Small children in Alaska have to have bigger problems than kids in most other states before they qualify for special help.
The infant learning program at REACH is designed to help children who are developing more slowly than expected. But the program can't serve all children who are behind.
Alaska has tighter standards than most other states for guaranteeing services to infants and toddlers with development problems.
The state is required to provide help to children up to 3 years old who are at least 50 percent behind their peers in a major area, such as speech, motor skills and vision. The state must also help children who have a high probability of developing at least a 50 percent delay, including those with conditions such as cerebral palsy or Down syndrome.
Alaska is one of only six states that require delays to be that great before a child is guaranteed services, said Jane Atuk of the state's infant learning program.
A 25 percent to 30 percent delay requirement is more common among states, said Michael Guralnick, director of the Center on Human Development and Disability at the University of Washington.
Children whose delays are less severe may be served by Alaska's programs -- but only if there's enough money after serving the more disabled kids.
That means some children don't get help.
Children who might fall into that category could include those who've had frequent ear infections and have fallen 30 percent to 35 percent behind in speech and language, said REACH's infant learning program director, Paula McMeen.
``There's a lot we could do to help bump them up,'' she said.
Another example might be a child whose development was slowed by abuse and neglect, but not slowed by a full 50 percent, McMeen said.
Children like that are put on a waiting list. They are rescreened every four to six months, and if they eventually fall far enough behind they can get services.
Thirty-six such children are on REACH's waiting list, McMeen.
The Legislature appropriated $700,000 more this year to eliminate the waiting lists at REACH and other infant learning programs around the state.
But the waiting lists haven't gone away.
Department of Health and Social Services officials said the money the Legislature targeted for the program can't actually be used for that purpose.
Instead of putting $700,000 in state money into the program, the Legislature allocated $700,000 from an expected federal grant. The state has applied for the grant, but won't know if it's approved and won't receive any money until September, said Russ Webb, deputy commissioner of health and social services.
When the money does come, he said, it's to be used for preventing fetal alcohol syndrome, not serving people affected by it. Some can be used for training for infant learning programs, but not for direct services, he said.
``Essentially what the Legislature did was appropriate money that isn't here yet for a purpose it can't be used for,'' Webb said.
He said he believes the department tried to tell legislators there was a problem with that funding.
But state Sen. Sean Parnell, co-chairman of the Senate Finance Committee, said he was not told of that problem and thought the program had been funded.
``My understanding was that money was available, and it was used as part of the conference committee process,'' said Parnell, an Anchorage Republican. ``I don't recall there being any issue there with the availability of funds.''
Children whose delays aren't serious enough to qualify for infant learning programs may not be completely left without help.
If a staff member for an infant learning program makes a trip to an outlying community to work with one severely delayed child, she may also work with children with milder problems since she's already there, McMeen said.
In Juneau other local organizations, such as Healthy Families or Even Start, sometimes work with children with milder delays or at risk of developing problems.
``Those programs are picking up kids, too,'' McMeen said. ``We have a real strong collaboration with the other home visiting programs, so we can support each other.''
However, the staff of those programs don't have the same expertise in areas such as speech therapy or physical therapy, McMeen said. They have a different focus. A program such as Healthy Families, for instance, has more of a social work focus, geared toward helping families cope with stress and be better parents.