Healthcare law will have new California Legislature scrambling

SACRAMENTO — When state lawmakers are sworn in Monday for the new legislative session, they will have little time to enjoy the pomp and circumstance.

Facing a federal deadline, the Legislature must move quickly to pass measures to implement President Obama's healthcare law and revamp the state's insurance market. New legislation will help extend coverage to millions of uninsured Californians and solidify the state's reputation as a key laboratory for the federal law.

Legislative leaders have said they also want to overhaul environmental regulations, curb soaring tuition at public colleges, and tweak the state's tax structure and ballot-initiative system.

But healthcare remains one of the largest and most immediate challenges.

The federal Affordable Care Act takes effect in January 2014, when most Americans face the requirement to buy health insurance or pay a penalty. State lawmakers must pass a series of rules to clear the way for enrollment in a new state-run insurance market next fall, including a requirement for insurers to cover consumers who have preexisting medical conditions and limits on how much they can charge based on age.

Gov. Jerry Brown is expected to call a special session of the Legislature next month — concurrent with the regular session — so healthcare bills that he signs can take effect within 90 days rather than the next year.

"It's a very, very big undertaking to make the promise of the Affordable Care Act a reality," said state Health and Human Services Secretary Diana Dooley. "We are working as hard and as fast as we can in a very complex area with a lot of conflicting information."

As an early adopter of the Affordable Care Act, California has already laid much of the groundwork.

It was the first state to establish an insurance exchange after Congress passed the legislation in 2010. More than 30 other states have since sought federal help in enacting their own. Millions of Californians will be able to purchase coverage, with federal subsidies earmarked for families earning about $92,000 or less annually.

One of the most significant proposals will be an expansion of Medi-Cal, the state's health insurance program for the poor. About 2 million low-income Californians would be newly eligible under the expansion, with the federal government subsidizing costs for the first three years. The state would then shoulder a portion of the bill.

According to a Kaiser Family Foundation study, the expansion could cost the state $6.3 billion over a decade, meaning a 1.7% increase in the amount California spends on Medi-Cal.

California got a head start on the effort by signing up more than 550,000 low-income people in a temporary program. They are expected to automatically move into Medi-Cal in 2014.

Lawmakers will also consider legislation that would create a health plan for people who cannot afford insurance on the open market but make too much money to qualify for Medi-Cal. The option, known as the Basic Health Plan, would provide coverage for individuals with incomes between 133% and 200% of the federal poverty level, or between $15,000 and $21,800 a year.

State Sen. Ed Hernandez (D-West Covina), chairman of the Senate Health Committee and author of the proposal, said the plan was needed to help California's working poor. "I don't think they should be choosing between putting food on the table and buying health insurance," he said.

Insurers urged lawmakers to resist requirements that could make policies offered through the exchange unaffordable.

"We think the Affordable Care Act does much to get millions of people coverage, but new insurance taxes, costly benefit requirements and age pricing restrictions all have the potential of driving up costs," said Nicole Evans, a spokeswoman for the California Assn. of Health Plans.

Healthcare advocates said it was critical for the Legislature to promote policies that would ensure a mix of healthy and sick policyholders to keep premiums affordable.

"It should be a goal of the state to have millions of people enrolled on Day 1," said Anthony Wright, executive director of the consumer group Health Access California, "to bring in those federal dollars and make healthcare cheaper for everybody."

michael.mishak@latimes.com

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Flow of Arms to Syria Through Iraq Persists, to U.S. Dismay

WASHINGTON — The American effort to stem the flow of Iranian arms to Syria has faltered because of Iraq’s reluctance to inspect aircraft carrying the weapons through its airspace, American officials say.

The shipments have persisted at a critical time for President Bashar al-Assad of Syria, who has come under increasing military pressure from rebel fighters. The air corridor over Iraq has emerged as a main supply route for weapons, including rockets, antitank missiles, rocket-propelled grenade and mortars.

Iran has an enormous stake in Syria, which is its staunchest Arab ally and has also provided a channel for Iran’s support to the Lebanese Islamist movement Hezbollah.

To the disappointment of the Obama administration, American efforts to persuade the Iraqis to randomly inspect the flights have been largely unsuccessful.

