S T A T E O F N E W Y O R K
________________________________________________________________________
6239--A
I N S E N A T E
(PREFILED)
January 8, 2014
___________
Introduced by Sen. SANDERS -- read twice and ordered printed, and when
printed to be committed to the Committee on Finance -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
AN ACT to amend the social services law and the public health law, in
relation to establishing the sickle cell treatment act of 2014; and
making an appropriation therefor
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. This act shall be known and may be cited as the "sickle
cell treatment act of 2014".
S 2. Legislative findings. The legislature hereby finds and declares
the following:
(1) Sickle cell disease (SCD) is an inherited disease of red blood
cells that is a major health problem in the United States.
(2) Approximately 100,000 Americans have SCD and approximately 1,000
American babies are born with the disease each year. SCD also is a
global problem with close to 500,000 babies born annually with the
disease.
(3) In the United States, SCD is most common in African-Americans and
in those of Hispanic, Mediterranean, and Middle Eastern ancestry. Among
newborn American infants, SCD occurs in approximately 1 in 500 African-
Americans, 1 in 36,000 Hispanics, and 1 in 80,000 Caucasians.
(4) More than 3,000,000 Americans, mostly African-Americans, have the
sickle cell trait. These Americans are healthy carriers of the sickle
cell gene who have inherited the normal hemoglobin gene from one parent
and the sickle cell gene from the other parent. A sickle cell trait is
not a disease, but when both parents have the sickle cell trait, there
is a 1 in 4 chance with each pregnancy that the child will be born with
SCD.
(5) Children with SCD may exhibit frequent pain episodes, entrapment
of blood within the spleen, severe anemia, acute lung complications
(acute chest syndrome), and priapism. During episodes of severe pain,
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10055-07-4
S. 6239--A 2
spleen enlargement, or acute lung complications, life threatening
complications can develop rapidly. Children with SCD are also at risk
for septicemia, meningitis, and stroke. Children with SCD at highest
risk for stroke can be identified and, thus, treated early with regular
blood transfusions for stroke prevention.
(6) The most feared complication for children with SCD is a stroke
(either overt or silent) occurring in 30 percent of the children with
sickle cell anemia prior to their 18th birthday and occurring in infants
as young as 18 months of age. Students with SCD and silent strokes may
not have any physical signs of such disease or strokes but may have a
lower educational attainment when compared to children with SCD.
(7) Many adults with SCD have acute problems, such as frequent pain
episodes and acute lung complications (acute chest syndrome) that can
result in death. Adults with SCD can also develop chronic problems,
including pulmonary disease, pulmonary hypertension, degenerative chang-
es in the shoulder and hip joints (bone necrosis), poor vision, and
kidney failure.
(8) The average life span for an adult with SCD is 45-50 years. While
some patients can remain without symptoms for years, many others may not
survive infancy or early childhood. Causes of death include bacterial
infection, stroke, and lung, kidney, heart, or liver failure. Bacterial
infections and lung injuries are leading causes of death in children and
adults with SCD.
(9) As a complex disorder with multisystem manifestations, SCD
requires specialized comprehensive and continuous care to achieve the
best possible outcome. Newborn screening, genetic counseling, and educa-
tion of patients and family members are critical preventative measures
that decrease morbidity and mortality, delays or prevents complications,
reduces in-patient hospital stays, and decreases overall costs of care.
(10) Stroke in the adult SCD population commonly results in both
mental and physical disabilities for life.
(11) Currently, one of the most effective treatments to prevent or
treat an overt stroke or a silent stroke for a child with SCD is at
least monthly blood transfusions throughout childhood for many, and
throughout life for some. This requires the removal of sickle cell blood
and replacement with normal blood (exchange transfusion).
(12) With acute lung complications (acute chest syndrome), trans-
fusions are usually required and are often the only therapy demonstrated
to prevent premature death.
The legislature declares its intent to develop and establish systemic
mechanisms to improve the prevention and treatment of sickle cell
disease.
