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The clash between Gov.

Mike DeWine and state lawmakers reaches a peak.

The former U.S. attorney on the Householder and Sittenfeld corruption cases speaks out.

And the bleak future for some hospitals, which are the economic hearts of many smaller communities.

All this weekend, the state of Ohio.

Welcome to The State of Ohio, I'm Karen Kasler.

It was a week of promises fulfilled at the state House.

First, Governor Mike DeWine did as he said he would and vetoed a bill that would give state lawmakers the power to overturn his health and emergency orders.

Then the next day, state lawmakers delivered on their vow to override that veto.

DeWine says the bill would endanger the public, open up state lawmakers to lawsuits, including damages, and is unconstitutional.

His fellow Republican lawmakers voted for the bill say it's a check on the governor's authority.

Twenty six other states allow this to that.

They are the only policymaking authority in the Constitution.

So what DeWine has been doing is unconstitutional.

Meanwhile, DeWine opened up vaccines to people over 16 if clinics need help in filling appointments.

Monday is the official day those over 16 can register and people under 18 are only approved for Pfizer shots.

More than half a million vaccines are expected this coming week.

But DeWine says there are one hundred and forty six point nine cases per 100000 residents up from last week.

The goal was 50 cases per 100000 Ohioans for all restrictions, such as the mask mandate to be lifted.

And DeWine announced the state's website will feature a list of fifty six nursing homes and one hundred and fifty eight assisted living facilities that haven't said if their residents and staff have been vaccinated.

The chief prosecutor in the cases involving Republican former House Speaker Larry Householder and suspended Democratic Cincinnati city council member Peggy Sittenfeld stepped down at the request of President Biden last month.

But former U.S. attorney for the Southern District of Ohio, David DeVillers, says he wishes he could have stayed on to work on the case involving corruption at Cincinnati City Council and the 60 million dollar bribery case that's thought to involve FirstEnergy and brought the arrests of Householder and four others, including lobbyist Neil Clark.

DeVillers and I sat down for a socially distanced interview in our studio.

You were the one that made the announcement about the death of Neil Clark, the lobbyist and former Ohio Senate Republicans finance director, at a meeting of the Ohio Consumers Council Governing Board.

Why was that information?

You knew and you could share it in a big federal case like the one that you were prosecuting before you left.

How does the death of a defendant affect that?

Yeah, so I was it was it was news at the time when I was told and it was confirmed to me about ten minutes before I started speaking and and I just wanted to give my condolences to the family.

I didn't like to have an official announcement or anything, anything like that, but I didn't want to give my condolences.

But it it doesn't I mean, in this particular situation, it doesn't at all.

The case will will go forward with the the other the other co-defendants.

It's a tragic event, but the investigation and prosecution will continue.

Now, we can't talk about the case.

You're not involved in the prosecution of it any longer.

But in your experience with big cases like this and of course, this is arguably, you've said the largest case of its kind in terms of those kind of charges in state history.

How long might it be before we might see a trial or some major movement?

Well, in cases like this, it's usually I'd say about it from nine months to a year and a half before from indictment to trial, that roughly.

But in this particular case, because of covid and shutting down the courts and shut down the grand jury and shutting down the juries for a period of time, that that's delayed everything.

And you have to understand, there are people that are actually locked up and they get priority from the court, rightfully so, to have their case heard first.

So it'll it'll be longer than usual.

Can we expect that there may be other charges added, other people added, or when a case like this is brought forward, is that it?

Have you presented everything?

I mean, when you spoke to us in July with the arrest and everything, was that the final thing?

No.

And as I said in July, that the investigation in some respects is just beginning back in July.

So the investigation is ongoing.

I can tell you that.

Do you expect and I know you can't say too much, do you expect that there might be more charges, more other more people who might be accused in this?

I don't want to get my my my colleagues, the U.S. attorney's office and any any bida.

You should always there's always a possibility of more individuals charged and more charges against individuals that have already been indicted.

We call them superseding indictments.

And it's not unusual in cases of public corruption and large white collar cases.

That is one big case that you were dealing with.

