WWW.MYDESERT.COM

To subscribe or report a delivery problem, call (800) 834-6052 or visit mydesert.com/cs

SATURDAY, FEBRUARY 9, 2013

GOODMORNING INSIDE TODAY’S PAPER

The DesertSun isprintedusing

recycledpaper $1 all markets

Daily

Definitely jacket weather today

Abby D11Bridge H5Comics D10The Deuce C2Lottery B8Movies D11

Obits B6,7,8Opinion B9Puzzles H4Starwatch B5Today in History B5Weather E8

59° 42°

CHASE THE CLOUDS AWAYForecasters say the storm that brought threat-ening clouds and some rain to the CoachellaValley spent most of its strength on Friday. B1

DISPENSARYDISPENSEDA judge grantsCathedral City anorder that will keepa medical marijuanadispensary closedfor now. B1

MONSTERSTORMSome 40 million inthe Northeastbraced Friday for amajor blizzard. A6

At Desert AIDS Project inPalm Springs, about 2,200 pa-tients are living long-termwithHIV and AIDS. They are visit-ing doctors, getting blooddrawn, having their teethcleaned, knitting quilts to help

with neuropathy, and pickingup prescriptions at an on-siteWalgreens.

The vast majority of pa-tients — staff estimate thenumber to be about 70 percent—will qualify for health insur-ance based on income under

Indians beat Lions inDVL thriller with two

40-point scorers■ SPORTS

Tequila, fruit of yourlime tree add up toheaven in a glass

■ HOME & GARDEN

DS-0000317453

SDSD

74-140 El Paseo •74-140 El Paseo • ##1 • Palm Desertwww.youngerbytonightspiritualspa.comwww.youngerbytonightspiritualspa.com

CUPID’S TIGHTENING FACIAL:Includes deep pore cleansing with extractions, lite acidwith microdermabrasion, microcurrent (firming for the

lower face & neck), ultrasound (for tightening eyes), photonlower face & neck), ultrasound (for tightening eyes), photontherapy (collagen building), and hydration infusion.(collagen building), and hydration in(collagen building), and hydration in

ONLY $99.00ONLY $99.00

Includes deep pore cleansing with extractions, lite acidIncludes deep pore cleansing with extractions, lite acidCUPID’S TIGHTENING FACIAL:CUPID’S TIGHTENING FACIAL:Includes deep pore cleansing with extractions, lite acidIncludes deep pore cleansing with extractions, lite acid

THE ULTIMATE WORKS!THE ULTIMATE WORKS!For Fast Skin Tightening!For Fast Skin Tightening!

Includes lite acid peel, microdermabrasion,Includes lite acid peel, microdermabrasion,RF (tightens skin), plus microcurrentRF (tightens skin), plus microcurrent

(firms muscles). No Downtime!

BUY ONE, GET ONE 50% OFF!!!BUY ONE, GET ONE 50% OFF!!!

(firms muscles). No Downtime!(firms muscles). No Downtime!

ONLY $99.00ONLY $99.00 Reg.Reg.$279.00$279.00

*BONUS*Ultrasound

for TighteningEyes!

A $10 donation will be given to theCoachella Valley Rescue Mission for

every "Works" purchased in February.

ttDDeserDeserteveevev

Total of $149 must be paid at time of purchaseTotal of $149 must be paid at time of purchase

Tourism officials champion better commuter rail link with L.A. ■ ESCAPE

HIV-AIDS careat a crossroads

By Victoria PelhamThe Desert Sun

HEALTH CARE

Medical Director Dr. Homayoon Khanlou is photographed last monthwith client Mitch Esmond at the Desert AIDS Project in Palm Springs.OMAR ORNELAS/THE DESERT SUN

WASHINGTON —A bipartisanquartet of senators, includingtwo National Rifle Associationmembers and two with “F’’ rat-ings from the potent firearmslobby, are quietly trying to finda compromise on expanding therequirement for gun-sale back-ground checks.

A deal, given a good chanceby several participants and lob-byists, couldadd formidablepo-litical momentum to one of thekey elements of President Ba-rack Obama’s gun control plan.Currently, background checksare required only for sales bythe nation’s 55,000 federally li-censed gun dealers, but not forgun show, person-to-personsales or other private transac-tions.

The senators’ talks have in-cluded discussions about waysto encourage states to makemore mental health recordsavailable to the national systemand the types of transactionsthat might be exempted frombackground checks, such assales among relatives or tothosewhohavepermits tocarryconcealedweapons, said peoplewho spoke anonymously.

