A New Jersey home-care agency

The audit · document 04 of 07

The proposed state

The same cycle, rebuilt: people stop chasing and re-typing and keep the judgment. Two ways out, both priced; the chosen one specified to buildable detail.

Two ways out — both priced

Staying put is a price too. All three columns at the agency’s own rates, from document 03 — the agency could act on either way out, with or without us.

stay put$8,100 a monththe platform + 24 office hours a week, forever — and the official form still rebuilt by hand
option a · rent cheaper$4,900 a monthmigrate to a lower-tier forms product (≈ $1,900/mo): the bill shrinks, but the re-keying, the chase, and the hand-built official form all stay
option b · own it — chosen$1,980 a montha purpose-built workflow, $25,000 fixed to build: re-keying and chasing removed, the official form exact — pays for its build in about four months
Why B: the arithmetic — and the owner’s requirement, recorded in the findings: own the workflow, end the dependency. Option A stayed on the table to the end; no build at all is always a valid audit outcome. Here, renting cheaper kept every broken step at a discount.

The rebuilt flow — from the visits to the filed record, in 2 business days

What checks itself, and where a person decides. The workforce’s tools are the phones they already carry; the office’s filing cabinet stays SharePoint.

  • Sign-in without passwords.each DSPA magic link by email or a code by text — for a workforce that lives on phones, not desktops. Nothing to forget, nothing to reset.
  • The week is recorded during the visits.each DSPDay rows in 15-minute steps — the unit the program bills in — activities, assistance given, an outcome note against the participant’s current plan, mileage, signature on the phone.
  • The packet checks itself before it can submit.deterministic checksMissing signature, missing note, overlapping times, hours over the participant’s authorized ceiling — flagged at entry, not discovered at review a week later.
  • Reminders go out before the deadline.system + coordinator calls the silentSaturday and Sunday, ahead of the 8 pm cutoff; Monday 8 am, the overdue view names the few still missing.
  • Review is one queue, side by side with the plan.office coordinatorEach packet against the participant’s current service plan and authorized hours — return with a named reason, or approve.
  • A return travels in-app.the worker correctsThe worker sees exactly what to fix and fixes it the same evening — no phone tag, no re-entry through the pile.
  • Approval triggers the rest.system · office manager runs exportsThe official multi-page PDF generates — exact to the pinned state layout, signatures placed — files into SharePoint by participant and week, and the pay & billing rows are staged for export.
  • Management sees the current state.owner + supervisorRosters, assignments, authorized hours, workflow state, exceptions — live, instead of reconstructed every Monday.

The same week, at a glance

Top row: today — every box is a person typing, calling, or rebuilding. Bottom row: after — the green boxes are the human touches left; everything between them checks, generates, or files itself.

today — 24 h 15 m of office doing

notes in the car→rebuild the week Sunday night→sort & log Monday→chase 18 workers→re-type into 3 sheets→review, a week late→phone-tag corrections→rebuild the official PDF→file by hand

after — ~5 h of checking and approving

record during the visit→submit — it checks itself→review beside the plan→return in-app, rarely→approve→PDF files itself · exports ready

The review screen — what approval looks like

The one interface the office lives in. Packets wait; a person decides. (Illustrative layout.)

A returned packet names exactly what it waits for, in the worker’s own app. Approving never batches: each packet is approved by name, and every view, return, edit, and approval is logged — who, what, when.

What changes in each person's week

Same people, same responsibilities — different work.

PersonTodayProposed
Each DSP Paper notes in the car; the week rebuilt from them — and from memory — on Sunday night; phone tag when something bounces. ~45 m, every Sunday night. Records during the visits on the phone; the packet checks itself; a rare return is fixed the same evening. ~25 m, during the visits.
Office coordinator Rebuilds the missing list from memory, chases 18 workers, phone-tags 15 corrections, rebuilds the official PDF, files by hand. ~17 h 15 m a week. Opens one queue, reviews each packet beside the current plan, returns with a named reason, approves. ~4 h 15 m a week — and the review got deeper, not thinner.
Office manager Types every worker-week into the pay sheet and the billing sheet, then checks a third sheet for authorized-hours overruns — after the fact. ~7 h a week. Runs the exports from approved packets into pay & billing; ceilings were enforced at entry. ~45 m a week.
Owner & supervisor Learns about overdue weeks, overruns, and mis-filings when they surface — days or a quarter later. Sees rosters, assignments, authorized hours, workflow state, and exceptions live; decides the blocked cases — the overrides that stay human.

Integration points — around the tools the agency keeps

  • SharePoint — the filing cabinet staysapproved official PDFs land in the agency’s own filing tree, by participant and week; the cabinet the state reviewer sees is always current.
  • Pay & billing — fed by exports, no re-keyingapproved packets export in the exact shape the office manager’s sheets accept; no re-keying anywhere.
  • Email & text — the channels the workforce already answersmagic links, sign-in codes, and deadline reminders ride the channels the workforce already answers.
  • The official form — generated exact, version pinnedgenerated pixel-exact to the pinned state revision; a format change is a versioned, human act, in one place.
  • Azure — the agency’s own tenancythe workspace runs isolated in the agency’s own tenancy, under a business-associate agreement.
  • The forms platform — the one thing replacedcanceled at cutover, after acceptance (document 07).

Where is the AI in this?

Mostly, deliberately, nowhere. The audit found a workflow problem, not an AI problem: every check in the rebuilt flow — completeness, overlaps, ceilings, versions — is a deterministic rule the agency can read in plain language. One AI layer was designed — draft guidance for outcome notes and a pre-submission quality check — and left switched off, pending the agency’s own compliance review. It appears in document 06 as an opportunity with a gate, not in this build.

The working rule: a care record is a legal document. This build runs on deterministic rules a person can read; anything generative waits for the agency’s written approval.
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Prepared by /analog · part of the home-care case study.
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