What will Duval DOGE do next on city’s telehealth contracts?

Telescope Health is defending its telehealth partnership with the city against allegations of wrongdoing by City Council member Rory Diamond and the Duval DOGE committee.

The DOGE effort, led by council member Ron Salem, will meet again Tuesday after it decided Nov. 12 to form a subcommittee chaired by Diamond to investigate what he alleges is “potential serious misuse of taxpayer funds, wrongdoing, and potential illegal conduct” linked to the contracts negotiated by Mayor Donna Deegan’s administration.

During the meeting, Diamond also floated the claim — without releasing evidence — that parties involved in the Healthlink Jax program could be “directing traffic to ERs that we ought not to be,” which he says could be Medicare/Medicaid fraud.

Telescope CEO Dr. Matthew Thompson says the goal of the Healthlink Jax program is to do the opposite and divert uninsured, nonemergency patients from the emergency rooms.  

Thompson and the Mayor’s Office have pushed back publicly against Diamond’s claims and defended the program’s success in keeping uninsured Duval County residents out of the emergency rooms and giving them access to primary care physicians and other medical services.

In a letter to Salem and DOGE on Nov. 11, Thompson called the allegations “false” and wrote: 

“Healthlink JAX facilitates care for uninsured patients who lack health care coverage. Therefore, Telescope Health cannot and has not billed Medicare, Medicaid or other payors for Healthlink JAX patients. Telescope Health guides Healthlink JAX patients to existing free or low-cost care via JaxCareConnect, seamlessly integrating with 60+ partners, including all five local health systems.”

Thompson and the Deegan administration also have defended the way the program — budgeted to cost $2.185 million in its first year — was created and Telescope was vetted. The company was selected through a competitive process over two other bidders. 

The city’s Office of Inspector General investigated that process in September after the oversight entity received an anonymous allegation that “there was potential inappropriate preference given to a contractor” related to the contract, according to the summary of the investigation released Sept. 24 by Inspector General Matthew Lascell. 

The memo says that after the inspector general reviewed the proposals and scored them as if the office were the selection panel, they determined it “would have given Telescope Health LLC the highest score as well” and determined the “contract was completed adequately.” 

“We are very transparent; we have complied and will comply with any information that’s requested,” Thompson told Jacksonville Today on Nov. 12 after the meeting at City Hall. 

“We went through and were selected through a (request for proposals) process because of our merrit and based on our expertise. That’s been already looked into. The first piece I would say is we want to make sure we’re complying with everybody so that they can see that there is no fraud here. There’s no corruption.” 

The city has another telehealth contract between the Jacksonville Fire and Rescue Department and San Antonio-based Rightsite Health Inc., which connects nonemergency calls that come in through the city’s 911 service to ambulatory, in-network care. 

Telescope’s Healthlink Jax city-funded program is patient-initiated and open to any uninsured Duval County resident, but it can receive referrals from 911 calls. 

Rightsite’s business model is different. According to Diamond, Rightsite doesn’t charge JFRD or the city for its service. It accepts uninsured patients but bills Medicare and Medicaid for the non-emergency 911 callers who are insured and averages out the two classes to make a profit. 

Rightsite’s contract with the city started in September 2023. It was drafted under former JFRD Chief Keith Powers and signed by Deegan.

The company also provides this service for the city of San Antonio, Texas. 

Diamond says he wants to know if Rightsite’s services could be expanded and do for free what Telescope is getting taxpayer funding to do.

“Why are we spending millions of dollars when we could be getting this service for free?” Diamond asked.

According to Thompson, Telescope’s program differs from Rightsite in its coordination with the city’s JaxCareConnect partner safety net clinic, area health systems and creation of a city branded Healthlink Jax web presence. 

The DOGE committee will hold its next meeting on the telehealth contracts from 11 a.m. to 12:30 p.m. Tuesday at City Hall.

Diamond questions Telescope’s connections

During the Nov. 12 meeting, Diamond said he received several tips from currently unnamed sources that urged him to look into how the telehealth services are operating and who is operating them.

“That led to a series of questions that I think have to be answered. And it can’t just be answered by a City Council member sitting up in their office saying, ‘Hey, I’d like to know about this. Let’s have a meeting.’ They need to be answered out in the public in the sunshine. Either do one of two things. Find out that we do have a problem or find out that we don’t have a problem.”

Diamond says he’s concerned about what he said could be perceived as conflicts of interest with overlap in the leadership and employees of Telescope Health and Baptist Health’s emergency room staffing agency, Emergency Resources Group, as well as contract work JFRD’s medical director has done with that agency. Diamond has made no specific accusations related to those links. 

Telescope was co-founded by Thompson and Dr. Matthew Rill. State Division of Corporations records show it was officially formed in September 2019. Rill is also CEO of ERG and is listed online as chief of the service of emergency medicine at Baptist Medical Center Jacksonville. 

JFRD Medical Director Bradely Elias is listed as an emergency medical specialist in Baptist Medical Center’s emergency rooms through ERG.