Another one was corruption in Cincinnati on Cincinnati City Council.

You said that you moved some resources around from tax cases and white collar crime to start dealing with some of these corruption cases.

Did you have a sense coming into office that corruption was an issue that hadn't been looked into or that there were serious problems out there?

Yeah, before I was the.

Up until I was confirmed, you know, I met with that being in the USA at the time anyway, I had the luxury of like working on these kind of cases and being read in and kind of in the strategy meetings with Ben Glassman, who was my predecessor, as well as people with the corruption unit.

And, you know, we we had a pretty good idea what what the issues were both locally and Cincinnati as well as in the state House.

So I think we as a team, quite frankly, and I supported that we needed to to move on these cases.

Is it done?

Have you do you feel like that there is a real grasp of corruption in the Southern District or are there other cases that you might have wanted to investigate?

Oh, heck, yeah.

I mean, there's there's a there's bunch I mean, unfortunately.

But I do think that I hope that this this these investigations and prosecutions in coming to light, you know, really kind of help the next generation of politicians and public servants and that, you know, the idea that you can accept money with a wink, wink, nudge, nudge, promise to do something that in your capacity as a as a politician or as a as a public servant for for money, whether it's going to pockets or whether it's going into your campaign fund.

You know, if you're making that promise and we turn for it, that's a crime is a federal crime, always has been.

And I think that that culture of people coming into service thinking, oh, this is the way it's supposed to be, hopefully now realize that it's not and that that next generation of of people that want to do the right thing will take heed of it.

You've been a prosecutor for a while.

I want to ask you, what are some cases that stand out for you, some characters that you have encountered, anything you could share that really you remember either fondly or not so fondly?

I mean, yeah, there are some scary people that I've prosecuted, some big cases both in the state and the federal system.

Ronald Dawson was probably the first real big case that I did where I was really concerned if if I failed, that people would be hurt and killed.

And that was a group called the Klan was an enterprise that did murder for hire, mostly for other interests in the central Ohio area in Columbus.

Yeah, yeah.

And that was that was a scary one because I realized, you know, we got to win.

Our witnesses are on Jeopardy and other people are cooperator in jeopardy.

And we have to completely wipe out that enterprise.

And we were fortunate that we were able to.

But it was it was it was tough.

Now, it was tough for you, too, personally, because you ended up getting chased down the freeway at one part at one point during this case.

Yeah, that made them a little tougher.

But yeah, I did.

And we had we had great protection with SWAT in the ATF, FBI and Columbus police, you know, really took care of me and my family as well as Doug said, who was my co counsel during that case.

So we felt I felt very protected.

So in my family for, you know, a good year when I was going on and this was a case from what time period this would have been really kind of ninety eight to two thousand violent crimes, a big problem.

And I just Columbus, Cincinnati, Dayton, Columbus, a huge problem.

And, you know, we really tried to we shifted our gears and we prioritized corruption.

We also do the same thing with violent crime and fentanyl cases, especially when it came to our cartel cases.

And yeah.

So anyone can you know, the county prosecutors are in charge of those kind of murder cases, the vast majority of them.

So someone commits a murder, there's investigation.

The police do the investigation and it's brought to the county.

We do with the help of the county prosecutors, quite frankly, kind of the longer term historical investigations where individuals have got away with it for a long time or enterprises have got away with for a long time, where people are afraid to cooperate, afraid to testify.

And those are the cases that we should focus on and have been over the past, I'd say six or seven years now with hearing about you being chased down the freeway, you were also involved in the prosecution of Saddam Hussein in Iraq.

And that was a time when you were enduring rocket attacks there.

Did it ever get to the point where it was overwhelming or it was just too much?

Or is this just part of the job?

I mean, this this seems like a lot to invest, and I've been part of the job.

Yes.

So it is Friday, of course.

You know, you get attacked by rockets and mortar rounds.

It's frightening.

But at the same time, you know, it's a team effort.

And particularly in Iraq, it was a team effort both with DOJ, who I was working with in my Iraqi colleagues.

