Duval DOGE Special Committee

Tuesday, May 5, 2026 11:00 AM City of Jacksonville 117 W. Duval Street Jacksonville, FL 32202 Meeting Minutes Council Chamber, 1st Floor, City Hall Duval DOGE Special Committee Council Member Ron Salem, Chair Council Member Chris Miller, Vice Chair - Excused Council Member Raul Arias Council Member Mike Gay - Excused Council Member Rory Diamond Legislative Assistant: Rebecca Bolton Council Research: Steven Libby Auditors: Kim Taylor and Brian Parks OGC: Mary Staffopoulos Duval DOGE Special Committee Meeting Minutes May 5, 2026 Meeting Convened: 11:00 a.m. Attendance: CVP Howland CM Carlucci I Call to Order and Introductions Chair Salem convened the meeting and called for introductions. II Public Comment No public comment cards were submitted. III Update on Telehealth - CM Diamond CM Diamond stated that documents reviewed by the telehealth subcommittee indicate the City could have saved $2 million by not entering into the Telescope Health contract. He stated that Telescope Health provided telehealth services to those who might be interested in going to the ER when someone dials 911, while multiple free options are available, including RightSite. He stated that the City has a longstanding contract with RightSite, and that the difference between the two providers is that Telescope Health bills the City more than $2 million for its services, while RightSite and similar providers do not bill the municipality but instead bill private insurers, Medicare, and Medicaid, and provide services at no charge to indigent patients, with costs averaging out across the patient population. CM Diamond recommended that the City use a free service, either RightSite or another entity, and stated that Telescope Health's services have not saved the City money but have saved money for the hospitals. He stated that he had provided a copy of the report to Telescope Health for its response and held multiple meetings with Telescope Health for feedback. CM Diamond stated that the subcommittee investigated potential Medicare and Medicaid fraud at Telescope Health, but ended the investigation upon learning that Telescope Health does not bill Medicare or Medicaid patients, and made no conclusions on that question. He stated that the subcommittee also investigated illegal conflicts of interest, including those of Dr. Thompson, and found that he filed the proper paperwork and did not violate any state statute, and that the subcommittee found no violation of law by Dr. Thompson or by anyone at Telescope Health. CM Diamond recommended that, when budget season begins, all contracts be scrutinized to ensure the City is realizing actual savings, and stated that he was concerned the Telescope Health contract was a no-bid contract. A motion to adopt the telehealth report was moved and seconded. Chair Salem stated that he had never been in favor of the Telescope Health contract and believes it represents government overreach in healthcare. He stated that he was astounded RightSite had provided significant training to JFRD but, for reasons unclear to him, the service had not gained traction with JFRD. Page 1 of 8 Duval DOGE Special Committee Meeting Minutes May 5, 2026 Chair Salem stated that if RightSite is to serve as the City's free telehealth provider, the public needs to have confidence in the program for it to be successful. He stated that during the last budget process, he had asked repeatedly why the hospitals were not supporting Telescope Health if the program was saving them money. He stated that the subcommittee's investigation revealed that Baptist Health owns 10 percent of Telescope Health. Chair Salem stated that RightSite has been successful in other cities and can be successful in Jacksonville if embraced by JFRD and other relevant entities. He emphasized that Telescope Health does not save the City money. CM Arias asked CM Diamond how many years RightSite has been under contract with the City. CM Diamond stated that he believed it had been four years. CM Arias asked CM Diamond whether there was a reason the City had decided to use Telescope Health rather than RightSite. CM Diamond stated that the issue is that JFRD must direct individuals to the free service, whereas Telescope Health and the Mayor's administration created Healthlink JAX as an alternative model that does not bill Medicare or Medicaid patients and does not include insured patients. He stated there is no good reason for the City to spend $2 million. CM Arias asked whether other cities in Florida are using free telehealth services or paying for them. CM Diamond responded that Tampa, Orlando, and South Florida have different approaches to delivering telehealth services, though well-run cities use the free service. CM Arias asked why the City decided to invest $2 million in Telescope Health if there are no issues with RightSite. CM Diamond stated that