If you passed Reuben Bresler on the street you likely would not guess the 25-year-old had a care in the world, much less health issues.

“I don’t look like I have a pre-existing condition, right? Unless I point it out,” Bresler said.

But the recent Ohio University graduate takes several medicines a day to keep his Type-I Diabetes under control.

And there was a time when Bresler was not sure how he would pay for his Insulin and other medications.

“There was a gap. It was like four or five months before the current health care thing kicked in but after the old one had sort of started working for me that I basically just didn’t have insurance,” he recalled.

Bresler remained on his parents’ health insurance until he finished his English and film degrees. But once he got his diploma, he was no longer covered.

That was the story for many young adults, a situation made worse by the weak economy.

With no job prospects, Bresler faced, on the low end, a $420 monthly pharmacy bill. And that did not include syringes or blood testing strips.

“That was not fun. That was pretty difficult…you know, I sort of told my doctor’s about the situation. And they’d seen it with lots of other people…But they worked with me to be like, ‘alright we’ll try to figure something out. And we’ll hope for the best for you,’” Bresler said. “Yeah, it was pretty hectic there trying to scramble.”

But a provision in the Affordable Care Act let Bresler get back on his parents’ health insurance. The law allows parents to keep adult children on their family policies until they are 26 years old.

“Most people are graduating when they are 22 or 23. That gives them a couple of years to try and find a job. That’s all people really need is they need a little gap; they need a little bit of a chance to get there. And without that, there’s no chance, right? You’re sort of tripping on the starting line,” he said.

The law took effect in 2010, and some states have adopted certain conditions and increased the age. In Ohio, a young adult can stay on until age 28.

Bresler finally found a job, albeit out of state. But it offers health insurance. He said he’s not worried about himself. Instead, Bresler said he’s concerned for other recent grads

“I think it’s important to realize it’s an issue for everybody. And people like me can be a symbol of that. It’s not just for people who know people who are sick. It’s for people who know people who are sick. It’s for people who could be sick in the future. And I think it’s sort of short sighted of people to assume it’s not their issue,” he said.

Whether young adults will continue to benefit from the law depends on the Supreme Court’s decision this summer.

One major change involves record keeping. The health care law requires hospitals to have electronic medical records. The goal is to reduce medical errors and cuts costs.

The OSU Medical Center finished its conversion to electronic records last year. But CEO Dr. Steven Gabbe said the medical center began planning for the switch in 2008.

“Our patients have full access to the electronic medical record, they can see the results of their tests, they can communicate with their doctors and nurses,” Gabbe said.

E-records also are expected to cut back on duplicate testing. Let’s take blood tests for example. Doctors within the same health system would be able to review a patient’s record and see blood work results instead of ordering and paying for another blood test.

Ohio Health also began integrating electronic records before the law was passed. Now the system is making sure their system matches the law’s requirements.

Another requirement stands to affect hospitals more. Beginning next year, some hospitals taking part in a pilot program will start to change how they charge patients and insurance companies. Hospitals are encouraged to switch to bundled payments.

Right now, if you’re on Medicare and you go to the hospital for say, a gall bladder attack, lab fees, radiology fees and doctors’ fees all are charged separately. Under a bundle payment, hospitals would receive one flat rate.

Ohio Health president and CEO David Blom said the goal is to lower the cost of treatment.

“If there’s an episode of care that costs $9,000, if the provider community can do it effectively and efficiently for less than $9,000, those dollars are kept by those folks. If it costs more they are at risk for it. So the bundle payment is intended to create the incentives for all parts of the systems to deliver it more efficiently and effectively,” Blom said.

Neither OSU nor Ohio Health will be taking part in the federal bundle payment pilot program. Ohio Health is reviewing it.

But OSU’s Steven Gabbe said the system is equipped to handle bundled payments if they’re implemented.

The new health care law also requires hospitals to cut re-admissions – patients who have to go back to the hospital for preventable follow-up visits. As many as a quarter of people who are hospitalized for serious ailments such as heart attack are back in the hospital within a month of being discharged.