But I mean, we were in bed with the military, you know, and it was you know, you see these 17, 18, 19 year olds, you know, you're getting rocket and you see them be professional and calm and do their job.

You know, at the time I was in my thirties and, you know, you realize, all right, these guys know what they're doing.

And so it did become overwhelming simply because of of everyone else's help.

When you were in the office, there was the case involving Republican former Speaker Larry Householder.

It feature the arrest of him, as well as Matt Borders, the chair of the Ohio Republican Party, but also the arrest of Democrat.

Democrats on Cincinnati City Council, Peggy Sittenfeld, Jeff Pastor, so you were asked to resign as part of a mass resignation when President Biden took over, though, you were appointed by President Trump.

Why don't U.S. attorneys stay on through different administrations like the FBI director does?

If your work is really non partizan, you're going to have to ask.

The president said it.

And it isn't just President Biden has done either.

President Trump did it to some extent and so did the president before him.

But there was a time, I think, in the in the 80s where that tended to happen a bit more.

But I think we're just had a partizan sort of by both sides, by the way, where, you know, there's just a clean sweep and people think they want to just change everything.

And I get that, you know, I'm not I understand it.

I understand the concept.

And I knew going into this job that that was I want to get fired by some that I'm just this one isn't sure which one, but this was not something you wanted you wanted to stay on.

Oh, yeah, yeah, yeah.

And I can't go back as a as an AUSA because that's there's a law.

We can't go back and work for federal government for five years after a presidential appointment, Senate confirmation.

So yeah, I, I had to leave.

As you leave the office, are you are you satisfied with what God accomplished?

I mean, again, as history making arrests last summer, some other things that have happened, some of the cases that you've been talking about here, are you are you satisfied with what you were able to accomplish in your fairly short time there?

No, no.

You know, there's a lot that I think we would have liked to done and more that I would again, I have no, I don't.

I'm disappointed, but I'm not disappointed at anybody for it.

But, yeah, I would like to have finished up a lot of those.

You know, I don't think I've I've been secret about that.

I've been on what I keep keep going with some of the things that happened.

But it's not once, you know, it's no one's fault.

It's the process.

And the work does continue with the people, the aide, the associate assistant attorney, U.S. attorneys who are the only people that left the office with me and yeah, the AUSA that on the case of these cases are fantastic.

Some of the best that we have, if not the best we have.

And then, you know, VPA Patel is the acting.

He was the first assistant both under me and under the Obama administration.

He'll be fair.

He's a bright career AUSA who's now acting U.S. attorney.

So I've got all the confidence and world, both in the USA on the case and VPA and finish up.

There's a history of former federal prosecutors and former US attorneys running for office.

I'm thinking of Chris Christie, Eliot Spitzer, Rudy Giuliani, Doug Jones, Dick Thornburgh.

You've said you don't do well sitting idly.

So could you possibly consider running for office?

I'd love to be an office holder.

I just want to run for office.

I know the concept of raising money.

It's just so I just and I understand that's what you have to do and to want to to to do that.

And it's not something that that I'm built for.

This week, DeWine announced DeVillers will join the investigation into thousands of fraudulent claims in the state's unemployment system.

He has a unique background in complex investigations and a background in dealing with matters with international components and connections.

DeVillers is now working at a Columbus law firm and at Bowling Green State University, where he'll look into the alleged hazing death of sophomore Stone Foltz.

He died earlier this month after an off campus event organized by Pi Kappa Alpha, which reportedly involved a large amount of alcohol.

Bowling Green is one of the forty seven so-called Hobb small towns and cities in Ohio, as defined by researchers at the Center for Community Solutions.

Thirty five of them have hospitals, which are the economic engines of those communities.

Brian Alexander explored the issue of the losses of major employers such as factories in small communities.

In his book Glass House, centered around the devastating fall and slow recreation of anchor Hocking in Lancaster, his hometown.

His new book, The Hospital, tells the story of the northwest Ohio town of Brian, where the hospital is the largest employer and was losing money before the pandemic.