campaign contributions to the Mayor's team may suggest why she chose this provider. CM Arias asked whether legislation could be filed requiring that any contract over a certain dollar threshold automatically go through a competitive bid process to prevent no-bid contracts. CM Diamond responded that the rule is already in place, but that the rules are often waived or contracts are written such that only one entity is eligible to apply. CM Arias asked, if Telescope Health were cut next year, what would happen to the $2 million invested and what would happen to telehealth services in Jacksonville. CM Diamond responded that if JFRD utilizes RightSite, the City could save $2 million for other priorities. Chair Salem stated that RightSite currently operates Monday through Friday for sixteen hours per day and would be open to providing 24/7 service if there was sufficient volume to justify it. CM Carlucci asked why he had not received a copy of the report at the same time as the Chair. CM Diamond stated that CM Carlucci was not a member of the committee and that they were doing committee work. CM Carlucci stated that it would be unfair for the Special Committee to adopt the draft report given that he had not had a chance to read it or provide feedback. CM Carlucci asked Kim Taylor, Council Auditor, whether the telehealth contract was a no-bid Page 2 of 8 Duval DOGE Special Committee Meeting Minutes May 5, 2026 contract. Ms. Taylor responded that there were three bids for the telehealth contract through an RFP process, and that RightSite was not among the bidders. CM Carlucci stated that he had many unanswered questions. He stated that RightSite could have bid on the contract but did not. He stated that RightSite responds only to individuals with insurance and bills the insurance companies, which allows it to provide its services at no cost to the City, whereas Telescope Health serves uninsured individuals and therefore requires payment from another source. He stated that more time was needed to review the draft report before adoption. CM Arias asked Mary Staffopoulos, OGC, whether the draft report would go to a standing committee for input before being voted on by Council. Ms. Staffopoulos responded that the report is currently a draft, so it would be appropriate for Committee members to make changes or address items in the draft. She stated that the Committee should clarify whether the motion's intent is to adopt the draft as presented and direct the drafter to finalize it into a final report. Ms. Staffopoulos asked the Special Committee for direction on what to do with the report, noting that Special Committees traditionally produce a final report that is sent to the Council President with findings and recommendations. She stated that Committee members may want to include next steps in their recommendations and that long-term recommendations could be transmitted to the Council President as recommended directives. She added that the Special Committee could also adjust its recommendations to seek input from a standing committee. CM Diamond moved to amend the motion to adopt the draft report, with modifications to Section VI, recommendations to the Council President, to include other no-cost providers with RightSite, change the requirement to JFRD to a recommendation, and specify that Dr. Elias would be advised by OGC and the City's Ethics Office. Ms. Staffopoulos informed the Committee that some of the recommendations would not be accomplished by the current Council President given the end of the Council Year on June 30, and that the Committee may need to discuss with the incoming Council President to implement all of the recommendations. Chair Salem emphasized that RightSite's model depends on insured patients and that RightSite is capable of serving indigent patients if there is a commitment to use the service for insured patients as well. Chair Salem stated that RightSite did not participate in the telehealth contract bid because the bid was limited to indigent patients rather than all patients. CM Arias asked for clarification on Recommendation 6, which provides that the Committee continue monitoring both programs and report back to the Special Committee in six months, given that the Special Committee may have concluded by then. Ms. Staffopoulos stated that, given that the Oversight Committee ordinance is going through the legislative process, the Committee may want to change Recommendation 6 to direct the report back to a permanent standing committee, and that the Finance Committee makes the most sense given its charge. Ms. Taylor asked for clarification on Recommendation 1 regarding what the Special Committee Page 3 of 8 Duval DOGE Special Committee Meeting Minutes May 5, 2026 was specifically seeking from the Council Auditors. CM Diamond stated that the primary concern is ensuring the Finance Committee is aware that