The city’s chief communications officer, Phil Perry, told Jacksonville Today that “there is no conflict of interest” with Elias.

“He was not involved in awarding or managing the contract with Telescope,” Perry said in an email. “His only involvement with Emergency Resources Group is being an independent contractor that was placed by the ER doctor staffing agency for a single monthly shift in the Baptist emergency room.” 

Telescope also lists Baptist Health as a customer on its website, creating the system’s desktop and app-enabled telehealth platform for patients in Florida and Georgia. 

“There’s a lot of names showing up in the same entities,” Diamond told reporters after the meeting. “There’s a contract that I don’t think we should have at all that’s costing the city millions of dollars. The question is, why did that happen and why is it going to these places and why do the same names keep popping up.

“So I just want to answer those questions and get to the bottom of it. To me, it looks like corruption, but I try not to jump to that,” he said. “I want to be fair and open minded on the front end and see what is said.”

Analytics compiled by Telescope and provided by the city show a plurality — 44.7% — of the nonemergency patients who called Healthlink Jax and were diverted away from the emergency rooms last year said they would have gone to Baptist. 

That was 857 patients. University of Florida Health Jacksonville was second at 20.5% of the diversions. City lawmakers approved $56 million in this year’s city budget to UF Health for indigent care.

Telescope says in its letter to DOGE that’s $11.1 million in cumulative cost savings to the region’s health systems, “alleviating pressure on local emergency departments and clinics.”

Telescope’s relationship with the city goes back to 2020, when officials in then-Mayor Lenny Curry’s administration partnered with the company and Baptist to open the first locally sponsored COVID-19 testing site. Rill was also on Curry’s advisory committee to reopen the city during the pandemic.

The Diamond-led subcommittee will request documentation and voluntary testimony from Telescope and other entities, but City Council President Kevin Carrico stopped short Nov. 12 of issuing it subpoena power. He says he’s keeping that option open. 

Telehealth apples and oranges?

For its work, Rightsite’s Jacksonville referrals have been declining overall in this year. Rightsite data provided by the city shows its 2025 calls peaked in January at 19 calls from JRFD dispatch and field referrals and was down to two total referrals in October.

Rightsite did not submit a bid to the Healthlink Jax request for proposals.

Telescope began operating the Healthlink Jax service free to patients in October 2024 after the contract was signed in July. City Council authorized $205,020 in gap funding for the program to keep it going from July 1 of this year through Sept. 30.

Healthlink Jax was the subject of a budget battle between City Council’s Finance Committee and the Deegan administration in August when it stripped $2.185 million in Deegan’s proposed 2025-26 budget for the program. 

The committee later reinstated $1.5 million of that, and Perry says it will work with council to cover the program’s full $2.3 million cost for the fiscal year.

Former Mayor Lenny Curry was in council chambers Nov. 12 shortly before the DOGE meeting began. Rightsite’s lobbyist registered with the city is Jordan Elsbury, Jacksonville managing partner of Ballard Partners, the firm where Curry also works as a partner.

Speaking Nov. 12 on WJCT News 89.9’s First Coast Connect, Mayor Donna Deegan defended the program and said it has saved “millions of dollars” in emergency room expenses and saved patients “hundreds of thousands” in emergency room bills. 

The mayor also pointed to the validity of the bidding processes that was cleared by the inspector general.

“First of all, I hate to say that this is the way the Councilman Diamond seems to operate. He throws out a lot of stuff without a lot of backing.” Deegan said. “I’m certainly willing and interested to hear where all this goes. But at the end of the day, I want to point out a couple things. I don’t know how there can be Medicare or Medicaid fraud in a program that has nothing to do with Medicare or Medicaid. This is specifically for uninsured people. Period. Full stop. This is for people who have nothing.

“As is so often the case, every accusation is a confession. I’ll just say that.” Deegan said.

Salem’s talks with Telescope

During the DOGE meeting, Salem said: ”I was critical of the concept of Telescope from the very beginning. I have grave concerns on the dollars that we’re spending on that contract.”

He says it’s the hospitals not the city that receives the financial benefit from those emergency room diversions, and Salem has called for those systems to fund the program. 

Salem was one of the leading voices during the council’s Finance Committee budget process against continuing to fund a city-led telehealth program while the city was funding indigent care at UF Health. 

Prior to the company’s telehealth contract with the city, Salem briefly had business interactions with Telescope’s leadership in 2023 outside of his work on council through his consulting firm, Salem & Associates, which he’s managed since 2007.

An email obtained by Jacksonville Today shows Salem contacted Thompson and Telescope Health in November 2023 through his firm offering to “help your team develop a plan to target nursing homes, jails and other similar facilities.”

“I’m interested in some type of financial arrangement but don’t have any specifics at this time,” Salem wrote. “I would like to discuss this at lunch or before time permits. Please let me know if I can facilitate anything. Thanks.”

Salem said Thursday that his conversation with Telescope “went nowhere.”

“That was the end of it,” Salem said. “Nothing materialized. We had one meeting and nothing occurred after that. … I would never have had a discussion with them if they had a contract with the city.”