Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

___

Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

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School Shooting Victims Were Shot Multiple Times

The gunman who massacred 20 children in a Connecticut elementary school riddled them with bullets, shooting some of them as many as 11 times, the medical examiner said today.

"I've been at this for a third of a century so my sensibilities may not be the that of the average man, but it's probably the worst I've ever seen," said Chief Medical Examiner H. Wayne Carver II, who has been a medical examiner for 36 years.

A team of 14 medical technicians worked through the night to complete the grisly job of identifying the children killed by Adam Lanza, 20, in the Sandy Hook Elementary School massacre so their names could be released today.

Several weapons were found in the school, including a semi-automatic rifle.

"All the wounds that I know of at this point were caused by the long weapon," Carver said, and many were shot at close range.

CLICK HERE for full coverage of the tragedy at the elementary school.

"I believe many of them were hit more than once," and he said the wounds were "all over" the children's bodies.

"I only did seven of the autopsies. The victims I had ranged from 3 to 11 wounds a piece," Carver said.

The names of the children slain Friday in the Newtown, Conn., school were released today.

To carry out the identifications, Carver said they "did not bring the families and the bodies into contact." He said the identifications were made through photographs of the children's faces. "It's easier on the families," he said.

Additional work is needed to complete the autopsies and identifications of the seven adults slain in Lanza's killing spree.

Emmanuel Dunand/AFP/Getty Images

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Fresh details of the massacre emerged including the fact that all of the young victims were first graders in two rooms.

Based on the Sandy Hook school directory, all the kids killed were in the first grade and were in two classrooms.

In one class, 15 of the 16 students listed were killed. In the other class, five of the 16 students died along with their teacher Victoria Soto. Also, nine of the deceased students have siblings in the school.

At a nearby firehouse that has become a center for the town a makeshift memorial and vigil has emerged under a sign that reads "Sandy Hook School." People have left flowers, candles, signs that read "Rest in Peace" and "God Bless Sandy Hook Elementary," as well as a cross made of blue flowers and a wreath of teddy bears

With the tally of Lanza's carnage complete, authorities and the grieving people of Newtown, Conn., are left to wonder why he turned the elementary school in this quaint New England town into a slaughter house.

Connecticut State Police Lt. Paul Vance said the investigation "did produce some very good evidence" about motive, but he would not go into further detail.

He indicated the evidence came from the shooting scene at the school as well as at the home where Lanza's mother, Nancy, was slain.

Also key will be the lone person shot by Lanza who wasn't killed. The female teacher has not been publicly identified.

"She is doing fine," Vance said at a news conference today. "She has been treated and she'll be instrumental in this investigation."

Vance said it appears that reports of an altercation involving Lanza at the school in the days before the mass slaying are not checking out.

Vance said that Lanza forced his way into the school, but did not say how.

Evidence emerged today that Lanza's rampage began in the office of school principal Dawn Hochsprung while the school intercom was on. It's not clear whether it was turned on to alert the school or whether it was on for morning announcements, but the principal's screams and the cries of children heard throughout the school gave teachers time to take precautions to protect their children.

Hochsprung was among those killed in the Friday morning killing spree.

READ: Connecticut Shooter Adam Lanza: 'Obviously Not Well'

Authorities have fanned out to New Jersey, Connecticut and Massachusetts to interview Lanza's relatives, ABC News has learned.

According to sources, Lanza shot his mother in the face, then left his house armed with at least two semi-automatic handguns, a Glock and a Sig Sauer, and a semi-automatic rifle. He was also wearing a bulletproof vest.

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Violence flares in Cairo as Egyptians vote

CAIRO (Reuters) - Islamists attacked the offices of an Egyptian opposition party newspaper on Saturday, security sources said, as people voted on a new constitution intended to pull the country out of a growing political crisis.

The newspaper of the Wafd party in Cairo was targeted with petrol bombs and birdshot, the sources said, in the latest of a series of violent incidents surrounding a divisive referendum designed to pave the way to national elections next year.