a free option exists during the next budget process. Ms. Taylor confirmed that the Council Auditor's Office can perform the work CM Diamond described and noted that RightSite differs slightly in that it serves all patients rather than the targeted population specified in the Telescope contract. She stated that her office can present the challenges and implications of pursuing that option. CM Diamond stated that the question would be whether using the free option would increase costs elsewhere, and that his expectation would be that it would not. He cited the success of San Antonio's telehealth services in support of that expectation. Ms. Staffopoulos stated that, given the number of changes to the draft report being discussed, the Committee may want to direct OGC to prepare a final document as a redline and bring it back to the Special Committee for formal adoption at the next meeting. CVP Howland asked CM Diamond who authored the report. CM Diamond stated that the report was drafted by counsel to the Special Committee, with assistance from Jason Teal, Counsel to the City Council and Council Secretary, and with edits provided by CM Diamond and Chair Salem. CVP Howland asked what the authors were specifically charged with investigating. CM Diamond responded that the investigation was multi-faceted: whether there was Medicare and Medicaid fraud, which was quickly dropped; whether Telescope Health saved the City money; whether it saved hospitals money; and whether other services were available for free. CVP Howland asked if the charge to the authors was to look at only Telescope Health and RightSite, or at all telehealth providers. CM Diamond stated that the investigation looked at both providers and focused on RightSite because the City already had an existing relationship with the company. CVP Howland asked Ms. Staffopoulos whether it was possible for the administration to terminate the contract and rebid it to find the best provider. Ms. Staffopoulos stated that she had not reviewed the contract but that RFPs typically contain provisions favorable to the City. She further stated that the Committee can ask the administration to terminate and rebid the contract but cannot require it to do so. CM Arias asked what would happen if Council did not fund the telehealth contract in the next budget year. Ms. Taylor stated that if Council decided not to fund the contract, the administration would have to find alternative funding by reallocating existing funds. She stated that the contract amount would be too high to fully replace through reallocation, so the administration may only be able to partially fund the service if the Mayor remained committed to Telescope Health. The Special Committee unanimously approved a motion to direct OGC to prepare a redline of the draft report for formal adoption at the next meeting. IV Discussion on Oversight Committee - CM Diamond CM Diamond cited the existence of permanent oversight committees at the state and federal levels and in most municipal governments in proposing the creation of a permanent oversight committee for the City. CM Diamond stated that the City Council should have a platform to Page 4 of 8 Duval DOGE Special Committee Meeting Minutes May 5, 2026 investigate and ask questions, and cited the investigation into the potential sale of JEA. Chair Salem stated that he had gone back and forth on the proposal, considering whether the Finance Committee or a subcommittee of it should serve that role, versus an Oversight Committee that is not a standing committee but is constituted by the President as needed. CM Diamond stated that the proposed Oversight Committee could meet on a quarterly basis as a permanent committee, with members able to raise concerns and the President able to request investigations. CVP Howland stated that the City Council needs to provide oversight and that the Finance Committee does not have the time to address it. He asked Ms. Staffopoulos about the possibility of establishing a Select Committee that is convened at the request of the President. Ms. Staffopoulos explained that Select Committees are ad hoc committees that give exclusive attention to a single subject matter, are created by the President, and have a 60-day window that may be extended by the President. CM Arias asked CVP Howland whether multiple issues could be addressed through a Select Committee, similar to the Special Committee on Duval DOGE. CVP Howland stated that the purpose of a Select Committee is to prevent scope creep, citing the expansion of charges in the Special Investigatory Committee on JEA from two to five, and stated that the Special Committee on Duval DOGE is experiencing scope creep as well. He stated that the purpose of a Select Committee is to resolve one major issue before moving to the next. CM Diamond stated that he favors scope creep when there are legitimate issues to