1. 1962 University Ave. #1, Berkeley, CA 94704 I 510-8981301 I EIN: 262274537 Berkeley, April 18, 2014 The Honorable Richard Pan Chairman, Assembly Committee on Health State Capitol, Room 6005 P.O. Box 942849 Sacramento, CA 95249-0009 RE: AB 1893 Oppose Dear Chairman Pan: I am the Co-Founder and President of Diabetes Hands Foundation, a Berkeley, CA based nonprofit aimed at connecting, empowering, and mobilizing the diabetes community: we do this through our peer-to-peer networks of more than 60,000 people touched by diabetes, and our diabetes advocacy network. Im writing to share my profound concerns with the current draft of AB 1893. I encourage members of the Assembly Health Committee and others to oppose the bill unless it is significantly amended. The bill authors have utilized inflammatory rhetoric to support the legislation, much of which has no basis in fact, science, or reputable research. As a consequence, the bill is framed in a way that fails to meet its stated goals1 (AB-1893 reduces costs to taxpayers, reduces needle-stick injuries, and helps sharp users comply with current disposal laws.) Since 2008, Diabetes Hands Foundation has been driven by the belief that no one touched by diabetes should ever feel alone. Diabetes is frequently stigmatized and dismissed through arguments like the ones supporting the bill, as if people who have to take multiple insulin injections per day dont have the slightest idea about sharps management. When we first heard of AB 1893, we found California Product Stewardship Council (CPSC), identifying itself as the primary sponsor of the legislation. We found the following quote on the Sharps page of the CPSC website2 troubling in multiple ways: 1) Mr. Erickson is member of the board of directors of CPSC3 , and his company is the maker of UltiCare, one of the top funders of the CPSC4 . These two factors together, along with the very broad range of people outside of healthcare

2. 1962 University Ave. #1, Berkeley, CA 94704 I 510-8981301 I EIN: 262274537 supposedly injured by sharps each year (450,000 to 863,000, a variation of nearly 100%) make this quote dubious as an independent and credible source of statistics in connection with the issue the bill seeks to address. 2) UltiCare's "UltiGuard Safe Pack" is listed on the CPSC Sharps page alongside county and city-based sharps take-back programs. This listing describes UltiCare as the only sharps manufacturer that only sells sharps with a container for safe disposal. This language is profoundly misleading. A cursory search online exposes more than 50 manufacturers of sharps and sharp containers, with at least 5 that sell both. Considering these observations, in light of the fact that the bill proposes that: Sharps sold to the general public in California shall be sold with a sharps waste container that is approved by the department. and taking into account that Mr. Ericksons company stands to benefit financially if legislation passed that could result in a mandate that sharps be sold with a sharps waste container, I want to ask the members of the Assembly Committee on Health to consider the significant bias of the data presented in support of the bill. Additionally, I dont believe there is justification for a patient mandate to purchase a sharps container each time a needle, syringe or lancet purchase occurs in California. There are free and inexpensive sharps disposal tools that are just as useful, if not more. All these options (including empty detergent containers, old bleach containers, and tools to clip a sharp from a needle or syringe) are supported by the FDA5 , EPA6 and state and local health agencies. Another matter of great concern is the patient mandate proposed by this bill. Since insurance coverage does exist in some places for needle and syringes disposal systems, it may be a smarter approach to mandate insurers and Medi-Cal, and petition the federal government to direct Medicare to cover sharps containers and other disposal options for sharps to ensure uniform coverage. This approach also ensures the cost of this care doesnt primarily burden millions of people with diabetes with an unnecessary additional expense on top of the cost of managing this very expensive chronic condition. Before closing, please allow me to revisit the point about the responsibility people with diabetes take when disposing of their used needles, syringes and lancets. Every FDA- approved sharp product contains a product insert that stresses the need to dispose consistently with local law. As someone who has injected insulin more than 10 thousand times in the past 12 years, I can attest to reading these labels multiple times and to having made sure to always dispose of sharps the way they should be handled. And this is consistent with what I have read from the members of our networks in the course of the past 7 years. Considering one of the primary aims of this bill is to reduce the risk of HIV and hepatitis transmission to sanitation workers and others, the primary audience that should be 3. 1962 University Ave. #1, Berkeley, CA 94704 I 510-8981301 I EIN: 262274537 aimed with the bill (per CDC and others) is IV drug users. Yet the bill does nothing to encourage proper syringe handling or disposal by this group. As drafted, this bill will not accomplish its stated goals, and unless it is changed, it will ultimately turn into law a scenario that will create a burden for millions of people with diabetes in California, promoting and benefiting a single company, while being at odds with existing practices endorsed by FDA, EPA, CDC, local public health entities throughout California and others. This is not what we, the people of California want to see happen in our state. Therefore, I respectfully request that the provisions in the bill mandating consumers to purchase a sharps container whenever syringes, needles or lancets are purchased be dropped from AB 1893 altogether. Thank you for your time and appropriate consideration of my remarks. Sincerely, Manny Hernandez President Diabetes Hands Foundation cc: Asm. Matt Stone Asm. Susan Talamantes Eggman Committee Staff Asm. Nancy Skinner (District 15 representing Berkeley) Senator Loni Hancock (District 09 representing Berkeley) 1 CSPC - AB 1893 Fact Sheet: http://www.calpsc.org/admin-document-upload/doc_download/1486-ab-1893-fact-sheet- 2014-04-17 2 CSPC Sharps page: http://www.calpsc.org/products/sharps 3 CPSC - Voluntary Board Members: www.calpsc.org/about-cpsc/board-and-employees 4 CPSC - Funders: www.calpsc.org/about-cpsc/partners 5 FDA - Cleared Sharps Containers: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/Sharp s/ucm263236.htm 6 EPA - Disposal of Medical Sharps: www.epa.gov/osw/nonhaz/industrial/medical/disposal.htm