OPENPUBLICA · PUBLIC MEETING RECORD
Record of Proceedings

Final Doge Committee Meeting – June 16, 2026: Telehealth, Budget Lapse, and Health Insurance

City Council — Tuesday, June 16, 2026
BodyJacksonville, Florida
SessionCity Council
DateTuesday, June 16, 2026
StatusFILED
Video Record
0:00 / 1:18:59
Transcript — Verbatim
0:01

Good morning.

0:03

Welcome to the final Doge meeting.

0:10

Council members, I I just wanted to mention, I think I've said this before, but uh council elect uh president howland is has plans to go in a different direction in terms of this type of effort.

0:26

So I indicated to him that we would wrap up the last item, which is this insurance issue today, and give him the maximum flexibility to move in any direction he wants to.

0:40

So with that, let's begin with introductions to my far left.

0:46

Stephen Libby, Council Research.

0:48

Mary Stefopoulos, Office of General Counsel.

0:50

Brian Parks, Council Auditors Office.

0:52

Philip Peterson, Council Auditor.

0:54

Good morning.

0:54

Rory Diamond, District 13, the beaches.

0:57

Ron Salem, group two at large.

0:59

Morning, raw areas, district eleven.

1:01

My gay district two.

1:03

Will Lane and District 3 visit.

1:06

Matt Carluccia at large group for just visiting.

1:09

And are you going to be taking up the telehealth update?

1:13

Yes, I am.

1:14

Okay.

1:14

Thank you.

1:15

Yes, I am.

1:16

And uh Councilmember Miller is hoping to make it might make it, might not, is what I've heard.

1:24

Is there any public comment?

1:26

None.

1:27

Okay.

1:28

Um, I know you've got uh a couple of telehealth updates, please, sir.

1:37

Yes, sir, through the chair of the committee.

1:39

So uh our office was asked to look into um kind of comparing the two programs telescope uh through the Health Link Jacks initiative and then the um right site or a right site like um provider.

1:54

And uh so through conversations with both JFRD um with telescope and then with members of the mayor's office, uh we've ultimately come to the conclusion that the in their current form, these are two separate programs.

2:08

Um to do a true cost-benefit analysis, we would need to to have programs that kind of lined up together and provided the same service.

2:18

Um an easy um way to see that is is a dedicated phone line is set aside for uh Healthlink Jacks.

2:26

There's a specific phone number 904 925 care, and you can call that or or a resident can call that and receive services from Health Link Jacks.

2:36

Whereas the right site model in its current form, uh someone contacts 911.

2:40

You're you're obviously aware of this, but in order to get to right site, you have to go through 911.

2:46

And so that is a strain on 911 resources, it can be a strain on JFRD uh personnel depending on how the call is deployed.

2:54

Um so it in the in that manner, there are two different programs.

2:59

Um you obviously are aware of the clientele that they serve, uh, even though right site will take uh uninsured uh patients.

3:06

Right now, their model is for uh insured patients, whereas telehealth is specifically for uninsured.

3:13

Um, and then obviously the cost, we know that telehealth uh currently is a 1.5 million dollar cost to the city in the current year.

3:20

Wright site is a zero cost contract.

3:23

Um if right site were to expand into a different area or or expand their services to where we have a dedicated phone line, they're taking in more calls.

3:33

I don't know that that would remain the same.

3:35

Maybe it would, but until we until we got to that place, we wouldn't know.

3:40

And then lastly, uh the usage um, very aware that you reading the con uh the report that this Doge committee adopted.

3:48

Um right side just hasn't taken off given um a number of of instances.

3:53

Um maybe it's lack of training, maybe it's lack of involvement, maybe it's lack of marketing.

3:59

Uh, there's there's just not a dedicated push for a right site or a right side like concept.

4:05

So in their current format, two totally different um programs while maybe having the overall same goal, um, they they don't serve the same purpose, and so it's difficult to do a cost benefit analysis.

4:20

Uh, we were also asked to look into uh things that can I stop you right there and let council member diamond wanted to jump in.

4:28

Uh I know uh thank you through the chair.