Beginning in fiscal year 2013, the health care law would penalize health systems for excessive re-admissions for pneumonia, heart failure and heart attack. OSU’s readmission rates are in line with the national average – about 25 percent. Dr. Gabbe said a key component to reducing re-admissions is communication.

“If the patient has his or her medications, if they have a follow up visit within a short time…we communicate effectively with their primary care physician in their community we can prevent that readmission,” Gabbe said.

Gabbe anticipates this readmission penalty will include additional conditions as the law tries to contain costs.

Ohio Health’s David Blom said he’s not worried about the program’s penalties.

“Yes, there is a revenue issue there but it’s not sufficiently concerning for us as we really think about this. We’re focused on minimizing the number of re-admissions,” Blom said.

If the Supreme Court upholds the law, nearly one million additional Ohioans will be eligible for medical care.

Both Gabbe and Blom anticipate a shortage of physicians.

Blom said Ohio Health has hired more primary care doctors. As the way health care is delivered changes, Blom expects doctors will be spending more time with their patients.

“If we can coordinate the care by deeper relationship of a patient with their primary care physician, they can avoid perhaps other steps in the system with specialists because they’re dealt with on the front end,” Blom said.

Gabbe said preventive clinics with pharmacists and nurse practitioners will have to be used more to meet the need. But that won’t be enough.

“We think we will need to train more physicians. And there’s been talk about shortening the length of time students need to be in medical school. We think we need to train more nurses.” Gabbe said.

But what if the U.S. Supreme Court strikes down the law? Gabbe and Blom maintain their hospitals will continue on the same path to make health care more efficient and effective.

“Well we will continue on the same course and follow the same strategic plan that we have today,”Gabbe said.

“It won’t be for naught. We need to reform the health care system…the economy will not be able to withstand the current escalation of health care costs over the long term,” Blom added.

Marion Thompson arrived at the Columbus Zoo in a large red truck pulling a long, steel trailer.

Waiting just beyond the fence were zoo workers, U.S. Department of Agriculture officials and the animals: two leopards, two primates and a brown bear.

One of the leopards growled as its cage was hoisted into the trailer. A fork lift had to be used for the bear.

Thompson greeted each animal, peering into the crates.

“We feel like we’re losing one of our family,” Columbus Zoo President and Chief Executive Officer Dale Schmidt said. “They’re going off to somewhere where we’ll never see them again, and we’re concerned for their welfare.”

The zoo’s Chief Operating Officer Tom Stalf said the conditions at the Thompson farm last fall were unacceptable.

“Not only was the area not clean, feces and mud and debris and the lack of shelter, but the space wasn’t appropriate and nothing for enrichment. These animals were in very small holding areas and didn’t have much of a life,” Stalf said.

The USDA also was interested in the animals’ welfare. Schmidt said agents requested to be at the exchange.

“They want to find out where they’re going to go,” he said.

USDA representatives followed Thompson as she and the animals left the zoo. But Schmidt said they have no legal grounds to inspect her private farm.

Most of the 50 or so exotic animals released from the farm last fall were shot and killed by Muskingum County Sheriff’s Deputies before they could be captured.

While Sheriff Matt Lutz said no one has called his office to complain about the animals’ return, he does not expect most area residents are pleased about it.

“I think our community feels very blessed and very lucky that we were fortunate enough that nobody got hurt out of the last incident. And I think the majority of the public does not want them back in our county,” Lutz said.

The sheriff said his office will monitor any complaints about the farm.

Schmidt said he blames the state officials for the animals’ current position.

“For not having a law in place prior to this that says you have to have certain standards and you have to follow certain guidelines,” Schmidt said.

State legislators now are considering a bill to restrict the ownership of exotic animals beginning in 2014.

Thompson did not speak to reporters. And it’s unknown if she will repay the zoo the $120,000 it has spent caring for them.

Come Thanksgiving, the Hollywood Casino is expected to be teeming with the dings and bells of slot machines and, of course, people, including 2,000 employees. And many of them will be dealing the cards and running gaming tables.

The casino opened its career center to online applicants who met the basic job requirements. Fifteen-thousand people already have applied for more than 600 dealer positions.

