The ideal time to test would be before conception or birth, but testing at birth may also be of some help to the newborn. Absence of Consistent National Policy Readers may wonder why there is no national policy about which disorders are screened, as there is in most other countries. The United States Constitution does not provide authority for federal legislation requiring newborn screening. Therefore the matter always has been, and always will be, left to the states. Some states screen for ten disorders, others for only two.
Some states specify screening tests by law, others by public health department regulation.
States use different methods to follow up infants who need additional testing or require treatment. IRB's, by law, must include members of the lay public, and thus represent another avenue for consumer input. These states include Alabama, Arizona, Arkansas, Delaware, Georgia, Idaho, Kentucky, Minnesota, Missouri, Nebraska, North Carolina, Ohio, South Carolina, Utah, Vermont, West Virginia and Wyoming. In 24 states, consumers had no input on follow-up policy for children when tests indicate a possible disorder. Mandatory Tests, Informed Consent, and Informed Refusal Newborn screening is the only mandatory genetic testing in the United States and most other countries.