Adding to American concerns, Western intelligence officials say they are picking up new signs of activity at sites in Syria that are used to store chemical weapons. The officials are uncertain whether Syrian forces might be preparing to use the weapons in a last-ditch effort to save the government, or simply sending a warning to the West about the implications of providing more help to the Syrian rebels.

“It’s in some ways similar to what they’ve done before,” a senior American official said, speaking on the condition of anonymity to discuss intelligence matters. “But they’re doing some things that suggest they intend to use the weapons. It’s not just moving stuff around. These are different kind of activities.”

The official said, however, that the Syrians had not carried out the most blatant steps toward using the chemical weapons, such as preparing them to be fired by artillery batteries or loaded in bombs to be dropped from warplanes.  

Regarding the arms shipments, Secretary of State Hillary Rodham Clinton secured a commitment from Iraq’s foreign minister in September that Iraq would inspect flights from Iran to Syria. But the Iraqis have inspected only two, most recently on Oct. 27. No weapons were found, but one of the two planes that landed in Iraq for inspection was on its way back to Iran after delivering its cargo in Syria.

Adding to the United States’ frustrations, Iran appears to have been tipped off by Iraqi officials as to when inspections would be conducted, American officials say, citing classified reports by American intelligence analysts.

Iran’s continued efforts to aid the Syrian government were described in interviews with a dozen American administration, military and Congressional officials, most of whom requested anonymity to discuss intelligence matters.

“The abuse of Iraqi airspace by Iran continues to be a concern,” an American official said. “We urge Iraq to be diligent and consistent in fulfilling its international obligations and commitments, either by continuing to require flights over Iraqi territory en route to Syria from Iran to land for inspection or by denying overflight requests for Iranian aircraft going to Syria.”

Iraqi officials insist that they oppose the ferrying of arms through Iraq’s airspace. They also cite claims by Iran that it is merely delivering humanitarian aid, and they call the American charges unfounded.

“We wouldn’t be able to convince them, even if we searched all the airplanes, because they have prejudged the situation,” Ali al-Musawi, the spokesman for Prime Minister Nuri Kamal al-Maliki of Iraq, said of the American concerns. “Our policy is that we will not allow the transfer of arms to Syria.”

Mr. Musawi acknowledged that one of the planes was not inspected until it was returning from Damascus, but said it was a simple error, not a deliberate effort to help the Iranians. “Mistakes sometimes occur,” he said.

But one former Iraqi official, who asked not to be identified because he feared retaliation by the Iraqi government, said that some officials in Baghdad had been doing the bare minimum to placate the United States and were in fact sympathetic to the Iranian efforts in Syria.

Michael R. Gordon and Eric Schmitt reported from Washington, and Tim Arango from Baghdad. David E. Sanger contributed reporting from Washington.

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Microsoft updates Android Xbox SmartGlass app for 7-inch tablets

While Nintendo (NTDOY) has chosen to create second-screen experiences with the new Wii U GamePad, Microsoft’s (MSFT) strategy for the Xbox 360 involves bringing your own devices (BYOD) with the Xbox SmartGlass app for Android, iOS, Windows Phone 8 and Windows 8. One of the more frustrating things initially about the Xbox SmartGlass app was that it wasn’t natively compatible with 7-inch Android tablets such as Google’s (GOOG) excellent Nexus 7, but Microsoft’s gone ahead and updated the app to take advantage of 7-inch Android tablets while squashing a batch of bugs at the same time. While still in its infancy, Xbox SmartGlass is a glimpse at the future of smartphones and tablet and how they connect to the TV. 

Last month, we said: “SmartGlass isn’t just a fancy touchscreen remote control app for the Xbox 360 — it’s much more than that. With the app, users can start a movie on any mobile device and resume on the Xbox 360 (and vice versa), monitor real-time sports stats, bios and highlights on a secondary display, navigate the newly added Internet Explorer with multitouch gestures such as pinch-to-zoom and enhance gameplay with new gameplay options.”

The new Xbox SmartGlass is available for free in Google Play Store here.

