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diaTribe 804 Haight Street San Francisco CA 94117 +1 415 241 9500 www.diaTribe.org

San Francisco, April 22, 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 Unless Amended Dear Chairman Pan: Our names are Kelly Close and Nancy Liu and we are writing on behalf of The diaTribe Foundation to express our concern with the current draft of AB 1983. We are the Editor-in-Chief and Managing Editor, respectively of diaTribe, a free education resource for people with diabetes. We are also the Director and Secretary, respectively of The diaTribe Foundation, a non-profit committed to improving the lives of people affected by diabetes and prediabetes, and advocating for action. Kelly is the founder of Close Concerns, a diabetes and obesity information company that aims to keep everyone smarter about diabetes and improve patient outcomes and has had type 1 diabetes for nearly 30 years. Both organizations are considered widely respected authorities on the diabetes and obesity markets as well as advocates for patients with diabetes. We’re writing to share our profound concern with the current draft of AB 1983, which requires consumers to purchase a sharps container whenever syringes, needles, or lancets are purchased and pose a large burden particularly for people with diabetes. We encourage you and members of your committee to oppose the bill unless it is significantly amended to resolve these concerns. Although there is little data on how people with diabetes dispose of needles, there is certainly not enough evidence that people throw needles in the trash or in the toilet to impose such legislation, and after almost 30 years of living with diabetes and working in the industry, Kelly has never heard or met someone with diabetes who has done this. The cost issue associated with buying a sharps container whenever the necessary syringes, needles, or lancets are purchased would put an unjust burden on people living with diabetes. The costs of diabetes management are already sky-high (something the New York Times ran a front page article on this month), and further adding to the requirements of this expensive chronic condition by requiring the purchase of sharps containers would be both inappropriate and unjust. If the legislature truly cares about disposal systems for patients, we suggest requiring all insurers, Medi-Cal, and Medicare to cover sharps containers and other disposal options for sharps to address the cost and access issues. The legislation also overlooks promoting more cost-effective and convenient options for sharps disposal that are equally if not more effective. These other means are supported by the FDA, EPA, and state and local health agencies and include options such as empty

diaTribe 804 Haight Street San Francisco CA 94117 +1 415 241 9500 www.diaTribe.org

detergent containers, old bleach containers, and tools which can clip a sharp from a needle or syringe. Using a clipper could retail for less than a container, last for a longer period, and can be used during travel. Clearly, patients need more support and education to help them learn how to address sharps disposal, and not more costs and regulations associated with their disease.

Given the unintended impact this legislation will have on people with diabetes in California, we strongly urge the committee to consider holding the bill for further consideration. We thank you for your time and consideration of our remarks and for listening to the voices of people with diabetes who may have their lives significantly and unfairly burdened by this legislation. Sincerely,

Kelly L. Close Nancy Liu Founder and Director, The diaTribe Foundation Secretary, The diaTribe Foundation Editor-in-Chief, diaTribe Managing Editor, diaTribe Founder and President, Close Concerns