The private discussions in-volve liberal Sen. ChuckSchumer ofNewYork, theNo. 3SenateDemocratic leader;WestVirginia Sen. Joe Manchin, anNRA member and one of thechamber’s more moderateDemocrats; Sen. Tom Coburn,R-Okla., another NRA memberand one of the more conserva-tive lawmakers in Congress;

The off-roader hits the rocksin Johnson Valley like a motori-zeddesert tortoise tryingtofinda way over a vertical boulderthe size of aVolkswagenBeetle,tipping to one side then pulling

forward. The 37-inch wheelsspin wildly and inside the cab,the driver looks to be fightingwith the steering wheel.

This is Chocolate Thunder,one of the rock-crawling can-yonsonthecourse in theKingofthe Hammers, and the 5,000spectators perched on rocks be-hind safety barriers Fridaymorning are having a contactadrenaline rush.

Everyone’s yelling, cheeringfor the driver to get over therocks. In the moment, there is

no place on earth you wouldrather be, despite the dust bil-lowing in clouds andacoldwindthat cuts through several layersof sweaters and jackets.

Considered one of the pre-mier off-road races in the coun-try, the King of the Hammersnow draws crowds of about30,000 to Johnson Valley,188,000 acres of federally pro-tected open space and off-road-ing trails located about 20miles

Racers put the Hammers downThis year’s coursethe most extreme indesert race’s historyBy K KaufmannThe Desert Sun

Tony Pelligrino navigates the Chocolate Thunder section of the King ofthe Hammers race on Friday. JAY CALDERON/THE DESERT SUN Please see HAMMERS, A2

BIGBEARLAKE—Morethan100 armed officers trudgedthrough the heavy mountainsnow tops Friday, searchingdesperately— and unsuccess-fully — for any sign of a for-mer cop accused of a revengekilling spree.

They searched hundreds ofcabins in the San BernardinoNational Forest, driving inglass-enclosedsnowmachinesand armored personnel carri-ers in their hunt for Christo-pher Dorner.

With bloodhounds in tow,officers went door to door as

Group ofsenatorsseeks dealon checksfor buyersBy Alan FramAssociated Press

Desert AIDS Project, clients uncertain howAffordable Care Act will affect operation

Hunt for accused killerpresses on in snowstormFocus is Big Bear,but sightings arereported evenin the valleyBy Kate McGintyThe Desert Sun

CHP officers search inside the back of a truck with weapons drawn during their dragnet for accusedkiller and former police officer Christopher Dorner at a checkpoint at the intersection of Highway 38 andHighway 18 on Friday in Big Bear. A large media and police presence were on scene during the secondday of the mountain-based manhunt. RICHARD LUI/THE DESERT SUN

LOS ANGELES POLICE SHOOTINGS

GUN CONTROL DEBATE

Please see DEBATE, A19

Please see DAP, A18

COMING SUNDAY

An iSun investigation on therise in California gun sales inrecent years.

GO TOMYDESERT.COM FOR UPDATES AND TO VIEW IMAGES FROM THE SEARCHPlease see MANHUNT, A3

A18 | THE DESERT SUN | SATURDAY, FEBRUARY 9, 2013 FROM PAGE 1

the Affordable Care Act (ACA)or through an expansion ofMediCal, California’s version ofMedicaid, to most of those liv-ingbelow138percentof the fed-eral poverty level. Or, to amuchlesser extent, some will be cov-ered through state exchanges,online insurance marketplacesfor middle-income people.

Those who are currently un-insured or using a transitionaryLow-Income Health Plan willsee the most impact when ACAgoes into effect in 2014.

This newaccess to insurancecould potentially be a hugeboost to patients, DAP CEODa-vid Brinkman said.

But President Obama’shealth care reform also con-cerns the AIDS community andthe organization, as they strug-gle to figure out how it will fitinto the current funding andcare model without disruptingthe treatment and services theysay are improving patients’quality of life.

ManyHIVandAIDSpatientsdo not qualify for MediCal,which currently requires both alow-income status and disabil-ity, until they have full-blownAIDS and are sick enough tomeet the disability component,Brinkman said.

“You can imagine livingwitha chronic disease for the rest ofyour life that you don’t have in-surance foruntil theAffordableCare Act and, now all of a sud-den,youhaveawaytoseeaphy-sician and get medications andsee specialists,” he said. “Thatis an enormous benefit of theACAtopeoplewithHIVwhoarelow-income.”

He added that when patientsrequire specialized care forcancers and infections that oc-cur often as a result of weak-ened immunesystemsand toxicmedications, many strugglesince there is no way to paywhen they are uninsured. Thespecialists are asked to take onthe case at no cost.