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Ashley Hebert and J.P. Rosenbaum Are Married

People Exclusive

By Monica Rizzo

12/01/2012 at 06:15 PM EST

J.P. Rosenbaum and Ashley Hebert

Victor Chavez/Getty

It’s official: Bachelorette star Ashley Hebert and her fiancé J.P. Rosenbaum tied the knot Saturday afternoon in Pasadena, Calif.

Surrounded by family, friends and fellow Bachelor and Bachelorette alumni like Ali Fedotowsky, Emily Maynard, and Jason and Molly Mesnick, the couple said "I do" in an outdoor ceremony officiated by franchise host Chris Harrison.

"Today is all about our friends and family," Hebert, whose nuptials will air Dec. 16 on a two-hour special on ABC, tells PEOPLE. "It's about standing with J.P., looking around at all the people we love in the same room there to celebrate our love."

The 28-year-old dentist from Madawaska, Maine, met New York construction manager Rosenbaum, 35, on season 7 of The Bachelorette. The couple became engaged on the season finale.

Hebert and Rosenbaum are the second couple in the franchise's 24 seasons to make it from their show finale to the altar, following in the footsteps of Bachelorette Trista Rehn, who married Vail, Colo., firefighter Ryan Sutter in 2003.

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Asperger's dropped from revised diagnosis manual

CHICAGO (AP) — The now familiar term "Asperger's disorder" is being dropped. And abnormally bad and frequent temper tantrums will be given a scientific-sounding diagnosis called DMDD. But "dyslexia" and other learning disorders remain.

The revisions come in the first major rewrite in nearly 20 years of the diagnostic guide used by the nation's psychiatrists. Changes were approved Saturday.

Full details of all the revisions will come next May when the American Psychiatric Association's new diagnostic manual is published, but the impact will be huge, affecting millions of children and adults worldwide. The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.

This diagnostic guide "defines what constellations of symptoms" doctors recognize as mental disorders, said Dr. Mark Olfson, a Columbia University psychiatry professor. More important, he said, it "shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care."

Olfson was not involved in the revision process. The changes were approved Saturday in suburban Washington, D.C., by the psychiatric association's board of trustees.

The aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment, said Dr. David Kupfer. He chaired the task force in charge of revising the manual and is a psychiatry professor at the University of Pittsburgh.

One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger's disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.

And some Asperger's families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.

But the revision will not affect their education services, experts say.

The new manual adds the term "autism spectrum disorder," which already is used by many experts in the field. Asperger's disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don't talk or interact, as well as those with milder forms.

Kelli Gibson of Battle Creek, Mich., who has four sons with various forms of autism, said Saturday she welcomes the change. Her boys all had different labels in the old diagnostic manual, including a 14-year-old with Asperger's.

"To give it separate names never made sense to me," Gibson said. "To me, my children all had autism."

Three of her boys receive special education services in public school; the fourth is enrolled in a school for disabled children. The new autism diagnosis won't affect those services, Gibson said. She also has a 3-year-old daughter without autism.

People with dyslexia also were closely watching for the new updated doctors' guide. Many with the reading disorder did not want their diagnosis to be dropped. And it won't be. Instead, the new manual will have a broader learning disorder category to cover several conditions including dyslexia, which causes difficulty understanding letters and recognizing written words.

The trustees on Saturday made the final decision on what proposals made the cut; recommendations came from experts in several work groups assigned to evaluate different mental illnesses.

The revised guidebook "represents a significant step forward for the field. It will improve our ability to accurately diagnose psychiatric disorders," Dr. David Fassler, the group's treasurer and a University of Vermont psychiatry professor, said after the vote.

The shorthand name for the new edition, the organization's fifth revision of the Diagnostic and Statistical Manual, is DSM-5. Group leaders said specifics won't be disclosed until the manual is published but they confirmed some changes. A 2000 edition of the manual made minor changes but the last major edition was published in 1994.

Olfson said the manual "seeks to capture the current state of knowledge of psychiatric disorders. Since 2000 ... there have been important advances in our understanding of the nature of psychiatric disorders."

Catherine Lord, an autism expert at Weill Cornell Medical College in New York who was on the psychiatric group's autism task force, said anyone who met criteria for Asperger's in the old manual would be included in the new diagnosis.

