Encore OS — Documentation

Spec: specs/pf/specs/PF-96-medicaid-state-compliance-configuration.md Owner: PF (Platform Foundation) Created: 2026-03-29

Integration Overview

PF-96 provides the jurisdiction profile system — a multi-tier configuration layer that decouples state-specific Medicaid compliance rules from hardcoded constants. It is consumed by CL, PM, and PF features via a resolution function and frontend hook.

Platform Integration Layer

Location: src/platform/jurisdiction/ Public API:

Export	Type	Purpose
`useJurisdictionProfile(siteId?)`	React hook	Resolve effective profile for current org + optional site
`useClinicalRules(siteId?)`	React hook	Convenience accessor for clinical rule pack
`useBillingRules(siteId?)`	React hook	Convenience accessor for billing rule pack
`useComplianceRules(siteId?)`	React hook	Convenience accessor for compliance rule pack
`JurisdictionProfile`	TypeScript interface	Resolved profile shape
`ClinicalRules`	TypeScript interface	Clinical rule pack
`BillingRules`	TypeScript interface	Billing rule pack
`ComplianceRules`	TypeScript interface	Compliance rule pack

Edge Function Helper:

Export	Location	Purpose
`getJurisdictionProfile(client, orgId, siteId?)`	`supabase/functions/_shared/jurisdiction.ts`	Server-side profile resolution

Event Contracts

Events Published

pf_jurisdiction_profile_changed

Publisher: PF-96 (on org/site jurisdiction config change)
Subscribers: CL-02, CL-04, CL-40, PM-07, PM-08, PM-41, PF-91

Payload Schema:

{
  event_id: string; // UUID - unique event identifier for deduplication
  organization_id: string; // UUID
  site_id?: string; // UUID, present if site-level change
  old_profile_code: string; // e.g. "az-ahcccs"
  new_profile_code: string; // e.g. "ca-medi-cal"
  changed_by: string; // UUID of user who made the change
}

Status: ✅ Complete

Events Consumed

Event	Source	Purpose
`pf_organization_created`	PF-01	Set default federal baseline jurisdiction profile on new org
`pf_site_created`	PF-19	Prompt for jurisdiction profile if org is multi-state

API Contracts

RPC Functions

pf_resolve_jurisdiction_profile(p_org_id UUID, p_site_id UUID DEFAULT NULL)

Type: PostgreSQL RPC (SECURITY DEFINER)
Returns: JSONB — Merged profile with { profile_id, state_code, program_code, display_name, clinical, billing, compliance }
Consumers: All CL/PM features, PF-91 compliance dashboard, edge functions
Resolution Order: Federal baseline → State profile → Org overrides → Site overrides
Status: ✅ Complete

Consumer Integration Points

Consumer Spec	What It Reads	How It Integrates
CL-02 (Assessments)	`clinical.assessment_required_elements`, `clinical.assessment_completion_hours`	`useClinicalRules()` hook
CL-04 (Progress Notes)	`clinical.documentation_timeliness_hours`, `clinical.required_note_elements`	`useClinicalRules()` hook
CL-11 (Consent)	`clinical.minor_consent_age`, `clinical.sud_confidentiality_standard`	`useClinicalRules()` hook
CL-40 (Intake)	`clinical.intake_assessment_type`	`useClinicalRules()` hook / edge function helper
PM-07 (Charge Capture)	`billing.min_billable_minutes`, `billing.modifier_conventions`	`useBillingRules()` hook
PM-08 (Claims)	`billing.filing_deadline_days`	`useBillingRules()` hook
PM-10 (Prior Auth)	`billing.bhrf_urgent_pa_exempt_days`	`useBillingRules()` hook
PM-18 (Scrub Rules)	`billing.modifier_conventions`	`getJurisdictionProfile()` edge fn
PM-41 (Compliance Reports)	`billing.compliance_window_hours`	`getJurisdictionProfile()` edge fn
PF-91 (Compliance Dashboard)	All rule packs	`useJurisdictionProfile()` hook

Security

RLS: All three tables have RLS + FORCE enabled
Profile access: All authenticated users can read active profiles (shared reference data)
Config access: Org-scoped via pf_has_org_access(); admin writes via pf_has_org_role()
Federal baseline enforcement: pf_validate_jurisdiction_override() trigger prevents weakening federal requirements
No PHI: Profiles contain configuration data only; no patient data

References

Compliance & Staff Operations — Integration Nonprofit Governance Controls — Integration Document

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Medicaid State Compliance Configuration — Integration Documentation

Integration Overview

Platform Integration Layer

Event Contracts

Events Published

Events Consumed

API Contracts

RPC Functions

Consumer Integration Points

Security

References

​Integration Overview

​Platform Integration Layer

​Event Contracts

​Events Published

​Events Consumed

​API Contracts

​RPC Functions

​Consumer Integration Points

​Security

​References

Integration Overview

Platform Integration Layer

Event Contracts

Events Published

Events Consumed

API Contracts

RPC Functions

Consumer Integration Points

Security

References