The attack came as officials began counting votes after polling stations closed at 11 p.m. (1600 ET).

Official results will not come until after a second round of voting in remaining areas of the country next Saturday, but conflicting claims were already emerging from the rival camps.

A spokesman for the opposition National Salvation Front said it had indications that 60-65 percent of voters in Cairo and other cities had rejected the new constitution, while President Mohamed Mursi's Muslim Brotherhood allies said that after 1 million votes had been counted, 72.5 percent were in favor.

Mostafa Shafik, managing editor at Wafd's newspaper, which is located next to the party headquarters, said his offices had been damaged.

"The attackers used Molotov cocktails to enter, which left minor areas burned," he said.

A Reuters photographer saw a dozen or so cars damaged inside the Wafd headquarters' grounds, their windows broken. Glass was also broken in the headquarters, but he saw no immediate signs of fire damage. Two people appeared to have been injured.

Wafd blamed followers of Hazem Abu Ismail, a Salafist preacher, for the attack, but he used his Facebook page to deny involvement.

Violence in Cairo and other cities has marred the run-up to the referendum. Several party buildings belonging to the Muslim Brotherhood's Freedom and Justice party have been burned in protests.

Rival factions armed with clubs, knives and swords fought in the streets of Alexandria on Friday. Opposition supporters trapped a Muslim preacher inside his mosque after he backed a "yes" vote in favor of the constitution.

ANGRY DEMONSTRATIONS

President Mursi provoked angry demonstrations when he issued a decree last month expanding his powers and then fast-tracked the draft constitution through an assembly dominated by his Muslim Brotherhood group and its allies. At least eight people were killed in clashes last week outside the presidential palace.

His liberal, secular and Christian opponents say the constitution is too Islamist and tramples on minority rights. Mursi's supporters say the charter is needed if progress is to be made towards democracy nearly two years after the fall of military-backed strongman Hosni Mubarak.

"The sheikhs (preachers) told us to say 'yes' and I have read the constitution and I liked it," said 53-year-old Adel Imam as he queued to vote in Cairo on Saturday. "The country will move on."

Turnout was high enough for voting to be extended by four hours in Cairo and some other cities.

In order to pass, the constitution must be approved by more than 50 percent of voters who cast ballots. A little more than half of Egypt's electorate of 51 million are eligible to vote in the first round in Cairo and other cities.

Rights groups reported some abuses, such as polling stations opening late, officials telling people to vote "yes", bribery and intimidation.

But Gamal Eid, head of the Arab Network for Human Rights Information, which is monitoring the vote, said nothing reported so far was serious enough to invalidate the referendum.

TRANSITION

Christians, making up about 10 percent of Egypt's 83 million people and who have long complained of discrimination, were among those waiting at a polling station in Alexandria to oppose the basic law. They fear Islamists, long repressed by Mubarak, will restrict social and other freedoms.

"I voted 'no' to the constitution out of patriotic duty," said Michael Nour, a 45-year-old Christian teacher in Alexandria. "The constitution does not represent all Egyptians."

Howaida Abdel Azeem, a post office employee, said: "I said 'yes' because I want the destruction the country is living through to be over and the crisis to pass."

Islamists are counting on their disciplined ranks of supporters and the many Egyptians who may fall into line in the hope of ending turmoil that has hammered the economy and sent Egypt's pound to eight-year lows against the dollar.

Mursi was among the early voters after polls opened at 8 a.m. (0600 GMT). He was shown on television casting his ballot shielded by a screen and then dipping his finger in ink - a measure to prevent people voting twice.

The second round will be held in other regions on December 22 because there are not enough judges willing to monitor all polling stations after some said they would boycott the vote.

Egyptians are being asked to accept or reject a constitution that must be in place before a parliamentary election can be held next year to replace an Islamist-led parliament dissolved in June. Many hope this will lead Egypt towards stability.