Like in many small towns, you end up where political leaders, Chamber of Commerce types, they have begun to realize how important these hospitals are and to agitate on their behalf.

Because if that hospital closes down the damage that Brian has taken, especially since the Great Recession, is going to be massively compounded.

The same is true throughout especially more rural counties and small town counties in Ohio.

But all over the Midwest and in places like upstate New York, parts of the south where hospitals are closing.

When the hospital closes, the town continues to dry up.

I mean, it really can be the final nail in the coffin of a town.

So is the saving grace for a big health care system to come in or private equity to come in?

Is that what saves these hospitals?

Not necessarily so.

In the case of private equity, what often happens is private.

It actually would come in.

It would change from a nonprofit to a for profit hospital.

Private equity would then sell the land that the hospital sits on to a real estate investment trust.

They would take that money for themselves and then the hospital would be found to be leasing the land it used to own.

Therefore, adding to its debt burden and hospitals often close that way.

Now, in the case of a big system, so let's say that paramedic up in Toledo were to take over HWC and Brian or Parkview in Fort Wayne, Indiana, takes over.

Brian, let's just say that happens.

But what do they do?

Well, they don't need back office building anymore.

Those people lose their jobs.

They probably contract out for the housekeeping services.

They probably contract out for the food services.

So even if a hospital still exists, there are a lot of those employees lose their jobs and specialty care, which Brian does have things like pain clinic, a GI clinic, a women's clinic that may go away also because paramedics would say, look, we'll give you basic care and we'll have an emergency room.

But for specialties, you're going to drive into Toledo or go to our hospital in Defiance, Ohio.

So those jobs also leave so that nurses lose their jobs.

Those doctors no longer live in the town.

It really downsizes these hospitals.

And it also has an effect potentially on the residents there, because as you note and other researchers have noted, people in smaller communities, in rural areas quite often have health issues that they need specialists for.

You know, the book that the people in Williams County, the the white people in Williams County may have had more in common with poor black people in inner cities than they might have wanted to think.

And there are some health factors that are involved here that may not be able to get taken care of if indeed the hospital either goes away or shrinks.

That's absolutely correct.

And that the same is true in the broader context of this.

So I talk a little bit about food deserts in Williams County and the rise of the dollar stores.

Well, the same exact thing happens in neighborhoods in Dayton, Cleveland, Columbus, Cincinnati, Youngstown, Steubenville.

The dollar stores come in the small grocery store that used to stock fresh fruits and vegetables and so on that goes out of business.

And then people start to eat even worse diets than before this.

These sorts of forces are what I mean when I say that urban black people and some of these rural white people, which may seem to be at opposite ends of a spectrum, they're actually in the same basket.

And I think if they were to ever realize how much they have in common, they could be really quite a potent force.

Now, it's kind of amazing that the largest employer in Ohio now is the Cleveland Clinic and nearly half of Ohio's employers, top employers are in the health care sector.

18 percent of the American economic engine system is health care.

But hospitals are still in danger of going under and people still potentially don't have care.

We have better technology, but lower life expectancy.

How is all this?

Has all this happened consolidation?

I mean, look at the Cleveland Clinic, which is officially nonprofit.

Same with America, same with Mersea, same with Ohio Health.

They're all nonprofit.

In fact, they're giant corporations and they're taking over entire regions.

When they do that, they have pricing power and they can increase their prices, increase their rates, health insurance rates go up.

Insurance companies then consolidate to try to match up against the consolidated health systems.

Device manufacturers are consolidating.

So you pay more and more for a knee replacement, for example.

So this incredible consolidation leaves patients at the bottom end.

You are absolutely correct compared to our peer countries, rich Western industrialized countries, Americans live shorter lives.

We live in worse health and we pay an extraordinary amount more for health care than they do.

We're failing at this, even though we have this amazing technology, amazing science.

If you can afford it, you can access the best care in the world.

But the mass of Americans are having a harder and harder time doing that.

And as you note, there's often a conflict between the business of running the hospital and the mission of the hospital to care for the people in its community.

That's the central tension in the book.

How do you reconcile two, in my view, irreconcilable things.

