in order to ensure full costs coverage of the necessary medical services, care, and medicines provided to the persons who are officially recognized as stateless and to those who have applied for the Stateless Determination Procedure (SDP).

In the context of the implementation of an SDP, it should be noted that the Human Rights Strategy aims to ensure that persons who have applied for the Procedure have the right to work, health care, and social protection. The implementation of this task is impossible without making the required changes in the legislation on financial guarantees of medical care. However, the relevant measures proposed by the public, unfortunately, were not included in the Action Plan of the National Strategy for Human Rights for 2021-2023.

Under the 1954 Convention relating to the Status of Stateless Persons, the Contracting States shall provide the stateless persons with the same status as nationals within their territories. This includes the same rights in the following areas: social protection, employment, job rights, occupational diseases, maternity, illness, disability, age of retirement, death, unemployment, family responsibilities, and other cases that, in accordance with domestic laws or other regulations, fall within the scope of the social security system.

Charitable Fund "Right to Protection" (R2P) has repeatedly expressed its position on the vulnerability of the undocumented persons who have difficulty proving citizenship or whose citizenship is uncertain. In particular, we have informed the Ministry of Health of Ukraine and the National Health Service of Ukraine about the status of these categories of persons and asked for an appropriate dialogue on that matter. Yet, the issue of legislative provision of access to medical services for these groups still remains unresolved.

«For years the undocumented and stateless persons have been suffering due to a complete lack of access to the medical services. A person is not entitled to free medical care even after filling the Stateless Determination Procedure application and even after being recognized as such and until the moment of obtaining a permanent residence permit. For Ukraine in order to comply with its international obligations, lawmakers need to review legislation on financial health care guarantees and provide people with adequate protection.»

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