If the constitution is voted down, a new assembly will have to be formed to draft a revised version, a process that could take up to nine months.

The army has deployed about 120,000 troops and 6,000 tanks and armoured vehicles to protect polling stations and other government buildings. While the military backed Mubarak and his predecessors, it has not intervened in the present crisis.

(Writing by Edmund Blair and Giles Elgood; Editing by Tom Pfeiffer)

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Counting under way in Egyptian referendum

CAIRO: Counting was under way early Sunday after a first-round referendum on a divisive new constitution pushed through by President Mohamed Morsi and his Islamist allies despite weeks of opposition protests.

Polling stations in half the country, including the biggest cities of Cairo and Alexandria, were tallying the results from Saturday's voting.

The second round of the referendum is to be held next Saturday, after which the official result is to be given.

Morsi's Muslim Brotherhood and main media outlets said that, based on very early unofficial figures, it appeared that the polling was trending towards 70 percent support for the draft charter.

But the opposition disputed that, saying its preliminary figures suggested that 66 percent of the voters had rejected the proposed constitution. It claimed the Muslim Brotherhood had sought to "rig" the vote.

If those contradictory positions are maintained, Egypt's turmoil of the past three weeks over the draft constitution will not subside.

Violent clashes claimed eight lives on December 5 amid a highly polarised political climate.

Late Saturday, riot police fired tear gas to disperse dozens of hardline Islamists who attacked the central Cairo headquarters of the opposition liberal Wafd Party with fireworks and stones, officers at the scene told AFP.

On Friday, clashes between stone-throwing and sword-wielding Islamists and opposition supporters erupted in Egypt's second city of Alexandria, injuring 23 people according to the official MENA news agency.

To ensure security, 120,000 troops were deployed to reinforce 130,000 police.

Voting was being staggered, with half the country casting their ballots on Saturday and the other half a week later.

The Muslim Brotherhood has thrown its formidable organisational machine behind a campaign in favour of the draft constitution.

The proposed charter "offers rights and stability," said one Cairo voter who backed it, Kassem Abdallah.

It will help Egypt "return to normal", agreed another, Ibrahim Mahmoud, a teacher.

But many opposition voters were especially hostile toward the Brotherhood, which the Front believes wants to usher in strict Islamic sharia laws.

Abbas Abdelaziz, a 57-year-old accountant, said he voted against the charter "because I hate the Muslim Brotherhood. It's very simple. They are liars."

Sally Rafid, a 28-year-old Christian, said: "There are many things in the constitution people don't agree on, and it's not just the articles on religion."

International watchdogs, the UN human rights chief, the United States and the European Union have expressed reservations about the draft because of loopholes that could be used to weaken human rights, including those of women, and the independence of the judiciary.

Analysts said it was likely - but not certain - that the draft constitution would be adopted.

Whatever the outcome, "lasting damage to the civility of Egyptian politics will be the main outcome of the current path Morsi has set Egypt on," one analyst, Issandr El Amrani, wrote for his think tank, the European Council on Foreign Relations.

"If the 'no' vote wins, the Morsi presidency will have been fully discredited and the pressure for his resignation will only increase," he said. "If 'yes' wins, the protest movement is unlikely to die down, (and) may radicalise."

- AFP/de

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Govt plans own channel, real autonomy for DD

NEW DELHI: The information and broadcasting (I&B) ministry has asked regulator Trai for a review of the policy which disallows government ownership of television channels. This letter to the regulator is seen as a precursor to the Centre launching a TV channel of its own.

On November 30, I&B secretary Uday Kumar Varma wrote to Trai chairman Rahul Khullar asking him "to kindly provide your recommendations as to whether the following may be allowed" in broadcasting: central and state government ministries and departments, state-owned companies, undertakings and joint ventures.

Varma cited the instances of the governments of Gujarat, Punjab, Andhra Pradesh and the Union HRD ministry seeking permission to operate and distribute their TV channels which the I&B ministry has turned down because the current policy doesn't allow government presence in broadcasting.

