Emma Sharp • November 19, 2025

National Council Publishes Performance Benchmarks for Utilization of LAMs

Author

Emma Sharp

Date

November 19, 2025

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Earlier this week, the National Council for Mental Wellbeing published a report on the utilization of long-acting medications (LAM), providing the first-ever standardized performance measures and benchmarks to help providers optimize their use of LAMs.

LAMs are consistently underutilized despite strong evidence of their superior outcomes compared to oral medications. However, a set of standardized performance benchmarks provided in the report will make practice patterns visible and drive systematic improvement. The goal of the report is to help every provider identify opportunities to offer these evidence-based treatments to appropriate patients.


Key Report Highlights:
LAMs remain dramatically underutilized despite years of education and case discussions. The problem is not with knowledge, but with measurement.

  • Two Critical Gaps:
  • Initiation: Many eligible patients never receive their first dose of an LAM.
  • Continuation: There is a substantial drop-off between first and second administrations of LAMs.
  • Evidence-based benchmarks can drive real change. The Medical Director Institute proposes:
  • Antipsychotic LAMs: 30% initiation benchmark with 85% continuation to second dose.
  • Opioid Use Disorder LAMs: 10% initiation benchmark with 80% continuation to second dose.
  • Alcohol Use Disorder LAMs: 10% initiation benchmark with 60% continuation to second dose.


Read the full report here.

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ODP Updates the MAAC on Paid Relative Caregiving & Travel Limitations

By Tim Sohosky • May 29, 2026
On Thursday, May 28, the Office of Developmental Programs (ODP) provided an update to the Medical Assistance Advisory Committee (MAAC) regarding current policies and upcoming regulatory changes following a recent Commonwealth Court decision. On February 17, 2026, the PA Commonwealth Court issued a decision in Dunkelberger v. Department of Human Services that determined that ODP’s limitations on provider model services (specifically the 40/60-hour caps and 90-day travel maximums) were null and void. The decision was based on process rather than policy validity; the Court found that these limitations were not properly promulgated as regulations in accordance with the Commonwealth Documents Law and Regulatory Review Act. To maintain a balanced approach between flexibility and oversight, ODP is moving forward with the following actions: Regulatory Amendments: ODP will amend regulations to establish formal authority for setting service delivery limits that support individual welfare and program integrity. Self-Directed Model Agreements: ODP has already modified agreements for self-directed models to clarify limits on overtime, combined relative service provision, and travel restrictions. Travel Restrictions: Due to the inability to monitor services effectively over long distances, service provision will now be limited to Pennsylvania and contiguous states. Waiver Changes: ODP will seek modifications through the amendment process to the Consolidated, P/FDS, Community Living, and Adult Autism Waivers to include: New requirements for agencies providing IHCS and Companion services to disclose a DSP's relationship to participants; and Strengthened programmatic oversight and integrity measures. Life Sharing Alternative: For participants requiring more than 60 hours of paid care from a relative, the Life Sharing (24/7) service model remains the recommended alternative. ODP anticipates a public comment period for these proposed waiver changes beginning in January 2027.
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By Tim Sohosky • May 28, 2026
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ODP Provides Updates to PBC 2026/27 Residential Pay-for-Performance

By Cathy Barrick • May 28, 2026
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