Shawn Williamson, from Obetz, is one of them. Williamson drove a school bus, but she was laid off.

“When I heard they were coming here I was hoping and praying that I’d have a chance to get in,” she said.

And Williamson likely had a leg up on some of the applicants. From Atlantic City, she used to deal blackjack. But like everyone else, Williamson will have to take the mandatory dealer classes. She’ll study poker and craps.

“The more games you have the more valuable employee you are. And you don’t have to deal the same game all the time, repetition, repetition, switch it up. Helps keep you on your toes,” Williamson said.

Samuel McCauley, from the West Side, also is unemployed; in his case, for more than a year.

“I’m still looking for a job. Every time I go somewhere I’m either overqualified, under-qualified, I want too much money,” he said.

McCauley’s never dealt cards before, but he’s convinced he can do it.

“We have to go to school, it’s five days a week, four hours a day for anywhere from six to eight weeks. [Wow, that’s a pretty big commitment.] Yes, it is. [Do you think you’re going to like it?] Oh, I’m going to love it. I like people. I always have a good time,” McCauley said.

Treesje Mock, from the South Side, has a full-time job right now. But the company Mock works for was recently bought out.

“So, I don’t know what the future holds. So this gives me the opportunity to have my foot in the door,” Mock said.

The dealer course that Mock, McCauley and Williamson will have to take costs $200, and the casino will reimburse them once they’ve successfully completed it.

Casino general manager Ameet Patel said the average completion rate for these classes is between 70 and 80 percent.

“I think the process is a big part of it. If you commit to looking for an online application; if you commit to coming here on your scheduled time, on time, if you commit to panel interviews; if you commit to a dealer school, chances are, your commitment level is very high,” Patel said.

Many of those who applied for Hollywood Casino jobs say they also applied for positions at the Scioto Downs Casino, which is expected to offer video lottery terminals.

“Columbus Police. If you’re in here sound off.”

Police officers went from room to room making sure everyone who had been staying at Motel One had received word to leave.

“25 is clear.”

Police escorted out a couple of stragglers: an elderly woman and a man. But the rest of the tenants were gone by noon. Many toted plastic garbage bags or laundry baskets that held their belongings.

Thursday, Franklin County Municipal Court Judge Harland Hale ordered the motel temporarily closed.

Near the intersection of East Main Street and James Road, Motel One is known in the community for its unsavory clientele, police runs and unsanitary conditions. Since November, the state fire marshal’s office cited the owners more than 20 times for code violations. Police have been called to the motel hundreds of times in previous years.

As city workers cut pieces of wood to place in broken windowsills to deter break-ins, others placed large orange vacant signs on windows.

Area neighbors came to watch.

“This is a very good situation for the neighborhood,” Scott Huggins said.

Huggins, a life-long area resident who leads the Kel-Brook Block Watch, said the closure is a step in the right direction.

“We have been watching this building get worse and worse and worse. And it hides the beautiful family community that’s behind it,” he said.

Terry Moore has owned Murray’s Tool Rental across the street since 1979. Moore said the community has tried desperately to improve, but he said the motel has been a thorn in its side.

“I think that one step at a time. You can’t take that mile without the first step, and I think this is a very large step,” Moore said.

Ashley Ross and Dean Groves surveyed the action from a gas station across the street. Ross and Groves had been living at the motel. The two moved to Columbus from Pike County last month.

“We came here because it was affordable. And now we’re just, pretty much like he said, we’ll be living paycheck to paycheck. We’ll be broke paying for rent, you know. But right as of this moment we are homeless,” Ross said.

Owner Helene Steed did not return calls to WOSU for an interview. Motel workers declined to comment.

Next week, the City Prosecutor’s office will ask Judge Hale to make the closure permanent.

Motel One’s closure will be temporary. But Columbus City Attorney Rick Pfeiffer said his office will ask the judge next week to make that permanent.

“We’ve proved by a clear and convincing standard that the place is a public nuisance because it has had drug dealing, prostitution and many police runs,” Pfeiffer said.

