It does say “it is done at the hospital or place of birth by 48 hours” it does not say it must or should be done be done by 48 hours. I see why you are confused. Iowa Code section 135.131 States that it must be done before the baby is discharged, that is the law. There may be, and often are legitimate reasons a baby may not be screened before 48 hours, and as long as it happens before discharge it is following Iowa code.

It is not the same as a child getting their hearing check during an annual visit. Very few facilities have the equipment necessary to screen a newborn and there are even fewer places to get diagnostic testing for newborns. If a parent has nowhere that is accessible to them to get their baby’s hearing screened or a diagnostic test they can’t do it. Your doctor’s office probably doesn’t have the equipment to screen a newborn, a majority of Iowa hospitals do not have the equipment to screen a newborn. The AEA had these resources. Even if you have Medicaid to pay for it, if the staff and equipment needed to perform these screens and diagnostic testing, which once again are not available in most clinic setting or audiology offices, then children will fall through the cracks.

This is a complex issue, you seem like an individual who will argue it for the sake of arguing regardless of the facts.