By: Zach Wendling
Nebraska Examiner
Partnership between Nebraska DHHS and Iowa’s SafeNetRx is national first, targets patients at or below 200% of federal poverty line
LINCOLN — Donated medicine collected by Iowa’s SafeNetRx nonprofit is finally flowing back across its border with Nebraska in the nation’s first multi-state prescription drug donation program, years in the making.
SafeNetRx CEO Jon Rosmann confirmed the Nebraska-Iowa partnership has been operational since July 1. The initial two-year contract between the nonprofit and Nebraska Department of Health and Human Services, at $475,000 per year, follows Nebraska laws passed in 2024 and 2025 that allow unexpired, pharmacist-inspected medicine to flow back to Nebraska patients.
The program serves patients at or below 200% of the federal poverty line. For a family of four, that would be an annual household income up to $64,300.
“It’s all systems go,” Rosmann told the Nebraska Examiner.
Overwhelming legislative approval
Nebraska State Sen. Jana Hughes of Seward began eyeing the partnership with SafeNetRx in late 2023, her freshman year, including an October tour of the nonprofit’s facility. She passed legislation in April 2024, 47-0, to authorize the program that September before being blocked by a decade-old federal law.
Those congressional guidelines were meant to replace a patchwork of state laws regarding the chain of custody of pharmaceutical meds and were phased in over a decade. It was unclear what the guidelines meant for drug donation programs.
Hughes had earned overwhelming legislative approval this March, 46-0, to get the partnership around that final roadblock while also adding language that Nebraska DHHS and the Nebraska governor could access the donated medicine during or in preparation for a governor-declared state of emergency, such as during a pandemic or natural disaster.
Before, medicine could flow only from the Cornhusker State to the Hawkeye State, but now the floodgates have opened the other direction.
Upon learning of the signed contract, Hughes told the Examiner: “Super pumped to hear this!!!!”
‘A long time coming’
While federal regulations initially blocked the partnership, Gov. Jim Pillen’s mid-March signature cleared the way for the program to begin as soon as March 12.
Yet the partnership waited in the wings partly because Pillen had already asked lawmakers to defund the program two months prior — one of many “last in, first out” cuts his administration proposed to close a major projected deficit. The budget-writing Appropriations Committee initially agreed.
Lawmakers also accepted a recommendation from the governor’s team to reword the authorizing language around the spending.
Rather than requiring DHHS to identify a nonprofit to carry out what would effectively be a defunded program at the time, the committee forbade DHHS from absorbing the cost of the program through other state dollars.
Despite every member of the Appropriations Committee having voted for Hughes’ program, some more than once, some said they still had questions on the funding and how the program would work.
Those changes left Hughes “incredibly disappointed” but determined to fight for the program.
Hughes worked to correct some of that “misinformation,” including one that Iowa wasn’t putting in any state dollars to SafeNetRx while it had just put in $600,000 in its most recent budget. The committee voted 6-1 to restore funding but left DHHS the flexibility to choose whether to start or maintain the program.
State Sen. Machaela Cavanaugh of Omaha cast the lone “no” vote as an effort to push the committee to restore the original language around the spending, which the committee ultimately adopted with her support.
Rosmann said at the time that for every dollar SafeNetRx received, patients and clinics received $20 in donated medicine.
“I feel like this is a long time coming!!!” Hughes said in a text. “Very excited to get this up and going.”
A commitment to safety
SafeNetRx pioneered the prescription drug donation model in 2007 and had grown to receive medicine from pharmacists and patients nationwide.
Since its inception, SafeNetRx has received donated medicine or medical supplies from 250 health care facilities nationwide, worth $155 million. This has helped more than 160,000 underserved patients receive free medication, according to SafeNetRx.
Until now, medicine could not be sent to patients beyond Iowa’s borders, and Nebraska is the first state SafeNetRx is partnering with.
SafeNetRx is already working with four Nebraska sites, Rosmann said, and when the program was delayed for a year from getting started — facing federal but also Nebraska funding roadblocks — Rosmann said SafeNetRx instead took that time to ramp up donations
Between July 1, 2024, and June 30, 2025, Rosmann said his nonprofit gathered $28 million in donated medicine.
“All of that is available to Nebraskans now,” Rosmann said.
Before medicine is ready for redistribution, a licensed Iowa pharmacist inspects each donated drug, ensuring it is labeled correctly and usable — meaning not expired, not tampered with, not requiring refrigeration and not a controlled substance.
Rosmann said those patient safety and medication integrity standards help separate SafeNetRx from other similar organizations or nonprofits.
Nebraska pharmacists are able to access SafeNetRx inventory in real time to order meds for patients. Medicine is returned via courier, such as the United Parcel Service or Spee-Dee Delivery Service.
‘It’s time to get cracking’
Rosmann said the focus now is on education and enrollment, a task SafeNetRx is subcontracting with the Nebraska Pharmacists Association to fulfill, including recruiting participating clinics and pharmacies.
There also is an emphasis on “safety net” providers, Rosmann said — federally qualified health centers, free clinics and community mental health centers — “those organizations that are on the front line of taking care of our most vulnerable patients.”
Haley Pertzborn, the CEO of the Pharmacists Association, said of the partnership: “We are feeling super excited for this to be able to finally hit the ground and start helping Nebraskans!”
Pertzborn is an Iowa native who previously volunteered for SafeNetRx. She helped Hughes get the Nebraska-Iowa partnership off the ground that both have noted could provide cost savings and shore up health care gaps.
Those wishing to donate medicine or participate can learn more at safenetrx.org/Nebraska.
“It’s time to get cracking,” Rosmann said. “We’ve got a huge inventory of medicine, and now we need to get it to the patients that need it.”