feat(assessments): layered clinical assessment engine end-to-end

Add a template-driven assessment system with universal intake, clinical
pathways, disease instruments (stroke MVP + extended, diabetes, and ten
specialty packs), scoring, patient outcome trends, REST/API + FHIR
export, and Enterprise org-level assessment analytics. Seed packs and
design/licensing docs ship for deploy and pre-GA review.

app/Services/Care/CareFeatures.php

@@ -0,0 +1,40 @@
+<?php
+
+namespace App\Services\Care;
+
+use App\Models\Organization;
+
+/**
+ * Product rollout flags stored under organization settings.rollout.*
+ * Distinct from PlanService entitlements (lab/pharmacy/billing plan features).
+ */
+class CareFeatures
+{
+    public const ASSESSMENTS_ENGINE = 'assessments_engine';
+
+    public const PATHWAY_SUGGESTIONS = 'pathway_suggestions';
+
+    public const ASSESSMENT_REQUIRED_ON_COMPLETE = 'assessment_required_on_complete';
+
+    public function enabled(Organization $organization, string $flag): bool
+    {
+        $settings = $organization->settings ?? [];
+        $rollout = is_array($settings['rollout'] ?? null) ? $settings['rollout'] : [];
+
+        return (bool) ($rollout[$flag] ?? false);
+    }
+
+    /**
+     * @param  array<string, mixed>  $flags
+     */
+    public function setFlags(Organization $organization, array $flags): Organization
+    {
+        $settings = $organization->settings ?? [];
+        $rollout = is_array($settings['rollout'] ?? null) ? $settings['rollout'] : [];
+        $settings['rollout'] = array_merge($rollout, $flags);
+        $organization->settings = $settings;
+        $organization->save();
+
+        return $organization->fresh();
+    }
+}