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Beneficiary Rights Under the Drug Medi-Cal Organized Delivery System (DMC-ODS)
Understanding beneficiary rights is crucial for clinicians working in substance use and mental health treatment. Clients receiving services funded through Medicaid or other public programs have the right to file grievances, request appeals, and pursue State Fair Hearings if they disagree with service decisions. Understanding beneficiary rights is crucial for clinicians working in substance use and mental health treatment. Clients receiving services funded through Medicaid or other public programs have the right to file grievances, request appeals, and pursue State Fair Hearings if they disagree with service decisions. The Notice of Adverse Benefit Determination (NOABD) process ensures that clients are informed when services are denied, reduced, or terminated, allowing them to challenge these decisions. Additionally, Alcohol and Other Drug (AOD) certification standards uphold client rights by ensuring ethical, evidence-based care and protecting individuals from discrimination or substandard treatment.
Clinicians must be well-versed in these rights to advocate for their clients, navigate regulatory requirements, and foster a fair, transparent treatment environment that promotes recovery and trust. This course will explore Client Rights in the County of San Diego’s Drug Medi-Cal Organized Delivery System, or DMC-ODS,
with specific attention to the grievance and appeals, and State Fair Hearing processes.
This course will award 2 continuing education hours.
Course Objectives
- Define beneficiary rights, including the grievance, appeal, and State Fair Hearing processes.
- Explain the Notice of Adverse Benefit Determination (NOABD) and its role in protecting client access to services.
- Identify key client rights under Alcohol and Other Drug (AOD) certification standards and their impact on ethical care.
- Describe the steps clinicians must take to support clients in filing grievances and appeals.
- Discuss the importance of regulatory compliance in ensuring fair treatment and service accessibility.
- Demonstrate how clinicians can advocate for client rights while maintaining professional and ethical responsibilities.
Information
- Content Level: Intermediate
- Course Format: This course is offered as a self-paced distance learning format (reading-based online activity)
- System Requirements: This course is offered online. Internet connection required.
- Course Completion Information: To earn continuing education credit, professionals must register and pay the fee for the course. They must read the content and demonstrate understanding by earning a minimum score of 70 percent on testing materials. The certificate of completion will be able to be downloaded after the above is completed. Refunds will be granted upon request with the withdrawal of credit for the course. For questions, concerns, or to request special accommodations, please call 866-863-4225 or email [email protected].
- CEBroker Course ID: NA
- Credit Hours: 2