One reason for the change is that some states and school systems don't provide services for children and adults with Asperger's, or provide fewer services than those given an autism diagnosis, she said.

Autism researcher Geraldine Dawson, chief science officer for the advocacy group Autism Speaks, said small studies have suggested the new criteria will be effective. But she said it will be crucial to monitor so that children don't lose services.

Other changes include:

—A new diagnosis for severe recurrent temper tantrums — disruptive mood dysregulation disorder. Critics say it will medicalize kids' who have normal tantrums. Supporters say it will address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings and affected children are sometimes very irritable or have explosive tantrums.

—Eliminating the term "gender identity disorder." It has been used for children or adults who strongly believe that they were born the wrong gender. But many activists believe the condition isn't a disorder and say calling it one is stigmatizing. The term would be replaced with "gender dysphoria," which means emotional distress over one's gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner .

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Asian tourists flock to South Coast Plaza

It's Day 3 of his four-day visit, and, of course, Yuki Izuka — for the third time — is back at South Coast Plaza.

Sporting black slacks, leather tote, a pinstripe jacket and crisp tie, the pharmacist from Gunma, Japan, heads straight for the most glittering of shops: Tiffany.

He's on a mission to find a ring for his wife. "It is very expensive — but even more expensive in my home," he says. "Better if I can get something here."

Skipping tariffs and taxes, foreign shoppers flush with cash fill their Southern California trips with shopping sprees at places like South Coast Plaza, and increasingly, employees at the luxury shopping center are taking extraordinary steps to host them, trained to fulfill the tiniest of needs.

South Coast Plaza has become a destination for overseas Asians, who bundle trips to Disneyland with carefully plotted excursions to the retail mecca, stocking up on snug blue jeans, watches, luggage, purses and flashy sunglasses selling for $500 a pair.

"We could have seen it in American Vogue and we're here to get it," said Izuka, looking magazine model-sleek as he and his buddies walk past an Italian cafe and ride an escalator toward the center's Jewel Court, a cluster of high-end jewelry boutiques where foreigners pay cash for $100,000 necklaces or other sparkling baubles.

"I like to buy whatever I can because the prices are so low," says Lucas Xu, comparing the costs to those in China, his homeland.

"And every store has an Asian assistant," said Xu, an economics major in Colorado who has flown in with friends for a shopping excursion. "Wow."

"It's not just about selling somebody something. It's about making them feel important," says South Coast Plaza veteran Werner Escher.

In a sense, Escher is the director of foreign affairs at the center, though technically his title is director of domestic and international markets. He's been on the job more than four decades and travels to China at least once a year to firm up connections with influence makers. He partners with Disneyland and the Nixon Presidential Library & Museum, ready to whisk dignitaries from Beijing and Shanghai to the shopping center, even providing them chauffeurs and guides.

Under his direction, the staff is tightly focused on the foreign traveler.

There's a language-assistance program, with mall and store employees speaking more than 40 languages and dialects. Maps and directions are printed in Korean, Japanese, Spanish and Chinese, among others. Center executives carry business cards featuring Asian characters.

South Coast Plaza is now the first shopping center in the nation to accept UnionPay, China's leading credit card. Center reps also hand out VIP Passport booklets with exclusive offers for travelers. One afternoon, Escher shows it to Shelley Chen, who is from Guangzhou, an economic hub on China's southern coast. He bows and shakes her hand as she's on her way to look for a Gucci purse, having just graduated from law school.

"I like the famous names here," she says of the retailers. "My friends said I must come here."

Scott Hung, a sales director for a semiconductor company in Taiwan, wants to take home gifts for his twin boys. His boss is familiar with South Coast Plaza "and suggested me to go to this place," he said, asking about shops that carry children's goods and that have iPhone docking stations.

Visitors who are overseas celebrities get preferred treatment.

When Yang Mi, one of China's leading actresses, who boasts 22 million followers on Sina Weibo — similar to Twitter — came to South Coast, center officials entertained the actress and her entourage in a plush VIP Access Suite near Saks Fifth Avenue. They hosted the Chinese press corps, which swarmed in to interview and photograph her.