S 3. Section 365 of the social services law is amended by adding a new
subdivision 13 to read as follows:
13. ANY INCONSISTENT PROVISION OF THIS CHAPTER OR OTHER LAW NOTWITH-
STANDING, THE DEPARTMENT SHALL BE RESPONSIBLE FOR FURNISHING MEDICAL
ASSISTANCE FOR PREVENTATIVE MEDICAL STRATEGIES, INCLUDING PROPHYLAXIS,
AND TREATMENT AND SERVICES FOR ELIGIBLE INDIVIDUALS WHO HAVE SICKLE CELL
DISEASE. FOR THE PURPOSES OF THIS SUBDIVISION, "PREVENTATIVE MEDICAL
STRATEGIES, TREATMENT AND SERVICES" SHALL INCLUDE, BUT NOT BE LIMITED TO
THE FOLLOWING:
(A) CHRONIC BLOOD TRANSFUSION (WITH DEFEROXAMINE CHELATION) TO PREVENT
STROKE IN INDIVIDUALS WITH SICKLE CELL DISEASE WHO HAVE BEEN IDENTIFIED
AS BEING AT HIGH RISK FOR STROKE;
(B) GENETIC COUNSELING AND TESTING FOR INDIVIDUALS WITH SICKLE CELL
DISEASE OR THE SICKLE CELL TRAIT; OR
S. 6239--A 3
(C) OTHER TREATMENT AND SERVICES TO PREVENT INDIVIDUALS WHO HAVE SICK-
LE CELL DISEASE AND WHO HAVE HAD A STROKE FROM HAVING ANOTHER STROKE.
S 4. Article 31 of the public health law is amended by adding a new
title IV to read as follows:
TITLE IV
PREVENTION AND TREATMENT OF SICKLE CELL DISEASE DEMONSTRATION PROGRAM
SECTION 3126. PREVENTION AND TREATMENT OF SICKLE CELL DISEASE DEMON-
STRATION PROGRAM.
S 3126. PREVENTION AND TREATMENT OF SICKLE CELL DISEASE DEMONSTRATION
PROGRAM. 1. THE COMMISSIONER SHALL ESTABLISH AND CONDUCT A PREVENTION
AND TREATMENT OF SICKLE CELL DISEASE DEMONSTRATION PROGRAM IN THE CITY
OF NEW YORK AND FOR NO MORE THAN FIVE ADDITIONAL COUNTIES, FOR THE
PURPOSE OF DEVELOPING AND ESTABLISHING SYSTEMIC MECHANISMS TO IMPROVE
THE PREVENTION AND TREATMENT OF SICKLE CELL DISEASE, INCLUDING THROUGH:
(A) THE COORDINATION OF SERVICE DELIVERY FOR INDIVIDUALS WITH SICKLE
CELL DISEASE;
(B) GENETIC COUNSELING AND TESTING;
(C) BUNDLING OF TECHNICAL SERVICES RELATED TO THE PREVENTION AND
TREATMENT OF SICKLE CELL DISEASE;
(D) TRAINING OF HEALTH PROFESSIONALS; AND
(E) IDENTIFYING AND ESTABLISHING OTHER EFFORTS RELATED TO THE EXPAN-
SION AND COORDINATION OF EDUCATION, TREATMENT, AND CONTINUITY OF CARE
PROGRAMS FOR INDIVIDUALS WITH SICKLE CELL DISEASE.
2. ON OR BEFORE THE FIRST OF JANUARY, TWO THOUSAND SEVENTEEN, THE
COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE SPEAKER OF THE ASSEMBLY
AND THE TEMPORARY PRESIDENT OF THE SENATE ON THE IMPACT THAT THE
PREVENTION AND TREATMENT OF SICKLE CELL DISEASE DEMONSTRATION PROGRAM
HAS HAD ON INDIVIDUALS WITH SICKLE CELL DISEASE IN REGARDS TO COORDI-
NATION OF SERVICE DELIVERY, GENETIC COUNSELING AND TESTING, BUNDLING OF
TECHNICAL SERVICES RELATED TO THE PREVENTION AND TREATMENT OF SICKLE
CELL DISEASE, TRAINING OF HEALTH PROFESSIONALS AND THE IDENTIFICATION
AND ESTABLISHMENT OF OTHER EFFORTS RELATED TO THE EXPANSION AND COORDI-
NATION OF EDUCATION, TREATMENT, AND CONTINUITY OF CARE PROGRAMS FOR SUCH
INDIVIDUALS.
S 5. The sum of one million dollars ($1,000,000) is hereby appropri-
ated to the department of health out of any moneys in the state treasury
in the general fund to the credit of the state purposes account, not
otherwise appropriated, and made immediately available, for the purpose
of carrying out the provisions of this act. Such moneys shall be payable
on the audit and warrant of the comptroller on vouchers certified or
approved by the commissioner of health in the manner prescribed by law.
S 6. This act shall take effect immediately.