April 15, 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:
We are writing on behalf of the American Association of Diabetes Educators (AADE) to express
significant concerns and opposition unless amended to AB 1893. The legislation mandates
patients with diabetes and other chronic diseases who use medical sharps (e.g., needles, syringes,
lancets and other medical sharps) purchase a sharps container whenever purchasing one of these
items. The bill envisions an unworkable framework within the existing healthcare system, creates a
punitive approach for people with diabetes and other chronic diseases whenever purchasing
medical supplies, the fact sheets and supporting materials authored by the bill sponsors and the
California Product Stewardship Council lack truth, and the bill does not adequately meet the needs
of the California constituency impacted by the aforementioned diseases.
The AADE is a multidisciplinary association dedicated to empowering healthcare professionals with
the knowledge and skills to deliver exceptional diabetes education, management and support. We
advocate on behalf of diabetes educators and the patients they serve. We also work to ensure the
professional growth of our members and promote widespread recognition of the benefits of
diabetes education. We believe that AB 1893 places an unnecessary burden on people with
diabetes in California.
The language presented by the bill authors and the California Product Stewardship Council, the
organization sponsoring the legislation, is lacking in scientific basis or fact. In a time when we are
trying to improve the healthcare system we believe it is irresponsible, unwarranted and slanderous
of the authors and the California Product Stewardship to present legislation that is based on
anecdotal information and to paint those with diabetes and other chronic conditions as negligent.
Our organization fully believes people with diabetes and others with chronic conditions are the
ones most likely to remain responsible when it comes to disposing sharps. By comparison, there is
ample evidence those who use IV drugs are much less likely to dispose of syringes in the correct
manner. Quite frankly, when it comes to containing potential HIV and hepatitis transmission, this is
the very population waste handlers want to ensure correctly dispose of sharps. Yet, this legislation
does nothing to reach the IV drug using population when it comes to furthering syringe disposal
messaging and processes.
Further complicating matters with AB 1893 is the fact it mandates the purchase of one disposal
option by patients over several cheaper sharp containment and destruction options available and
cleared by the FDA, EPA, state and local health authorities and leading national groups like the
American Diabetes Association. These disposal options include the use of empty bleach bottles,
empty detergent bottles and needle clippers which make syringes inert. The bill unfortunately
mandates only those with chronic diseases do something and that something is to spend more to
care for themselves even when cheaper options are available.
The legislation also creates a sizable conflict with existing health insurance reimbursement when it
is available and exacerbates problems with Medi-Cal and Medicare coverage. Several large
employers today reimburse for sharps disposal systems making this legislation redundant when
coverage exists. When it comes to Medi-Cal and Medicare the programs today do not cover
disposal programs and California cannot place a purchase mandate on the patient or a drug or
sharps manufacturer due to federal reimbursement law. The state today though can enact a law
requiring the Medi-Cal program to cover sharps disposal items including disposal containers.
We strongly believe additional data is necessary on the impact of sharps in the waste stream and
respectfully ask that the bill is looked at to ensure responsible and meaningful language
considered by the committee going forward focuses on this need.
Thank you, in closing, for your time and consideration of our remarks. AB 1893 is a provision
which we cannot support unless several provisions harmful to the interests of people with diabetes
are dropped and the legislation is significantly amended. Further, the language utilized to promote
this legislation at the expense of people with diabetes is completely unjustified and calls for a
correction of the record and retraction by those authoring the documents.
President, American Association of Diabetes Educators
cc: Asm. Matt Stone
Asm. Susan Talamantes Eggman
bcc: Charles MacFarlane, Chief Executive Officer, AADE
Martha Rinker, Chief Advocacy Officer, AADE
James Specker, Director State Advocacy, AADE