"For her to be here is major," Escher says. "It fills out the playlist of the people we want to attract."

Not to miss a beat, the center — which bills itself as a "shopping resort" — served as a ping-pong tournament venue to the top players in the U.S. and China. The cast of "Raise the Red Lantern," a production of the National Ballet of China, also descended on South Coast, accompanied by diplomats.

That's apart from outreach directed at the local Asian clientele, highlighting the lunar new year and the autumn moon festival. Managers at anchor stores like Macy's scramble to hire Chinese-speaking staff. And shopping at South Coast means visitors might avoid three taxes for luxury items imported to China: customs tariffs, value-added tax and consumption tax. Trade missions between Southern California and China can include a stop at one of the most upscale malls in America.

Concierge Stepheny Southa came to the aid of a pregnant guest recently. Speaking in Mandarin, the woman told her: "You're my size. I need to buy some clothes that I can wear after having the baby."

Southa said she went with the expectant mother to try on multiple outfits for her.

"We have the ability to satisfy someone who comes from a long distance," Southa says.

Robert Sun, founder of the American Chinese CEO Society, says he has taken guests from China's Shandong province to South Coast for dinner and to buy presents.

"They fall in love because of the large number of brand names. No other place can compare," he recalls. Foreign visitors are familiar with Beverly Hills and Rodeo Drive, Sun added, "but now they see South Coast as the best shopping. When somebody has a good experience buying, like, a bag, they go and tell their friends."

If there's one thing missing from the experience for shoppers from China, it's a Chinese restaurant. And shoppers have pointed that out, said Escher, who's been scouting candidates when he travels overseas. Officials hope to make an announcement by the lunar new year in February, an event they anticipate will be covered prominently by the ethnic media.

"Shopping," Escher says, "is the No. 1 activity when people travel."

anh.do@latimes.com

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Senate Votes to Curb Indefinite Detention

WASHINGTON — The Senate voted late on Thursday to prohibit the government from imprisoning American citizens and green card holders apprehended in the United States in indefinite detention without trial.

While the move appeared to bolster protections for domestic civil liberties, it was opposed by an array of rights groups who claimed it implied that other types of people inside the United States could be placed in military detention, opening the door to using the military to perform police functions.

The measure was an amendment to this year’s National Defense Authorization Act, which is now pending on the Senate floor, and was sponsored by Senators Dianne Feinstein, Democrat of California, and Mike Lee, Republican of Utah. The Senate approved adding it to the bill by a vote of 67 to 29.

“What if something happens and you are of the wrong race in the wrong place at the wrong time and you are picked up and held without trial or charge in detention ad infinitum?” Ms. Feinstein said during the floor debate. “We want to clarify that that isn’t the case — that the law does not permit an American or a legal resident to be picked up and held without end, without charge or trial.”

The power of the government to imprison, without trial, Americans accused of ties to terrorism has been in dispute for a decade.

Last year, in the previous annual version of the National Defense Authorization Act, Congress included a provision stating that the government had the authority to detain Qaeda members and their supporters as part of the war authorized shortly after the terrorist attacks of Sept. 11, 2001. But lawmakers could not decide whether that authority extended to people arrested on American soil, and so they left it deliberately ambiguous.

Ms. Feinstein, arguing that law enforcement officials have proved capable of handling cases that arise on domestic soil, said the amendment was intended to “clarify” that the government may not put Americans arrested domestically in military detention.

Senator Kelly Ayotte, Republican of New Hampshire, objected to the restriction on security grounds, saying that even American citizens arrested inside the United States on suspicion of planning a terrorist attack for Al Qaeda should be held under the laws of war and interrogated without receiving the protections of ordinary criminal suspects, like a Miranda warning of a right to remain silent.

From the other direction, an array of civil liberties and human rights groups — including the American Civil Liberties Union and Human Rights First — objected to the amendment because it was limited to citizens and lawful permanent residents, as opposed to all people who are apprehended on United States soil.

“Senator Dianne Feinstein has introduced an amendment that superficially looks like it could help, but in fact, would cause harm,” said Chris Anders of the A.C.L.U.

But on the floor, Ms. Feinstein said that she limited the amendment to citizens and green card holders because she believed that language would “get the maximum number of votes in this body.”

