Data layer · Prepared · revised

Decision-Chain Methodology

Event-Level Authority Testing

The structural database says which organizations are present.

The event layer asks what happened when an actual decision moved through the system.

Each public event is encoded as:

origin / trigger → recommendation → professional review → approval or veto → implementation

This is deliberately stricter than identifying who sent an email, operated a computer system, signed a form, or appeared in a caption.

Decision-chain completeness

  • 5/5 — all five stages are publicly identifiable.
  • 4/5 — one material stage remains unknown.
  • 3/5 — professional review or final approval remains incomplete.
  • 2/5 — trigger and implementation are known but decision authority remains materially unresolved.
  • 1/5 — only the resulting action is publicly documented.

Completeness is not the same as proof of professional independence or management control.

Control-signal categories

County authority

The event shows the government client making or enforcing a contractual/governance decision.

Management administration

The event shows Wellpath/management handling process, systems, HR, finance, risk, or implementation.

Professional discretion

The event shows a clinical standard, licensed review, peer-review mechanism, or clinical-indication rule affecting the outcome.

Shared governance

The event requires multiple actors or a committee before implementation.

Open

The current public record is insufficient to identify the final substantive decision-maker.

Override rule

A true professional-control override event requires evidence that:

  1. two actors held materially different positions;
  2. one actor had authority to reject the other;
  3. the actor actually exercised that authority;
  4. implementation followed the prevailing decision.

The database does not label ordinary concurrence as a veto.

It does not infer a Wellpath-over-CFMG or CFMG-over-Wellpath override simply from implementation.

Important current result

The Phase V event layer now contains public examples of:

  • County approval and provider replacement;
  • County enforcement of staffing requirements;
  • multi-actor corrective-action approval;
  • a public recommendation incorporated into the Wellpath contract;
  • a blanket psychiatric-referral recommendation rejected because referral should depend on clinical factors;
  • professional peer-review mechanisms;
  • bankruptcy operational continuity;
  • a federal entity-identity correction.

None of these, standing alone, is yet a verified CFMG physician veto over a contrary Wellpath professional recommendation or the reverse.

That remains the highest-value public event type to locate.

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Kanwar Partap Singh Gill, MD
Family Medicine Physician · Fresno, California, USA

Original KPSGILL public-record investigation · public sources only · labelled as such · never official-government data · record current through 15 September 2026 · sources checked 15 September 2026 · prepared 15 September 2026 · revised 16 September 2026 · this revision pending review by Kanwar Partap Singh Gill, MD.