Sam Page of St. Louis County: Indictment, Ethics Probe, and Exit

Sam Page is the Democratic County Executive of St. Louis County, Missouri, a former anesthesiologist who took office in April 2019 after his predecessor resigned amid federal corruption charges. He is now facing his own four-count criminal indictment over mailers his office sent before a 2025 ballot measure, a separate county ethics investigation into whether he has kept practicing medicine in violation of a voter-approved ban, and open budget warfare with the County Council. In December 2025 he announced he would not seek a third term. His criminal trial is set for January 2027.

How He Became County Executive

Page served in the Missouri House of Representatives from 2003 to 2008 and won a special election to the St. Louis County Council in 2014, representing District 2. He was elected council chairman in 2017 and spent much of the next two years feuding with then-County Executive Steve Stenger over spending, leading a council effort in December 2018 that cut $35 million from Stenger’s proposed 2019 budget.¹

On April 29, 2019, Stenger resigned the same day he was indicted by a federal grand jury for steering county contracts to a major campaign donor. The county charter required a Democratic replacement, and the council appointed Page on a 5-1-1 vote, with Councilwoman Hazel Erby dissenting and Page abstaining. Taking the $140,000-a-year job required Page to resign from his anesthesiology practice.²

Elections and the Outside-Employment Ban

Page won a November 2020 special election with about 58% of the vote against Republican Paul Berry III, a race that turned largely on his COVID-19 restrictions.³ He returned in 2022 for a full four-year term, winning the Democratic primary over attorney Jane Dueker with 63% and going on to defeat Republican Katherin Pinner in the general.⁴

That primary was shadowed by an April 2022 charter amendment, approved by more than 61% of county voters, that barred the County Executive from holding outside employment under penalty of forfeiture of office.⁵ The council, on a 4-3 vote led by Republican Tim Fitch, had placed it on the ballot after questions about whether Page was still practicing medicine.⁶ Page separated from his medical practice after Dueker pressed the issue.⁴ That amendment now sits at the center of a second investigation described below.

The Felony Indictment Over Proposition B Mailers

In April 2025, St. Louis County voters considered Proposition B, a charter amendment that would have let the County Council fire department heads and the county counselor on a vote of five of its seven members. Voters rejected it 62% to 38%.⁷

Before the vote, Page’s administration used county funds to produce and distribute more than 50,000 mailers about the proposition, each carrying a “paid for” line reading “St. Louis County.” Page said the mailers were “informational only and did not advocate a position.”⁸

University City activist Tom Sullivan filed complaints with the Missouri Secretary of State and the Missouri Ethics Commission. Secretary of State Denny Hoskins’s office investigated and referred the matter to the St. Louis County Prosecuting Attorney, Melissa Price Smith, who cited a conflict of interest. A judge then appointed Missouri Attorney General Andrew Bailey as special prosecutor.⁹

On July 30, 2025, a grand jury returned a four-count indictment: two felony counts of stealing by deceit tied to the alleged misuse of more than $35,000 in county funds, and two misdemeanor election law violations under § 115.646, RSMo.¹⁰ A conviction on every count would carry up to 13 years in prison and $24,000 in fines.⁹

Page pleaded not guilty, waived his right to a speedy trial, and hired attorney Jeff Jensen. He told the council after the indictment, “I can’t imagine that anyone has done anything wrong,” and confirmed he had turned over his phone to investigators.⁸

His defense is largely a selective-prosecution argument. Page’s lawyers have identified 34 Missouri public entities, including the cities of Creve Coeur and Kirkwood and the Clayton School District, that they say sent “virtually identical mailers” using public funds without being charged, and they contend no one has ever been criminally charged under the statute before.¹¹

The case was moved to Greene County Circuit Court in Springfield to secure a neutral jury pool. In December 2025, Judge Kati Greenwade denied an initial motion to dismiss. After the original trial date was postponed in March 2026, Greenwade reset the trial for January 25, 2027, with proceedings expected to run five days. Two defense motions remained pending as of June 2026: one arguing the state failed to clearly explain the misdemeanor charges, and another seeking dismissal for political motivation.¹²