The Senate on Thursday also passed, 94-0, a series of additional American sanctions on Iran. The amendment would impose penalties on individuals selling commodities to Iran that might be used in ship-building or the nuclear program, including aluminum and steel. It also threatened countries, like Turkey, which are buying Iranian oil with gold, in an effort to circumvent banking sanctions.

The current language does not give the president the power to issue waivers, as he has done for countries like Japan, South Korea and India that buy Iranian oil. The White House has opposed the amendment, with officials saying they fear it could “threaten to confuse and undermine” existing effort to get allies, China and other countries to impose other sanctions already in the pipeline.

Also on Thursday, the Senate voted, 62 to 33, for a nonbinding amendment calling for an accelerated withdrawal of United States combat forces from Afghanistan. The measure was sponsored by Senator Jeff Merkley, Democrat of Oregon, and was backed by 13 Republicans.

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“Guardians of the Galaxy” director sorry for blog post seen as sexist, homophobic

LOS ANGELES (TheWrap.com) – James Gunn, the man entrusted with steering Marvel‘s “Guardians of the Galaxy” to the big screen, apologized publicly for a 2011 blog post that was criticized as sexist and homophobic.

Gunn, who is best known for directing the 2006 horror-comedy “Slither,” found himself under fire this week after reports about a blog post titled “The 50 Superheroes You Most Want to Have Sex With.” In it, he called the superhero Gambit a “Cajun fruit” and suggested that Iron Man could “turn” the lesbian Batwoman into a straight woman. He went on to joke that Batgirl, a masked avenger who happens to be a teen mother, was “easy.” The list was voted on by Twitter and Facebook users, but has since been removed from his site.

In a statement to the Gay & Lesbian Alliance Against Defamation (GLAAD), Gunn said his attempt at irreverence was misguided and stressed that he is a proponent of gay rights and women’s rights.

“A couple of years ago I wrote a blog that was meant to be satirical and funny,” Gunn said. “In rereading it over the past day I don’t think it’s funny. The attempted humor in the blog does not represent my actual feelings. However, I can see where statements were poorly worded and offensive to many. I’m sorry and regret making them at all.”

The post is an unwanted distraction from his efforts to give Marvel and its corporate owner the Walt Disney Company another hit. He plans to co-write the script for “Guardians of the Galaxy” in addition to directing. The film will be released in 2014.

“It kills me that some other outsider like myself, despite his or her gender or sexuality, might feel hurt or attacked by something I said,” he added in his apology. “We’re all in the same camp, and I want to do my best to make this world a better place for all of us. I’m learning all the time. I promise to be more careful with my words in the future. And I will do my best to be funnier as well. Much love to all.”

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Dennis Quaid Files for Divorce, Seeks Joint Custody

By Mike Fleeman

11/30/2012 at 09:20 PM EST

Kimberly Buffington-Quaid and Dennis Quaid

Casey Rodgers/NBC/AP

Dennis Quaid is ready to end his marriage for good.

After his wife of eight years, Kimberly Buffington-Quaid, sought legal separation in October, the Vegas star filed Friday for divorce in Los Angeles Superior Court.

The actor requests joint physical and legal custody of their 4-year-old twins, Thomas and Zoe, and offers to pay spousal support, according to the petition.

This will be the third divorce for Quaid, 58, who was previously married to Meg Ryan and P.J. Soles.

Kimberly, a former real estate agent, initially filed for divorce in March. She
put the divorce on hold a month later, pulling the papers so they could work on their marriage, before then filing for separation.

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Kenya village pairs AIDS orphans with grandparents

NYUMBANI, Kenya (AP) — There are no middle-aged people in Nyumbani. They all died years ago, before this village of hope in Kenya began. Only the young and old live here.

Nyumbani was born of the AIDS crisis. The 938 children here all saw their parents die. The 97 grandparents — eight grandfathers among them — saw their middle-aged children die. But put together, the bookend generations take care of one another.

Saturday is World AIDS Day, but the executive director of the aid group Nyumbani, which oversees the village of the same name, hates the name which is given to the day because for her the word AIDS is so freighted with doom and death. These days, it doesn't necessarily mean a death sentence. Millions live with the virus with the help of anti-retroviral drugs, or ARVs. And the village she runs is an example of that.

