Genetic counselors have been involved in developing and conducting training programs in several states. In California and Massachusetts, established programs lasting four days to one month, respectively, provide training to become a sickle cell educator-counselor or a hemoglobin trait counselor. Students are trained and supervised by master's-level genetic counselors. In addition to training, the California program also provides certification for sickle cell educators-counselors. The sickle cell educators must attend a four-day training course and pass a final certification examination. The sickle cell counselor must meet these same requirements plus attend an additional two-day counseling course and counseling practicum.

San Francisco General Hospital utilizes genetic aides to provide patient advocacy and education, and to act as liaisons between non-English-speaking patients and the genetic counselor. These bilingual or multilingual individuals are trained and supervised by genetic counselors, who continue to serve as case managers. A similar genetic aide program also exists at the University of California at San Diego. To date, the numbers of trained genetic aides remain relatively small. However, with the increasing Southeast Asian population in California, the need for multilingual individuals to provide state-supported genetic services is increasing. Actual job titles of such individuals vary according to their role or function and include, but are not limited to, single-gene counselor, single-disorder counselor, hemoglobin trait counselor, sickle cell educator, sickle cell counselor, genetic counseling aide, genetics educator, and genetic interpreter.