examine, and that he would prefer a permanent committee that allows all Council Members the opportunity to raise issues rather than only the President. CM Diamond stated his desire to hold a noticed meeting with several models for an Oversight Committee and allow all Council Members to provide input on what the Oversight Committee should look like. Chair Salem stated that he supports the idea. CVP Howland stated that Council Members always have the option of requesting that the President establish a Special Investigatory Committee if another issue arises that isn't being examined by the Select Committee. V Update on the 2% Lapse - Council Auditor’s Office Ms. Kim Taylor, Council Auditor, informed the Committee that the Council Auditor's Office had not received any requests from departments to restore funding. VI Purchasing Card (P-Card) Audit- Council Auditor’s Office Ms. Taylor presented the P-Card audit to the Committee. She stated that most P-Cards are assigned to individual employees, that the bulk of purchases are for training, travel, and dues, and that other purchases include items such as food for animals by Animal Care and Protective Services. Ms. Taylor stated that the Treasury Division, the Accounting Division, and the Procurement Division are jointly responsible for overseeing P-Card purchases. Ms. Taylor reported that, at the time of the audit, there were 111 active P-Cards across 33 departments, with 109 cards issued to individuals and 2 cards used by JFRD for emergencies. Ms. Page 5 of 8 Duval DOGE Special Committee Meeting Minutes May 5, 2026 Taylor reported that during calendar year 2024, there were 6,507 transactions totaling $2.1 million. Ms. Taylor stated that the audit examined whether purchases were appropriate, sufficiently documented, properly approved, accurately recorded, and timely processed. Ms. Taylor noted three internal control weaknesses: a lack of written policies and procedures for P-Card tasks performed by the Accounting Division, a lack of P-Card reconciliation, and several Merchant Category Codes that need to be blocked. The unblocked codes include those for internet gambling, timeshares, and amusement parks. Ms. Taylor added that the audit did not identify purchases of that kind but that blocking the codes would prevent them on the front end. Ms. Taylor noted that 202 transactions totaling $94,000 had missing or incomplete expense reports, with some outstanding for 200 days, and that $55,000 had not been reviewed or approved at all. She stated that after reviewing the transactions again two months after the initial testing, the audit team was unable to verify the legitimacy of purchases totaling a little over $10,000 due to a lack of supporting documentation. Ms. Taylor stated that some of those transactions were left pending due to employees leaving the City. Ms. Taylor reported that a small number of P-Cards belonging to former employees were not canceled in a timely manner. She noted that JFRD had reached out about the cancellations but was unaware that a new P-Card Program Administrator had been designated. She recommended the establishment of a generic email account for P-Card cancellations. Ms. Taylor reported that 3 P-Card transactions lacked proper authorization, including 2 travel-related purchases that did not have pre-approval. She stated that while gift cards can be purchased with P-Cards, a form must be completed for such purchases, and that one gift card purchase did not have proper authorization. She cited the use of gift cards by Military Affairs to assist veterans. Ms. Taylor noted that the audit team expanded its testing of travel-related purchases and found that the Risk Management Division lacked many pre-approvals. She added that expanded testing of gift card purchases identified $2,350 in transactions that lacked the required form. Ms. Taylor stated that City policy requires cardholders to submit expense reports within 7 working days and that 36% of transactions did not meet this requirement. Ms. Taylor further stated that the audit team identified one fraudulent transaction and, through expanded testing, found 59 fraudulent transactions totaling over $18,000 that were charged to a P-Card within JSO. She noted that if the cardholder had followed City policy, the fraud could have been identified and addressed sooner rather than persisting for 81 days. Ms. Taylor noted that over $13,000 in transactions were stuck in "Ready for Payment Processing" status and that expanded testing identified a total of $27,000 in such transactions. She stated that this is problematic because it distorts the department's expense reporting and leads departments to believe they have budget capacity they do not actually have. She noted that the issue was a system issue affecting court employees who were considered "contingent employees." Ms. Taylor noted that a few transactions were