One, you're running a business to you're supposed to be there is sort of an angel of mercy for people in need.

How do you do that when you've got to make a profit?

Now, these small community hospitals either make zero profit, are very, very small profit that might enable them to invest in a new machine or a new doctor or something.

Some of these big systems, they're making 10 percent, 13 percent in one case in Indiana, 48 percent margin.

That's essentially a 48 percent profit that they're making.

And yet they have this nonprofit status.

Don't pay those taxes.

It's a great deal for them.

And you are almost done writing this book and then the pandemic hits.

So you wrote an epilog.

How did that pandemic and what happened in the in the space of that epilog changed the whole focus of the book and what you were writing about it?

Well, it didn't to me.

To me, but the pandemic did was rip the paper off these fault lines that I described earlier in the book.

These are economic fault lines, inequality, fault lines, medical care system, fault lines.

And we want to pretend that these things aren't there because they're difficult.

These are difficult problems.

There's no doubt about that.

So the pandemic hits and it just blew all that wide open.

And so what do you get?

You get African-Americans, Hispanic Americans catching covid-19, dying from covid-19 up much higher rates than white Americans are.

Why?

Because they have low wage jobs, which we now like to call essential workers.

Right.

We applaud our essential workers, but we don't want to do much for them.

They're working in meatpacking plants.

They're working in hospitals oftentimes.

So they've got to be out working.

They can't be at home doing what we're doing right now, a zoo meeting.

And so it exposes all of that.

And it also exposed how consolidation in our health care systems.

Why didn't we have enough ventilators, for example?

Well, there's a reason for that.

It had to do with consolidation.

What happened to pay for some doctors?

Some doctors were actually fired out of emergency rooms.

Why?

Well, has to do with private equity owning the companies that staff emergency rooms.

So all these things are really exposed by covid.

And now it's like a raw nerve out there.

So is there the possibility the pandemic will open up some solutions here now that all this has been exposed, you have some hope that some of these underlying issues can be addressed, or is it potentially just going to get worse from here?

I do have hope.

So the one point nine trillion dollar bill that the government just passed just signed, what, a week ago, I guess it expanded the Affordable Care Act.

So the income thresholds are a little different now.

It's enticing some states that resisted Medicaid expansion.

It's enticing them to join and get their people some insurance.

These are all it also is more generous with the subsidies.

These are all good things.

Some of the antipoverty things that are in the one point nine trillion dollar bill that the argument is it's not related to covid.

Well, if you read the hospital, you realize it's all related and those things are going to get kids out of poverty.

For example, 30 percent decrease in child poverty is the estimate that will help Americans health.

So I am hopeful.

It's a it's a bright spot.

However, I want to say that I I really had concluded by the end of doing this and I did not go in thinking this the ultimate solution is to blow it all up and start over again.

And this will be painful.

It will be disruptive.

But I think we are going to have to face the music.

We can put bandaids on things like the measures I have just talked about.

That's helpful.

It's good.

But really completely reforming the system from the ground up is what I think is ultimately going to have to happen because it's not sustainable.

Last year, Northeast Ohio's university hospitals merged with Lake Health and Nationwide Children's Hospital in Columbus announced it would require Mercy Health Children's Hospital in Toledo.

The much smaller EDDINE health system based in Chillicothe, is planning its fourth acquisition this year.

And that's it for this week.

Please check out the Ohio Public Radio and Television Statehouse News Bureau website at statenews.org.

And you can follow us and the show on Facebook and Twitter.

And please join us again next time for The State of Ohio.

Support for the statewide broadcast of the state of Ohio comes from Medical Mutual, providing more than one point four million Ohioans.

Peace of mind with a selection of health insurance plans online at Medd Mutual dot com slash Ohio by the law offices of PorterWright Morris and Arthur LLP.

Now, with eight locations across the country, PorterWright is a legal partner with a new perspective to the business community, Morad PorterWright dot com and from the Ohio Education Association, representing one hundred twenty four thousand members who work to inspire their students to think creatively and experience the joy of learning online at O H E A dot org.