Neighbors have complained about the rundown motel for years. And in recent weeks have held protests against its operation.

The state fire marshal’s office was set to have a hearing next month to consider revoking the motel license.

Compared to where we were, Central Ohio appears to be experiencing a housing boom.

In Dublin, the number of residential building permits issued the during first quarter more than doubled, up 163 percent over last year. That sounds good, but not really. Dublin went from 11 permits last winter to 29 this year.

Columbus and Canal Winchester each saw modest gains.

Columbus-based real estate researcher Rob Vogt said don’t put too much stock in the numbers.

“I don’t think you can take away too many conclusions from just a couple of months of data. I think it’s important to take a look at the long term,” Vogt said.

Vogt said single family home builds have been flat since 2008 when the housing bubble burst.

He said new builds are tied to consumer confidence.

“Never in the history of housing have we had such affording housing rates that we have today, and if we’re not able to get these first-time home buyers to buy a house today with such really unprecedented interest rates, it’s going to be tough to get them to come out,” Vogt said.

Jim Hilz of the Building Industry Association of Central Ohio is slightly more confident about the new figures. Hilz said the industry is seeing an increase in permits and sales. And he said builders are gaining more confidence.

“As builders are planning for the future they’re concerns are different in terms of where they’re going to build. And that’s something that we haven’t heard in a while. And there is talk about land development again and about developing residential neighborhoods which is a good sign,” Hilz said.

To keep things in perspective, Columbus issued about 2,400 residential permits last year. In 2003, the city issued more than 12,000.

If it’s Wednesday at noon, you can expect to hear the tornado sirens. The sirens are tested each week to make sure they’ll work in the event of a real threat. They’ve sounded three times this year in Franklin County for real warnings and 42 times across the state.

Since 2007, the number of tornado warnings issued for Ohio has tripled. The reasons why are pretty simple: more severe weather and better technology.

But because we’re hearing the warnings more often experts admit they’re becoming less effective.

“The county is very large so I tend to go to a weather station first to find out where it is. So, seriously enough to check, but not seriously enough to dash to the basement,” Johanna McKenzie, of Columbus, said.

Rachel White, also of Columbus, said does not take tornado warnings very seriously, “Because most of the time it never amounts to anything…it seems like so many instances of like them going off and nothing happens. Like, there it goes again, another day.”

That ambivalence is even worse in Plains states which can experience hundreds of tornadoes a year. Meteorologists call it “car alarm” syndrome, where something is heard so often it becomes background noise.

A storm last spring provided a tragic illustration. Last May, a tornado warning was issued for Joplin, Missouri. As the tornado moved toward the city, it intensified to an EF 5, the most violent kind. Not everyone heeded the warning, and 160 people died.

To try to overcome complacency in Tornado Alley, the National Weather Service is trying out a new warning system in Kansas and Missouri.

“The intent is not to scare, but it is to inform,” Meteorologist Mike Hudson said.

Hudson is chief operations officer at the Kansas City National Weather Service. He read the most severe warning.

“This is a life threatening situation. You could be killed if not underground or in a tornado shelter. Complete destruction of entire neighborhoods is likely. Many well built homes and businesses will be completely swept from their foundations. Debris will block most roadways. Mass devastation is likely making the area unrecognizable to survivors.”

Hudson hopes the impact based warnings will help people relate to a storm’s potential.

Not all warnings will sound as intense as the one in this report. A catastrophic tornado warning will be reserved for Joplin-like tornadoes that have been confirmed on the ground. The other impact based warnings describe situations of significant building damage, uprooted trees or roads blocked by debris.
Columbus is not Tornado Alley. And the old warning system remains in place here.

About 70 percent of the time tornado warnings are false alarms. That’s because the current radars allow the National Weather Service to issue a tornado warning about 13 minutes before a tornado actually forms, if it ever does. Channel 4 Meteorologist Ben Gelber admits there’s a delicate balance between safety and crying wolf.