Sources in the ministry said Doordarshan was allowed because it was ostensibly run by an autonomous body, Prasar Bharati. They also said that it was a question of time before Prasar Bharati is likely to be asked to raise and manage its own finances and that would automatically lead to the public broadcaster asserting its autonomy.

It's in this context that the government's letter seeking Trai's views on government presence in broadcasting acquires significance. Incidentally, Doordarshan enjoys 92% coverage of the country through its terrestrial network with a viewership of about 2.5 crore people.

Not just TV channels, the government is also keen on having a presence in print and radio too. There is urgency to the move in view of elections in 2014 when the government having its own media would be undoubtedly helpful.

While the Punjab government sought permission for its own TV channel, the Gujarat government and HRD ministry sought the I&B ministry's nod to set up educational channels on their own DTH platforms.

90% of I&B funds spent on Prasar Bharati

Sources said that the I&B ministry was looking to recast Prasar Bharati as a financially autonomous public service broadcaster like the BBC with independent sources of funding like licence fees, commercial programming and ads.

At present 90% of the ministry's fund is spent on funding Prasar Bharati's operations. I&B minister Manish Tewari is said to have discussed the issue with senior memeber of the government. "Why should there be a veil of hypocrisy in running one's own channel or paper? If there are 800 TV channels, allowing 30 more will only be a drop in the ocean. If there are 3,000 radio stations, there can be space for 30 more, and the same is true for papers," the sources said.

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Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

___

Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

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20 Children Killed at Conn. Grade School, 7 Adults

Twenty children died today when a heavily armed man invaded a Newtown, Conn., elementary school and sprayed staff and students with bullets.

The gunman, identified as Adam Lanza, 20, was found dead in the school.

Lt. Paul Vance said 18 children died in the school and two more died later in a hospital. Six adults were also slain, bringing the total to 26.

In addition to the casualties at the school, Lanza's mother Nancy Lanza was killed in her home, federal and state sources told ABC News.

According to sources, Lanza shot his mother in the face, then left his house armed with at least two semi automatic handguns, a Glock and a Sig Sauer, and a semi automatic rifle. He was also wearing a bullet proof vest.

Lanza drove to Sandy Hook Elementary School and continued his rampage, killing 26 people, authorities said. He was found dead at the school. It appears that he died from what is believed to be a self inflicted gunshot wound. The rifle was found in his car.

In the early confusion surrounding the investigation, federal sources initially identified the suspect as Adam's older brother Ryan Lanza, 24. He is being questioned by police.

LIVE UPDATES: Newtown, Conn., School Shooting

"Evil visited this community today," Gov. Dan Malloy said at a news conference this evening.

First grade teacher Kaitlin Roig, 29, locked her 14 students in a class bathroom and listened to "tons of shooting" until police came to help.

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"It was horrific," Roig said. "I thought we were going to die."

She said that the terrified kids were saying, "I just want Christmas…I don't want to die. I just want to have Christmas."

A tearful President Obama said there's "not a parent in America who doesn't feel the overwhelming grief that I do."

The president had to pause to compose himself after saying these were "beautiful little kids between the ages of 5 and 10." As he continued with his statement, Obama wiped away tears from each eye.

He has ordered flags flown as half staff.

CLICK HERE for more photos from the scene.

The alert at the school ended when Vance announced, "The shooter is deceased inside the building. The public is not in danger."

The massacre prompted the town of Newtown to lock down all its schools and draw SWAT teams to the school, authorities said today. Authorities initially believed that there were two gunmen and were searching cars around the school, but authorities do not appear to be looking for another gunman.

It is the second worst mass shooting in U.S. history, exceeded only by the Virginia Tech shooting in 2007 when 32 were killed before the shooter turned the gun on himself. Today's carnage exceeds the 1999 Columbine High School shooting in which 13 died and 24 were injured.

