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Sickle Cell Disease

 


Photo Source:
Medical College of Georgia Sickle Cell Center


Sickle cell disease is a hereditary blood disorder that affects approximately 72,000 Americans, mostly those with ancestors from Africa, Spanish-speaking regions, the Mediterranean, India, and Saudi Arabia. The disease is found in 1 out of 500 births among African-Americans and 1 out of 1,000-1,400 births among Hispanic-Americans. A genetic mutation causes normally smooth and donut-shaped red blood cells to assume a stiff sickle conformation in individuals afflicted with the disease. The sickle-shaped red blood cells get stuck in small blood vessels causing episodes of pain, tissue and organ damage, which leads to serious medical conditions. 

Many individuals do not suffer from the disease but carry the sickle cell trait.  This is because carriers have only one copy of the mutation (when a copy is inherited from both parents, disease results).  The offspring of carriers may be at risk for sickle cell disease if the other parent is a carrier as well. There are approximately 2 million people in the United States who carry the sickle cell trait. (Sources: University of Maryland Medical Center; Pharmaceutical Research and Manufacturers of America)

Sickle cell disease can be detected in newborns through a simple, inexpensive blood test. There are currently 49 states and the District of Columbia that mandate the testing of sickle cell disease in newborns. New Hampshire does not mandate testing but will provide testing of selected populations, limited pilot programs, or by request. (Source: NNSGRC)

Sickle cell statutes that address a variety of issues such as commissions and task forces on sickle cell, discriminatory practices, health education, health insurance coverage and research are provided below.


                       First Letter of State: A C D F G H I K L M N O P S T U V W

State

Description

Alabama

Ala. Code 1975 T.22 Subt. 1 Ch. 10B Creates the Alabama Sickle Cell Oversight and Regulatory Commission and provides for its power, duties and appointments.

Ala. Code 1975 s 27-5-13 Prohibits health or disability insurance carriers from denying coverage on the basis of a sickle-cell anemia diagnosis.

Arkansas

Ark. Stat. Ann. § 20-15-302 Requires that all newborn infants are to be tested for sickle-cell anemia and that hospitals performing the tests will be reimbursed by Medicaid the cost of the tests.

Ark. Stat. Ann. § 20-15-304 Requires the Department of Health to provide information and advice to the public concerning the dangers and effects of phenylketonuria, hypothyroidism, and sickle-cell anemia.

Ark. Stat. Ann. § 23-79-129 Requires that health insurance coverage be provided to all newborn children for sickle cell anemia tests.

Arizona

Ariz. Rev. Stat. Ann. § 36-797.43 Authorizes children's rehabilitative services to develop and operate, either directly or by contracting with public or private providers, programs for the diagnosis, care and treatment of children suffering from sickle cell anemia. The law also states that the parent or other responsible person, agency or third party payor will reimburse the department for part or all of the costs of services rendered to a child pursuant to this section according to a scale of rates and charges established by the department and based on the cost of services provided and the ability of the parent or responsible person to pay for such services.

California

Cal. Health and Safety Code § 125025-125035 States that is the policy of the state to make every effort to detect, as early as possible, sickle cell anemia. The law gives the department the responsibility of designating tests and regulations to be used in executing this policy. It also outlines that testing for sickle cell anemia may be conducted at the following times: (a) Upon first enrollment of a child at an elementary school. (b) For any child not tested in elementary school, upon first enrollment at a junior high school or senior high school (c) Upon application of any person for a license to marry, (d) At any other times that the department may designate. The law gives parents or the person to be tested the right to object on the grounds that the test conflicts with his or her religious beliefs or practices. The law authorizes the department to make grants or contracts for demonstration projects to determine the feasibility of alternate methods of testing for sickle cell anemia, to provide counseling services, to evaluate the social consequences of the identification of sickle cell trait carriers, to provide training in genetic counseling, and to conduct research on the prevention of sickle cell anemia.