“I think the specialists in thiscommunity will be less scaredto answer the phone when theysee the Desert AIDS Project onthe caller ID when we’re mak-ing a referral,” Brinkman said.

Amy Killelea, senior man-ager of health care access forthe Washington D.C.-based Na-tional Alliance of State and Ter-ritorial AIDS Directors, saidthis insurance would providemore regular health care thanthe current patchwork systemand help to improve patients’overall health.

AIDS treatment is costly.Drugs can routinely cost about$24,000 each year per patient,and lab tests could cost up to$1,000 each test, staff said.Funds come froma network, in-cluding the Ryan White Pro-gram, a federal grant allocatedannually since 1990 to states todeal with HIV and AIDS care,and the AIDS Drug AssistanceProgram.

But Desert AIDS Projectstaff are cautious in their ex-citement for expanded insur-ance access.

Bill Quinn, chief programof-

ficer for Desert AIDS Project,said DAP is used to workingwith a person’s holistic health,so in some ways, they’re well-positioned to handle health carereform. But he added that cur-rent funding models, such askey Ryan White Program fund-ing, could be in jeopardy if poli-ticians believe there’s no longeras much need because their pa-tients are now covered underhealth insurance.

ManyHIVandAIDSpatientsare aging now and face addi-tional conditions as a resultsuch as cardiac disease and dia-betes that complicate theirhealth even more, he said.

Gettinghis life backMitch Esmond, a 52-year-old

Palm Springs resident livingwith AIDS, receives care atDAP.

Esmond, who was diagnosed12 years ago, was living in At-lanta with the disease and with-out treatment a few years agowhen he collapsed into a coma.He decided to move to PalmSprings and undergo treatmentat the Desert AIDS Project toface his illness.

Hewas shocked to not be puton waiting lists for the drug as-sistance as was the case for asimilar facility in Atlanta andby the different teams thatworked seamlessly together tokeep him healthy.

He said he is getting his lifeback, and he couldn’t have doneit without the thorough treat-ment he receives at the organi-zation, including nutrition careandacasemanagementworker.

“Itmade all the difference intheworld forme,”Esmondsaid.

Though he is not insured anddoes not know if he will qualifyfor insuranceundertheACA,hesaid he depends on existing ser-vicesand is trying togetdisabil-ity benefits, since his blood T-Cell count shows him to have amedical disability.

Quinn expressed concern

that these services that peoplelike Esmond rely on might fallby the wayside.

“The risk for a populationlike ours under health care re-form is that there are a lot of un-knowns about what will be thelong-term funding for some ofthewraparound services for so-cial services for food for hous-ing support that are critical tothe majority of our patients,”Quinn said.

Ryan White funding coversmedical bills, housing andtransportation assistance, men-tal health therapy groups andsubstance abuse services, andemergency pharmacy assis-tance for DAP, said Brande Orr,director of grants and qualityassurance at DAP. The organi-zation received $3.6 million inRyan White funds for fiscalyear 2013, of which $1.8 millionwas designated to medicalcosts.

Orr noted that the funding isdecreasing over time and willbe down 9.4 percent this year.

“Barringoneor twopotentialexceptions, services funded inthose other categories will notbe covered by MediCal Expan-sion and the Ryan White Pro-gramwill remainveryessentialand relevant to ensuring thatpeople livingwithHIV/AIDS donot fall outofcare,becomesick-er themselves, and becomemore infectious to others,” sheadded in an email.

Killeleaagreed that theRyanWhite Program is still a vitalpart of AIDS treatment “in aninsured world” and could beused as a 1-2 punch with insur-ance to tackle treatment of thedisease.

“We need to think innova-tively and carefully about theways the Ryan White Programworks in conjunction withhealth care reform,” she said.

Quinn said HIV/AIDS doc-tors and care staff have 30years of experience in dealingwith the evolving disease andnow the model is changing.

“What’s commonwhen thesebigprogramsroll out is there’sabroad sweeping brush to get itimplemented, but some of thespecialty populations within —children, people with specificchronic diseases — often all oftheir needs aren’t consideredbecause they’re complicated,”he said.“The knowledge isevolving all the time, and thatdoesn’t fit into themodel of justmaking insurance accessible.”

Pioneers in care“California in a lot of ways

has provided lessons becausetheywereearly expanders,”Ki-lelea said.

Riverside County launched aLow-Income Health Plan(LIHPS) in January 2012 as a“bridge to health care reform,”alongwithalmosteveryCalifor-nia county, Orr said. The countybegan to enroll people into theprogram who had been usingcounty funds for the medicallyindigent while Desert AIDSProjectwasstill engaged incon-tract negotiations with River-side and not yet in the network.