The Newtown shooting comes three days after masked gunman Jacob Roberts opened fire in a busy Oregon mall, killing two before turning the gun on himself.

Today's shooting occurred at the Sandy Hook Elementary School, which includes 450 students in grades K-4. The town is located about 12 miles east of Danbury.

State Police received the first 911 call at 9:41 a.m. and immediately began sending emergency units from the western part of the state. Initial 911 calls stated that multiple students were trapped in a classroom, possibly with a gunman, according to a Connecticut State Police source.

Lt. Paul Vance said that on-duty and off-duty officers swarmed to the school and quickly checked "every door, every crack, every crevice" in the building looking for the gunman and evacuating children.

A photo from the scene shows a line of distressed children being led out of the school.

Three patients have been taken to Danbury Hospital, which is also on lockdown, according to the hospital's Facebook page.

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NATO says Syrian Scuds hit "near" Turkey

BEIRUT (Reuters) - NATO accused Syrian President Bashar al-Assad's forces of firing Scud missiles that landed near to the Turkish border, in explaining why it was sending anti-missile batteries and troops to the bloc's frontier.

The Syrian government, which finds itself under attack from rebels in the capital Damascus and by a diplomatic alliance of Arab and Western powers, denies firing such long-range, Soviet-built rockets and had no immediate comment on the latest charge.

Admiral James Stavridis, the American who is NATO's military commander, wrote in a blog on Friday: "Over the past few days, a handful of Scud missiles were launched inside Syria, directed by the regime against opposition targets. Several landed fairly close to the Turkish border, which is very worrisome."

It was not clear how close they came. NATO member Turkey, once friendly toward Assad but now among the main allies of the rebels, has complained of occasional bullets and artillery fire, some of which has been fatal, for many months. It sought the installation of missile defenses on its border some weeks ago.

"Syria is clearly a chaotic and dangerous situation; but we have an absolute obligation to defend the borders of the alliance from any threat emanating from that troubled state," Stavridis wrote.

Batteries of U.S.-made Patriot missiles, designed to shoot down the likes of the Scuds popularly associated with Iraq's wars under Saddam Hussein in the 1990s, are about to be deployed by the U.S., German and Dutch armies, each of which is sending up to 400 troops to operate and protect the rocket systems.

The Syrian government has accused Western powers of backing what it portrays as a Sunni Islamist "terrorist" attack on it and says Washington and Europe have publicly voiced concerns of late that Assad's forces might resort to chemical weapons solely as a pretext for preparing a possible military intervention.

In contrast to NATO's air campaign in support of Libya's successful revolt last year against Muammar Gaddafi, Western powers have fought shy of intervention in Syria. They have cited the greater size and ethnic and religious complexity of a major Arab state at the heart of the Middle East - but have also lacked U.N. approval due to Russia's support for Assad.

Moscow reacted angrily on Friday to the way U.S. officials seized on comments by a top Kremlin envoy for the Middle East as evidence that Russia was giving up on Assad. Comments by Mikhail Bogdanov on Thursday in which he conceded Assad might be ousted did not reflect a change in policy, the Foreign Ministry said.

Assad's diplomatic isolation remains acute, however, as Arab and Western powers this week recognized a new, united coalition of opposition groups as Syria's legitimate leadership. Large parts of the country are no longer under the government's control and fighting has been raging around Damascus itself.

European Union leaders who met in Brussels on Friday said all options were on the table to support the Syrian opposition, raising the possibility that non-lethal military equipment or even arms could eventually be supplied.

In their strongest statement of support for the Syrian opposition since the uprising began 20 months ago, EU leaders instructed their foreign ministers to assess all possibilities to increase the pressure on Assad.

With rebels edging into the capital, a senior NATO official said that Assad is likely to fall and the Western military alliance should make plans to protect against the threat of his chemical arsenal falling into the wrong hands.