Colorado

C.R.S. § 23-21-201 to 204 Establishes a sickle-cell anemia treatment and research center within the University of Colorado school of medicine. The law also creates a sickle-cell anemia advisory committee and outlines the committee's duties.

Florida

Fla. Stat. § 381.815 Requires the Department of Health and Rehabilitative Services to establish a sickle-cell program to the extent that resources are available. The act provides for education and screening as well as cooperation with and grants to, not-for-profit centers.

Fla. Stat. § 228.201, 63.043 and 448.076 Prohibit mandatory testing for sickle cell anemia for the purposes of employment, admission into a state educational institution, or for adoption.

Illinois

Ill. Rev. Stat. Ch. 20, § 2310-410 Creates a public information campaign for health care personnel on sickle cell disease which includes cataloguing sickle cell resources in the state for distribution and referral purposes and coordinating services with the established programs including state, federal and voluntary groups.

Indiana

Ind. Code § 16-46-7-2 Directs the state department of health to establish a program for the purpose of providing funds for the prevention, care, and treatment of sickle cell anemia and for educational programs concerning the disease.

Iowa

Iowa Code § 136A.2 Establishes a birth defects institute within the Iowa department of public health. The institute will initiate and conduct investigations of the causes, mortality, methods of treatment, prevention and cure of birth defects and related diseases and develop and administer genetic and metabolic screening programs. The institute will be responsible for development and implementation of screening and educational programs for sickle cell anemia.

Kansas

Kan. Stat. Ann. § 65-1,105 Authorizes the secretary of health and environment to establish a statewide program of blood tests for sickle cell trait and the disease sickle cell anemia and to provide counseling and advice, without cost, to any person requesting such counseling relative to sickle cell anemia or sickle cell trait, its characteristics, symptoms, traits, effects and treatment. The law also establishes a program providing financial assistance for persons suffering from the disease sickle cell anemia who are unable to pay for their care and treatment on a continuing basis.

Louisana

La. Rev. Stat. Ann. § 17:1816 Gives Southern University and Agricultural and Mechanical College at Baton Rouge the authority to operate a sickle cell anemia research center.

La. Rev. Stat. Ann. § 22:652.1 Prohibits insurers from discriminating against individuals in rates or failure to provide coverage because of severe disability or sickle cell trait.

La. Rev. Stat. Ann. § 40:1299.4.2 (1993) Directs that several specific clinics be maintained for the treatment of victims of sickle cell anemia pending federal funding. In addition, the clinics will implement policies and plans to convert their individual facility into regionalized facilities, whereby each facility is responsible for patients in parishes surrounding the main facility.

La. Rev. Stat. Ann. § 40:2198.3 (1993) Authorizes the department of health and hospitals to establish a minimum of seven sickle cell anemia clinics.

Massachusetts

Mass. Gen. Laws Ann. ch. 76 § 15B Requires the department of public health to furnish necessary laboratory and testing facilities for a voluntary screening program for sickle cell anemia or for the sickle cell trait. The commissioner will promulgate rules and regulations for the testing, treatment, care and counseling of all susceptible persons. Any screening programs will include provisions for complete health education and post-screening counseling service and treatment as determined by the commissioner. Records maintained as part of any screening program will be confidential.

Mississippi

Miss. Code Ann. § 41-24-1, 41-24-3, 41-24-5 Authorizes the state board of health to establish a program to test for sickle cell anemia of those persons who, because of race, ethnic group or other reasons are determined to be particularly susceptible to the condition. The board is also authorized to prepare and distribute educational materials related to sickle cell anemia.

South Carolina

SC. Act No. 289 (2002) General appropriations bill for University access and equity program, sickle cell 2010.

S.C. Code Ann. § 44-33-10 (Law. Co-op 2002) Authorizes the Department of Health and Environmental Control to initiate a sickle cell education and prevention program based entirely upon voluntary cooperation of the individuals involved.

This compilation may not be exhaustive of all state activities.

 

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