charged $211 in Florida sales tax, contrary to Page 6 of 8 Duval DOGE Special Committee Meeting Minutes May 5, 2026 P-Card policies. Ms. Taylor further noted that $153 in credit card fees were identified in the initial sample, with an additional $85 in fees found through expanded testing. She stated that the City will receive rebates to offset these charges under the new P-Card program with JP Morgan Chase. Ms. Taylor stated that the audit team also conducted testing to identify transactions that may have been split to circumvent the spending limit. The audit team found 2 transaction sets totaling over $13,000 that appeared to be split purchases, one within Mosquito Control and one within the Mayor's Office. Chair Salem asked Ms. Taylor for confirmation that P-Cards must be pre-approved for use when traveling. Ms. Taylor confirmed. Chair Salem asked Ms. Taylor for confirmation that reports must be filed to a supervisor within 30 days of returning from the trip. Ms. Taylor clarified that reports must be filed within 7 working days for P-Card transactions. She further clarified that P-Cards should not be used for per diems, and that her office is working on an employee reimbursement audit. Chair Salem confirmed with Ms. Taylor that per diems are for meals. Ms. Taylor confirmed and stated that employees would seek reimbursement upon return. Chair Salem confirmed the process with Ms. Taylor. Ms. Taylor stated that she believed the timeline is 7 days but noted that there are issues with advances that may dictate a 30-day window within the policy. Ms. Taylor further stated that when a P-Card is charged for hotel or other expenses, the cardholder processes that charge, and that an expense report is required within 7 working days from either when the traveler returns or when the charge occurred. Chair Salem confirmed with Ms. Taylor that there is an online portal where a supervisor can verify that charges are correct. Ms. Taylor clarified that the cardholder is responsible for reviewing transactions, but that there is a backup person who also reviews credit card statements. Chair Salem further confirmed that a statement is generated per card. Ms. Taylor confirmed. Chair Salem confirmed with Ms. Taylor that the controls in the process are not occurring consistently. Ms. Taylor confirmed. Chair Salem confirmed with Ms. Taylor that a third-party vendor could track the P-Cards and verify whether the controls in the process were being followed, for a fee. Ms. Taylor confirmed and stated that the Accounting Division holds the contract with Card Integrity, which oversees suspicious, fraudulent, or inappropriate transactions, while the Accounting Division ensures timeliness and is working on a notification system. Chair Salem asked whether the Card Integrity system caught the JSO case in which a card was used by someone else for inappropriate charges. Ms. Taylor stated that the charges were caught within JSO after review by the cardholder and managers. Chair Salem asked why Card Integrity did not flag the case much earlier. Ms. Taylor stated that she did not believe the system was in place at that time. Chair Salem asked Ms. Taylor how much the City is paying for Card Integrity's services. Ms. Taylor stated that she did not know but could find out. Chair Salem stated that he had previously made recommendations to Ms. O'Leary to reduce the number of P-Cards, and that she had reduced the number by approximately 10. He questioned why 109 employees need a P-Card given the potential for fraud and abuse. CM Arias asked who controls the P-Cards and whether the City Council has any oversight or Page 7 of 8 Duval DOGE Special Committee Meeting Minutes May 5, 2026 input over them. Ms. Taylor stated that the administration controls the P-Cards and that the City Council does not have oversight or input over them. CM Arias asked whether the audit team could provide a breakdown of who has a P-Card, which departments hold cards, and how much each department and individual uses. He asked whether the 6,507 transactions totaling $2.1 million is higher than prior years. He asked whether a breakdown of currently allowable MCC codes could be provided, and whether the City Council could send a list to the administration of codes that should not be allowed. He asked how it is possible for gift cards to be purchased if their purposes cannot be verified. CM Diamond recommended that the City implement a policy similar to the Army's travel card program, in which employees obtain credit cards through a private provider on their own credit. He stated that the cardholder must timely file a report to reconcile spending. VII Comments from Committee There were no comments from Committee members. VIII Adjourn Chair Salem adjourned the meeting at 12:23 p.m. Minutes: Steven Libby, Council Research slibby@coj.net, (904) 255-5147 Posted: 5/12/26, 4:00 p.m. Page 8 of 8