HUNGER SPREADS

Desperation for food is growing in parts of Syria and residents of the northern city of Aleppo say fist fights and dashes across the civil war front lines have become part of the daily struggle to secure a loaf of bread.

"I went out yesterday and could not get any bread. If only the problem was just lack of food - there is also a huge shortage of fuel, which the bakeries need to run," said Ahmed, a resident of the battle-scarred Salaheddine district.

He said people get into fist fights over flour and rebels regularly have to break up fights by firing into the air.

The World Food Programme (WFP) says as many as a million people may go hungry this winter, as worsening security conditions make it harder to reach conflict zones.

Forty thousand people have now been killed in the most enduring and destructive of the Arab revolts. The government severely limits press and humanitarian access to the country.

U.N. humanitarian chief Valerie Amos said on Friday the United Nations is committed to maintaining aid operations in Syria.

"NOTHING OFF THE TABLE"

At the EU summit, Britain's David Cameron pushed for an early review of the arms embargo against Syria to possibly open the way to supply equipment to rebels in the coming months. Germany and others were more reluctant and blocked any quick move. But there was widespread agreement that whatever action can be taken under current legislation should be pursued, and the arms embargo would still be reviewed at a later stage.

"I want a very clear message to go to President Assad that nothing is off the table," Cameron told reporters at the end of a two-day summit. "I want us to work with the opposition ... so that we can see the speediest possible transition in Syria.

"There is no single simple answer, but inaction and indifference are not options."

Among factors holding Western powers back from arming the rebels is the presence in their ranks of anti-Western Islamist radicals. Following a U.S. decision this week to blacklist one such group, Jabhat al-Nusra, a "terrorist" group, thousands of Syrians demonstrated on Friday against ostracizing the movement.

The latest, weekly Friday protests in rebel-held areas were held under the slogan: "The only terrorism in Syria is Assad's".

Inspired by Arab uprisings across the region, Syrian protesters were met with gunfire by Assad's security forces in March 2011. Armed revolt overtook the movement, which has become increasingly sectarian - waged by majority Sunni Muslims against forces loyal to Assad, who is from the minority Alawite sect, an offshoot of the Shi'ite Islam practiced in Assad's ally Iran.

A video posted on the Internet showed dozens of Sunni rebels dressed in camouflage gear congratulating and kissing each other outside a burning Shi'ite shrine.

A fighter holding a rifle said the group was destroying the "dens of the Shi'ites". Reuters could not independently verify the video, which was posted on YouTube on Wednesday and purports to be filmed in the northern town of Jisr al-Shughur.

(Writing by Oliver Holmes and Alastair Macdonald; Editing by Michael Roddy)

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Football: Beaten but not outclassed

SINGAPORE: Aide Iskandar told his boys that when they pull on the national jersey and wear the national flag on their chests, they needed to play like there was no tomorrow.

On Friday night at the Jalan Besar Stadium, his Singapore Youth Selection matched the Liverpool under-19s stride for stride and, despite going down 1-0 in the semi-final of the four-team NexLions Cup, the future Lions were not disgraced.

From the opening hustings, it was clear the hosts, who will face Manchester United in the third-place play-off on Sunday, were not cowed by their vaunted English opponents and were determined to take advantage of their familiarity on the artificial surface and humidity.

Iqbal Hussain and Shahfiq Ghani made a menace of themselves, while Safirul Sulaiman showed the experience from his time in the LionsXII with pacey runs down the left flank, though he lacked the final delivery to make things count.

With the Singapore players not holding back in their tackles, frustrations surfaced as early as the 19th minute, when Liverpool forward Samed Yesil lashed out at Shakir Hamzah after he was felled.

Both escaped unpunished and Yesil exacted revenge less than 10 minutes later with a little moment of magic, backheeling the ball into goal after his captain Adam Morgan had tested the Singapore defence.

It turned out to be the only goal, which pleased the smattering of Liverpool fans among the 4,300 crowd.