The DAP contract was final-ized in August 2012, and its pa-tients were able to reenter ser-vices at the facility.

Dr. Homayoon Khanlou,medical director at DAP, point-ed out how this had created agap in treatment,noting that thelegislation could make HIVtreatment non-specialized. Hesaid that funding could be dis-tributed to general practi-tioners, rather than HIV-spe-cialized doctors like himself.This could cause a disruption intreatment, transportation con-cerns, and difficulty in access-ingHIVmedications, which areoften considered controlledsubstances and must be pickedup.

“California was very pro-gressive compared to otherstates,”Quinn said. “They start-ed immediately to have themodel programs that will beacross the country for the type

of insurance programs.”In implementing the LIHPS

transitional program, someAIDS patients at DAP were as-signed to general practitionersin Riverside County last yearandwerenot able to accessDes-ert AIDS Project by the follow-ing day, according to staff ac-counts. Khanlou said some pa-tients did not have care for ninemonths or more as a result, asthey had to drive 100 miles toget treatment and stopped tak-ing their medications.

“These are the things thatoverall in the big picture lookfantastic like everyone’s goingtohaveaccess to care, but in thelocal areas when it comes topracticality, it actually createda disaster,” he said.

Quinn said they’ve sincebeen able to engage in dialogueto “help rebuild those connec-tions and have some of the as-pects be reconsidered.”

Kilelea said that many otherproviders and HIV programsacross the country are now con-sidering ways to manage thetransition without interruptingcare, adding that they arework-ing to launchafailsafe toensurethat people working with spe-cific providers andmedicationswill continue with the sametreatment and will be includedin the right networks.

Khanlou also noted that Des-ert AIDS Project serves undoc-umented immigrants, who willnot qualify for ACA insurancefunds, and they had to be care-ful about what would happen totheir services and care underhealth care reform.

Killeleaechoed thatconcern,saying that the legislation hadbeen silent as far as the undocu-mented.

“Wereallyneed tomake surethat we have the safety nets inplace to ensure that everybodyhas access to care and treat-ment, services and providersnowmore than ever,” she said.

Share of cost, currently achallenge for many DAP pa-tients who qualify for insur-ances like MediCal but areasked to pay part of their bills,could also remain a barrier un-der health care reform forAIDS patients.

“Even though on paper, itsays that they’re eligible andthey could pay it, functionallythey still have to pay rent. Theystill have to buy food. They stillhave a car that they have to putgasin, thosekindofthings, inor-der to have their job,” Quinnsaid.

He noted that the organiza-tion could no longer providehome health care to patientswith share of cost because offederal law, even though theywere functioning well with theextra help.

“Unless that type of a glitchisworkedout,youtake iteventoa broader group of people,” hesaid.

Killelea said AIDS patientswould be hit harder by co-paysjust because they’re using thesystem more, a reflection of agap in health care reform forpeople with chronic conditions.

But she is still hopeful.“(The gap is) a concern, but

it’s somethingweasacommuni-ty are well prepared to ad-dress,” she said.

DAPContinued from A1

BY THE NUMBERSAnnual operating budget ofDesert AIDS Project for 2013:$9,087,517.64Number of people served:Morethan 2,200 annuallyNumber of workers: 98

Source: Desert AIDS Project website

People living with HIV/AIDS:U.S.: 1.2 millionCalifornia: 209,516Riverside County: 7,642

Centers for Disease Control andPrevention; Calif. Dept. of Public Health

STEVE CHASE GALA

What: 19th annual Steve ChaseHumanitarian Awards, hosted byJesse Tyler Ferguson of ABC’s “Mod-ern Family” and featuring perfor-mances by Melissa Etheridge andQueen Latifah. Honorees includeJake Glaser, Mario Lopez and LornaLuft.

When: 5 p.m. today

Where: Palm Springs ConventionCenter, 277 N. Avenida Caballeros,Palm Springs

Information: (760) 969-5743 orwww.desertaidsproject.org

Medical Director Dr. Homayoon Khanlou and Bill Quinn, chief programofficer (left), are photographed at the Desert AIDS Project.OMAR ORNELAS/THE DESERT SUN

“These are the things that, overall, in the bigpicture, look fantastic, like everyone’s goingto have access to care, but in the local areaswhen it comes to practicality, it actuallycreated a disaster.”DR. HOMAYOON KHANLOU,medical director, Desert AIDS Project

Dr. Homayoon Khanlou is medical director at the Desert AIDS Project. OMAR ORNELAS/THE DESERT SUN