641—109.7 (135M) Eligibility criteria for individuals to receive donated prescription drugs and supplies.
	 109.7(1) An individual who requests drugs from the prescription drug donation repository program shall certify to the repository that the individual is a resident of Iowa and meets one or both of the following criteria:
	  a.   	 Is indigent;
	  b.   	 Has no active third-party prescription drug reimbursement coverage for the drug prescribed.
	 109.7(2) The repository shall collect a signed intake form provided by the department or its contractor from each individual recipient.
	  a.   	 The intake form shall attest that:
	 (1) 	 The individual is a resident of the state of Iowa;
	 (2) 	 The individual’s income does not exceed 200 percent of the FPL;
	 (3) 	 The individual is uninsured and has no prescription coverage or is underinsured and has no prescription coverage;
	 (4) 	 The individual acknowledges that the drugs may have been donated; and
	 (5) 	 The individual consents to a waiver of the requirement for child resistant packaging of the Poison Prevention Packaging Act.
	  b.   	 The intake form will include a receipt to be given to the recipient for continued use for one year.
	 109.7(3) The receipt is valid for one year or until the new federal poverty guidelines have been published for all prescriptions and supplies.
	 109.7(4) A copy of the intake form is to be sent via regular mail, E-mail or facsimile to the centralized repository for data collection.