4:29

I know you're doing the council auditors, you know, view of this, but just you know, just for folks listening, um, the issue here is that you have to dial 911 and you get to right site, whereas the city is paying for the this phone line and for telehealth.

4:44

But it would also be true that if instead of getting the paid um telehealth folks, you could be redirected if right site or another group agreed to it to be routed to them and could get that for free.

4:58

Um the folks at Right Site say that that's how it works in other places.

5:01

It doesn't have to be 911 and their other providers.

5:04

Detroit has another provider where you don't have to dial 911 to get the what is a free to the city of Detroit service.

5:10

So we could set up that kind of thing if all the parties agree, correct?

5:15

Through the chair to Calcover Diamond.

5:17

So uh we have not had any uh specific conversations with right site directly.

5:23

Um what you're saying makes sense in its current format, you're right.

5:26

An in uh individual calls 911, they're they speak with the JFRD dispatcher, who then, based on the information that they take in, determine whether or not they can go to right site.

Discussion Breakdown — Share of Meeting
Fiscal Sustainability█████████████████████████████████████████████57%
Miscellaneous████████████████20%
Personnel Matters█████████████17%
Procedural███4%
Engineering And Infrastructure██2%
Summary of Proceedings

Final Doge Committee Meeting – June 16, 2026

The final meeting of the Doge committee was held on June 16, 2026. Chair Ron Salem announced that this would be the last meeting as council president elect Howland plans to pursue a different direction. The committee discussed a telehealth program comparison, the two percent budget lapse, and received a comprehensive presentation from the Bailey Group on employee health insurance contributions, stop loss coverage, and overall recommendations.

Discussion Items

  • Telehealth Comparison: Council Auditor Philip Peterson presented a comparison between Health Link Jacks (via telescope) and RightSite. Health Link Jacks uses a dedicated phone line (904-925-CARE) for uninsured residents at a city cost of $1.5 million. RightSite is a free-to-city program that requires a 911 call and is primarily for insured patients. Usage of RightSite has been low due to lack of marketing and training. Peterson noted that a true cost-benefit analysis is difficult because the programs are fundamentally different. Councilmember Rory Diamond stated that the finance committee will likely remove telehealth funding from the budget, urging JFRD to pursue free alternatives like RightSite. Councilmember Matt Carlucci supported the $1.5 million expenditure for uninsured care, calling it a quality of life issue. Councilmember Arias questioned who could push for expanded RightSite hours and marketing; Diamond responded that JFRD and the mayor must take the lead.

  • Two Percent Lapse: Peterson reported no immediate movement. The administration is waiting for third quarter projections (due by July 30) and intends to use the mayor's $500,000 transfer authority to address shortfalls. If transfers exceed that amount, they will return to council. Chair Salem supported keeping the two percent lapse and potentially increasing it in future budgets.

  • Bailey Group Health Insurance Review: Sabrina Abair, Sherry Bignet, and Travis Cummings presented findings and recommendations on employee contributions, stop loss, and overall plan strategy.

    • Employee Contributions: Current employee share is approximately 10% of total premium costs, compared to 25–30% at comparable public entities. Several budget-neutral scenarios were shown, including salary band options (e.g., increasing employer contributions for lowest salary tier by 5–7% and reducing for highest tier). Councilmember Diamond emphasized that gradual increases are necessary given the impending property tax referendum and the $21 million annual subsidy from the general fund. Councilmember Arias asked about reducing costs rather than shifting burden; the team noted that deeper analysis would be required.
    • Stop Loss Coverage: Bignet explained that stop loss insurance covers catastrophic claims above $1 million. Current premium is $16.60 per employee per month ($813,000 annually), which is above market estimates of $11.97. Preliminary quotes from PartnerRe ($18.24) and others were presented. The team recommended carving out stop loss for competitive bidding and considering gene therapy coverage (additional $4.75 per employee per month) given potential multi-million dollar claims.
    • Overall Recommendations: Maintain Florida Blue as third-party administrator (ASO/TPA) due to a 72% discount on allowed costs; carve out pharmacy benefit management (PBM) to realize up to $5.2 million in savings; gradually adjust funding and employee contributions; market stop loss separately; and ensure proper pricing for three additional agencies (First Coast Workforce Development, Northeast Florida Regional Council, Jacksonville Housing Authority) without jeopardizing ERISA exemption.
    • Discussion included the need to move beyond tweaks and adopt a multi-year approach to address the $21 million gap and future sustainability.