Earlier, United saw their good work in the first half undone by a rampant Sporting Lisbon that came back from a goal down to put four past their English counterparts and book their place in tomorrow's final against Liverpool.

United went into the break a goal up from James Wilson's 38th-minute strike but Sporting captain Carlos Mane equalised early in the second half. The match turned following a missed penalty by United's Jack Barmby. The Portuguese side took full advantage, with a double strike from second half substitute Edelino Ie and an injury-time goal from Cristian Ponde.

"They got a big boost when we missed the penalty and that made the difference," said United coach Paul McGuinness. "That gave them more confidence and that's something youth players have to overcome."

Sporting manager Pedro Luz felt his team prevailed because his boys never stopped running.

"(For our club), it is important that the players play every minute to win the match. This is a great result for us," he said.

For Aide, the night belonged to his boys, who showed they had the ability to mix it with the 18-time English league champions' best youngsters.

"They rose to the occasion. It's good for the fans to see that we have a good bunch of young players and this is the future of the national team," said the former Singapore captain.

"I am very proud of the boys. We managed to compete with a very good side, with players who have tasted Premiership action, and now they know they are able to compete at the highest level."

- TODAY

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Rice Withdraws From Sec. of State Consideration

Image Credit: Evan Vucci/AP Photo

UN Ambassador Susan Rice has withdrawn her name from consideration for Secretary of State, saying the criticism surrounding her comments on Benghazi had become an “irresponsible distraction.”

“I am fully confident that I could serve our country ably and effectively in that role,” Rice wrote in a letter to President Obama today. “However, if nominated, I am now convinced that the confirmation process would be lengthy, disruptive and costly – to you and to our most pressing national and international priorities.”

Read Susan Rice’s letter to President Obama

“That trade-off is simply not worth it to our country,” she added.

Rice has been criticized by Republicans for her response to questions on the Sunday talk shows shortly after the terrorist attack on the U.S. consulate in Benghazi killed four Americans.

“The position of Secretary of State should never be politicized,” Rice wrote. “As someone who grew up in an era of comparative bipartisanship and as a sitting U.S. national security official who has served in two U.S. Administrations, I am saddened that we have reached this point, even before you have decided whom to nominate. We cannot afford such an irresponsible distraction from the most pressing issues facing the American people.”

Sources tell ABC News that even before Rice withdrew her name from consideration to be Secretary of State earlier today, Senator John Kerry, D-Mass., had emerged as the leading contender, with the president convinced he would be the better Secretary of State.

The president is all but certain to nominate Kerry, sources say, though no official decision has been made.

The position of Secretary of Defense is not as far along in the process, but sources say former Sen. Chuck Hagel, R-Neb., seems to have an edge right now over other possible candidates such as former undersecretary of defense for policy Michelle Flournoy and deputy Secretary of Defense Ashton Carter.

The CIA director slot, sources say, will go to either acting director Michael Morrell or White House counterterrorism adviser John Brennan.

President Obama, who publicly defended Rice on several occasions, has accepted her decision to remove her name from the running.

“I have every confidence that Susan has limitless capability to serve our country now and in the years to come, and know that I will continue to rely on her as an advisor and friend,” Obama said in a written statement. 

“While I deeply regret the unfair and misleading attacks on Susan Rice in recent weeks, her decision demonstrates the strength of her character, and an admirable commitment to rise above the politics of the moment to put our national interests first,” he said. “The American people can be proud to have a public servant of her caliber and character representing our country.”

Two Republican members of Congress who had adamantly opposed Rice’s potential nomination both reacted quickly.

Sen. Lindsey Graham, R-SC., tweeted, “I respect Ambassador Rice’s decision.” And a spokesperson for Sen. John McCain, R-Ariz., wrote, “Senator McCain thanks Ambassador Rice for her service to the country and wishes her well. He will continue to seek all the facts surrounding the attack on our consulate in Benghazi that killed four brave Americans.”

–Jake Tapper and Mary Bruce

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