"AIDS is not a word that we should be using. At the beginning when we came up against HIV, it was a terminal disease and people were presenting at the last phase, which we call AIDS," said Sister Mary Owens. "There is no known limit to the lifespan now so that word AIDS should not be used. So I hate World AIDS Day, follow? Because we have moved beyond talking about AIDS, the terminal stage. None of our children are in the terminal stage."

In the village, each grandparent is charged with caring for about a dozen "grandchildren," one or two of whom will be biological family. That responsibility has been a life-changer for Janet Kitheka, who lost one daughter to AIDS in 2003. Another daughter died from cancer in 2004. A son died in a tree-cutting accident in 2006 and the 63-year-old lost two grandchildren in 2007, including one from AIDS.

"When I came here I was released from the grief because I am always busy instead of thinking about the dead," said Kitheka. "Now I am thinking about building a new house with 12 children. They are orphans. I said to myself, 'Think about the living ones now.' I'm very happy because of the children."

As she walks around Nyumbani, which is three hours' drive east of Nairobi, 73-year-old Sister Mary is greeted like a rock star by little girls in matching colorful school uniforms. Children run and play, and sleep in bunk beds inside mud-brick homes. High schoolers study carpentry or tailoring. But before 2006, this village did not exist, not until a Catholic charity petitioned the Kenyan government for land on which to house orphans.

Everyone here has been touched by HIV or AIDS. But only 80 children have HIV and thanks to anti-retroviral drugs, none of them has AIDS.

"They can dream their dreams and live a long life," Owens said.

Nyumbani relies heavily on U.S. funds but it is aiming to be self-sustaining.

The kids' bunk beds are made in the technical school's shop. A small aquaponics project is trying to grow edible fish. The mud bricks are made on site. Each grandparent has a plot of land for farming.

The biggest chunk of aid comes from the United States President's Emergency Plan for AIDS Relief (PEPFAR), which has given the village $2.5 million since 2006. A British couple gives $50,000 a year. A tree-growing project in the village begun by an American, John Noel, now stands six years from its first harvest. Some 120,000 trees have already been planted and thousands more were being planted last week.

"My wife and I got married as teenagers and started out being very poor. Lived in a trailer. And we found out what it was like to be in a situation where you can't support yourself," he said. "As an entrepreneur I looked to my enterprise skills to see what we could do to sustain the village forever, because we are in our 60s and we wanted to make sure that the thousand babies and children, all the little ones, were taken care of."

He hopes that after a decade the timber profits from the trees will make the village totally self-sustaining.

But while the future is looking brighter, the losses the orphans' suffered can resurface, particularly when class lessons are about family or medicine, said Winnie Joseph, the deputy headmaster at the village's elementary school. Kitheka says she tries to teach the kids how to love one another and how to cook and clean. But older kids sometimes will threaten to hit her after accusing her of favoring her biological grandchildren, she said.

For the most part, though, the children in Nyumbani appear to know how lucky they are, having landed in a village where they are cared for. An estimated 23.5 million people in sub-Saharan Africa have HIV as of 2011, representing 69 percent of the global HIV population, according to UNAIDS. Eastern and southern Africa are the hardest-hit regions. Millions of people — many of them parents — have died.

Kitheka noted that children just outside the village frequently go to bed hungry. And ARVs are harder to come by outside the village. The World Health Organization says about 61 percent of Kenyans with HIV are covered by ARVs across the country.

Paul Lgina, 14, contrasted the difference between life in Nyumbani, which in Swahili means simply "home," and his earlier life.

"In the village I get support. At my mother's home I did not have enough food, and I had to go to the river to fetch water," said Lina, who, like all the children in the village, has neither a mother or a father.

When Sister Mary first began caring for AIDS orphans in the early 1990s, she said her group was often told not to bother.

"At the beginning nobody knew what to do with them. In 1992 we were told these children are going to die anyway," she said. "But that wasn't our spirit. Today, kids we were told would die have graduated from high school."

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On the Internet:

http://www.trees4children.org/

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