Key Outcomes

  • The Doge committee concluded its work; council president elect Howland will determine the future direction of such efforts.
  • No formal votes were taken. The committee received the Bailey Group report and recommendations.
  • Councilmember Diamond signaled that the finance committee will likely remove the $1.5 million telehealth funding, forcing JFRD to explore free alternatives like RightSite or similar models.
  • The two percent budget lapse will be addressed after third quarter projections; the mayor intends to use transfer authority administratively.
  • The health insurance recommendations, particularly pharmacy carve-out and stop loss marketing, are left for the administration to consider during the upcoming budget process. The Bailey Group offered continued support.
  • Mary Stefopoulos from OGC confirmed that including the three additional agencies in the city's benefit plan does not compromise ERISA-exempt governmental plan status.

Meeting Transcript

Good morning. Welcome to the final Doge meeting. Council members, I I just wanted to mention, I think I've said this before, but uh council elect uh president howland is has plans to go in a different direction in terms of this type of effort. So I indicated to him that we would wrap up the last item, which is this insurance issue today, and give him the maximum flexibility to move in any direction he wants to. So with that, let's begin with introductions to my far left. Stephen Libby, Council Research. Mary Stefopoulos, Office of General Counsel. Brian Parks, Council Auditors Office. Philip Peterson, Council Auditor. Good morning. Rory Diamond, District 13, the beaches. Ron Salem, group two at large. Morning, raw areas, district eleven. My gay district two. Will Lane and District 3 visit. Matt Carluccia at large group for just visiting. And are you going to be taking up the telehealth update? Yes, I am. Okay. Thank you. Yes, I am. And uh Councilmember Miller is hoping to make it might make it, might not, is what I've heard. Is there any public comment? None. Okay. Um, I know you've got uh a couple of telehealth updates, please, sir. Yes, sir, through the chair of the committee. So uh our office was asked to look into um kind of comparing the two programs telescope uh through the Health Link Jacks initiative and then the um right site or a right site like um provider. And uh so through conversations with both JFRD um with telescope and then with members of the mayor's office, uh we've ultimately come to the conclusion that the in their current form, these are two separate programs. Um to do a true cost-benefit analysis, we would need to to have programs that kind of lined up together and provided the same service. Um an easy um way to see that is is a dedicated phone line is set aside for uh Healthlink Jacks. There's a specific phone number 904 925 care, and you can call that or or a resident can call that and receive services from Health Link Jacks. Whereas the right site model in its current form, uh someone contacts 911. You're you're obviously aware of this, but in order to get to right site, you have to go through 911. And so that is a strain on 911 resources, it can be a strain on JFRD uh personnel depending on how the call is deployed. Um so it in the in that manner, there are two different programs. Um you obviously are aware of the clientele that they serve, uh, even though right site will take uh uninsured uh patients. Right now, their model is for uh insured patients, whereas telehealth is specifically for uninsured. Um, and then obviously the cost, we know that telehealth uh currently is a 1.5 million dollar cost to the city in the current year. Wright site is a zero cost contract. Um if right site were to expand into a different area or or expand their services to where we have a dedicated phone line, they're taking in more calls. I don't know that that would remain the same. Maybe it would, but until we until we got to that place, we wouldn't know. And then lastly, uh the usage um, very aware that you reading the con uh the report that this Doge committee adopted. Um right side just hasn't taken off given um a number of of instances. Um maybe it's lack of training, maybe it's lack of involvement, maybe it's lack of marketing. Uh, there's there's just not a dedicated push for a right site or a right side like concept. So in their current format, two totally different um programs while maybe having the overall same goal, um, they they don't serve the same purpose, and so it's difficult to do a cost benefit analysis. Uh, we were also asked to look into uh things that can I stop you right there and let council member diamond wanted to jump in. Uh I know uh thank you through the chair.

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