“There’s no guarantee a tornado will drop from the clouds, so you issue a warning to cover a wide area just because there’s that small chance, but a very real risk once rotation is established. Trouble is, the public has heard so many warnings that there’s a tendency to wait until something is dangerously close. And if you have a storm that’s moving at 40 or 50 mph that can be too late,” he said.

Gelber said the only answer to what he calls “crying wolf” warnings is a radar set to be at the weather service’s finger tips later this year. Gelber said the new technology will give meteorologists a 3-D look inside a thunderstorm where tornadoes form.

“The hope is that technology will reduce the number of warnings when nothing touches down. In other words, a forecaster will have a better since of a real risk of a rotation leading to a tornado,” Gelber said.

The National Weather Service could decide this fall if the new impact based warnings will be used everywhere.

Rachel White, who earlier said she does not heed tornado warnings, said an impact based warning might change her mind.

“Yeah, that would definitely make me take it more seriously.”

Family members of victims the Christmas Eve house fire were outraged over what they considered a light sentence for troubled landlord Sam Vazirani.

Franklin County Municipal Court Judge Harland Hale whittled down an 18 month jail sentence to just one month for Vazirani who pleaded no contest to 21 misdemeanor housing code violations.

Vazirani faced charges in connection with two rental properties. The city ruled them uninhabitable, but he leased them anyway. One of the houses was 90 Wisconsin Avenue, where Jerrica Francisco, her four-year-old son, DaShawn, and friend Demetrius Chappel died after a space heater started the fire.

Jerry Moss is Francisco’s brother.

“Thirty days is not enough time. This is not justice, at all,” Moss said.

Vazirani tenants have complained broken furnaces, busted water heaters and sewage problems go unfixed for months. Before sentencing, Judge Hale heard from a number of family members and Franklinton-area residents who spoke out against Vazirani’s negligent practices.

“Due to all the lies Sam told my brother Demetrius Chappel and Jerrica Francisco their lives were cut very short,” Renata Miller, Chappel’s sister, said.

“So what if the sewage backs up onto the bathroom floor. So what if the gas lines are leaking and have to be shut off and require the families to use electric heaters in the bedrooms,” Susan Peters said.

But the judge also heard from a few Vazirani supporters. Kevin Williams began renting from Vazirani in late February.

“He’s always asking me how do I like the home,” Williams said.

In addition to jail time, Judge Hale ordered Vazirani to pay a $5,500 fine and court costs. And once Vazirani is released from jail, he will be placed under indefinite house arrest and five years probation.

The landlord, 72, also was ordered to repair all of his rental properties and not to rent any until they pass inspection.

City Prosecutor Bill Hedrick asked for the stiffest penalties for this case: 18 months in jail and a $10,000 fine. But Hedrick said he thinks the judge’s sentence sends a message to other negligent landlords and allows Vazirani fix up his properties.

“If the maximum had been administered like the judge said it we would have lost the ability to do anything about the properties in question. If he doesn’t do what he’s supposed to with those properties he still could be looking at all those days in jail, so this chapter may not be over,” Hedrick said.

Family members wanted Vazirani charged with reckless homicide, but the county prosecutor’s office said it did not find enough evidence for the more serious charge.

John Mallett, 37, faces 10 felony counts related to the March 14 stabbings at a downtown Columbus office building. Five of those counts are for attempted murder.

Four for each of the stabbing victims Franklin County Prosecutor Ron O’Brien said, and one for Columbus Police Officer Deborah Ayers.

“She was treated by the grand jury as a victim as well since he came at her wielding knives,” O’Brien said.

Ayers shot Mallett multiple times before he was captured.

Mallett’s father has said his son is schizophrenic and might have been under stress at the time of the stabbings.

O’Brien said whether Mallett’s mental health will be used as part of his defense likely would be brought up by his attorneys at next week’s arraignment.

“If you are competent to stand trial then you could have an examination requested regarding whether at the time of the offense due to a mental illness you knew the difference between right and wrong,” O’Brien said.

Investigators say Mallett carried three knives into 150 East Gay Street, which houses a career college and offices for Ohio attorney general staff. They say the attack appeared to be random.

O’Brien said Mallett faces a 55-year prison sentence. He is being held on $5 million bond.