The Ethics Investigation Over His Medical Work

A separate track opened in early 2026, when the County Council launched an ethics investigation into whether Page had violated the 2022 charter ban on outside employment. Records subpoenaed from SSM Health showed Page was connected to 330 instances of medical care at Saint Louis University Hospital between June 2023 and April 2026.¹³ Page’s office said he “volunteers a few hours a week at a hospital and enjoys helping patients,” and Page called the inquiry an “unserious spectacle.”¹⁴

In May 2026, the council voted 6-1 to forward the ethics committee’s findings to county and state prosecutors for possible action to remove him from office. The county prosecuting attorney’s office again recused itself and asked the Missouri Attorney General to take the matter.¹³ If the outside-employment allegations are proven, the 2022 amendment requires Page to forfeit the office.⁵

Budget Fights and the Travel-Authority Lawsuit

Page’s relationship with the County Council collapsed further after the 2024 elections, which left Councilwoman Lisa Clancy as his only reliable ally.¹⁵ In December 2025 the council adopted a 2026 budget that cut roughly $48 million from Page’s proposal.¹⁶

Page called the fiscal situation a “budget thunderstorm watch.” In February 2026, his administration closed the West County Government Center, reduced hours at three other offices, and announced two public pools would not open for the summer.¹⁷ He also identified $8.6 million in urgent needs, including jail elevator maintenance, courtroom space, and police security systems, and asked the council to reappropriate unspent funds.¹⁶ The two sides also traded blame over a roughly $6.4 million shortfall across seven departments, with Page citing council math errors and the council’s budget coordinator citing bad data from Page’s office.¹⁸

In April 2026, Page sued the council and its chairwoman, Rita Heard Days, to block a September 2025 ordinance that would automatically transfer executive authority to the council chair whenever the County Executive traveled outside the continental United States. Page argued the ordinance violated the county charter and that “we can’t have two county executives.”¹⁹ On April 16, 2026, Judge Mary Elizabeth Ott granted a temporary restraining order barring the council chair from acting under the ordinance during Page’s trade mission to London, finding the balance of harms favored preventing “confusion as to who constitutionally holds executive authority.”²⁰

Not Running Again

Page announced on December 18, 2025, that he would not seek a third term, saying, “Too many leaders have forgotten that courage means standing up for what’s right, not what brings them headlines or takes someone else down.” By then, State Senator Brian Williams had already launched a well-funded primary challenge, the felony indictment threatened both his candidacy and his medical license, and the council had just passed a budget he considered crippling.¹⁵

The August 2026 Democratic primary to succeed him drew three candidates: State Senator Brian Williams, State Senator Angela Mosley, and St. Louis County Assessor Jake Zimmerman.²¹

1
West Newsmagazine. Dr. Sam Page Takes the Helm as County Executive
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Call Newspapers. County Council Selects Sam Page as County Executive After Stenger Resigns
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St. Louis American. Dr. Sam Page Wins County Executive Race
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Spectrum News. Sam Page Wins Democratic Nomination for St. Louis County Executive
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FOX 2 St. Louis. St. Louis County Voters Ban Sam Page From Having a Side Job
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St. Louis Public Radio. Can the St. Louis County Executive Have a Second Job? Constituents Will Decide
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St. Louis Public Radio. St. Louis County Council Proposition B
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St. Louis Public Radio. St. Louis County Executive Sam Page Indicted on Felony Charges
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Missouri Independent. Grand Jury Indicts Top Democrat in St. Louis County Government on Felony Charges
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Missouri Attorney General. Attorney General Bailey Secures Felony Indictment Against St. Louis County Executive Sam Page
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St. Louis Magazine. Page Criminal Charges Selective Prosecution
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St. Louis Public Radio. St. Louis County Executive Sam Page to Go on Trial in January Over Campaign Materials
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Spectrum News. County Council Investigates County Executive
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First Alert 4. St. Louis County Executive Sam Page Faces Ethics Investigation Over Second Job Allegations
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St. Louis Public Radio. St. Louis County Executive Sam Page Reelection
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St. Louis Public Radio. Sam Page St. Louis County Budget
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St. Louis County. County Executive Page Details Service Reductions Due to Council’s Budget Cuts
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Spectrum News. St. Louis County Budget Possible Errors
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St. Louis Public Radio. Page Sues St. Louis County Council
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Spectrum News. Page Lawsuit Over London Trip
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St. Louis County Democratic Central Committee. Democratic Candidates August 2026 Primary