Essentials: Full Service Partnerships

Full Service Partnership (FSP) programs have become a priority for California’s public behavioral health system.

Far too often, people living with severe mental illness don’t get the treatment they need – and end up homeless, jailed or in and out of emergency rooms. Breaking this vicious cycle requires a holistic approach to care. 

That’s where Full Service Partnerships come in. 

Full Service Partnerships (FSPs) are a cornerstone of California’s behavioral health system, and an effective treatment program that has been shown to reduce incarceration, hospitalization and homelessness for people with behavioral health needs. Under the Behavioral Health Services Act (BHSA), passed by voters in January 2024 through Proposition 1, counties are now required to dedicate 35% of their BHSA budgets to FSPs.

What are Full Service Partnerships?

FSPs are intensive outpatient mental health treatment programs for people with serious mental illness (SMI). They are built on a “whatever it takes” approach, meaning services extend far beyond traditional mental health treatment. In addition to therapy and psychiatric care, FSPs offer wraparound supports like housing assistance, employment services, money management, and 24/7 crisis availability.

FSPs operate through a team-based care model: a client works with a primary clinician alongside other professionals such as case managers, peer support specialists, and housing specialists. Together, the team addresses the full range of a client’s needs. Examples of services offered through FSPs include:

• Wraparound mental health services
• Outreach and engagement
• Comprehensive assessment and treatment
• Intensive case management
• Housing support
• Medication support and education
• Vocational and educational services
• Benefits establishment

The core of FSP’s approach is a recovery-oriented philosophy. Each person works with their care team to create an individualized recovery plan, which is flexible and adapts to changing needs. The goal is to help participants develop practical skills, manage their mental health, and make progress toward long-term stability.

Respect, non-judgment, and strong interpersonal relationships are fundamental. Providers recognize that recovery looks different for everyone, and they strive to create supportive environments where people can thrive in their communities.

FSPs are California’s adaptation of Assertive Community Treatment (ACT) programs, a nationally recognized model for intensive, community-based care. While very similar, there are a few key differences. ACT programs focus primarily on clinical care and case management, with strict fidelity requirements to maintain their evidence-based status. FSPs, by contrast, were created specifically for California under the Mental Health Services Act and take a broader “whatever it takes” approach, placing stronger emphasis on housing, employment, and social supports alongside psychiatric care.

Who is eligible for FSPs?

Because FSPs are the most intensive form of outpatient treatment, eligibility is limited to those who need them most: individuals with serious mental illness who are experiencing homelessness, repeated hospitalization, or incarceration. FSP programs are also separated into four age brackets:

These criteria ensure that FSP slots are reserved for individuals with the most urgent and complex needs.

How are FSPs Funded?

Full Service Partnerships are funded through California’s Mental Health Services Act (MHSA), which voters passed in 2004 as Proposition 63. The MHSA created a dedicated revenue stream for behavioral health services by placing a 1% tax on personal incomes over $1 million. These dollars flow directly to counties, which use them to expand access to treatment and support services (like FSPs).

In 2024, California voters approved Proposition 1, which, among other things, restructured the MHSA into the Behavioral Health Services Act (BHSA). One of the most important changes under Prop 1 is the requirement that every county dedicate 35% of its BHSA funding specifically to Full Service Partnerships. This mandate reflects the strong evidence that FSPs reduce homelessness, incarceration, and hospitalization, and ensures that the most intensive community-based programs remain a priority in every county.

FSP Providers

FSPs are administered by county behavioral health agencies, but delivered through community-based mental health treatment organizations. Two of the largest providers, Telecare Corporation and Turning Point, operate programs in more than 20 counties statewide.

Program design often varies by county and by population served. For example, in Orange County, Telecare runs several distinct FSPs:

• TAO, a general adult program that serves adults meeting the full eligibility spectrum.
• The Home First FSP, which focuses on people with serious mental illness at risk of losing housing and provides more housing-intensive services, such as specialized case management.
• Programs that support people transitioning out of hospitals back into their communities, such as the Striving Toward Enhanced Partnerships (STEPS) program.
• Court-linked programs, such as Telecare Whatever it Takes (WIT), which support individuals mandated into treatment.

FSPs are flexible. They adapt to the needs of each county and population, while staying true to their central mission—helping people with serious mental illness avoid homelessness, incarceration, and repeated hospitalization.

FSP outcomes

Full Service Partnerships are one of the most studied components of California’s behavioral health system, and the research consistently shows that they have significant, measurable outcomes. Across evaluations, clients enrolled in FSPs experience:

• 41% reduction in psychiatric hospitalizations
• 82% reduction in jail days
• 80% reduction in days spent unhoused

Independent evaluations reinforce these findings. The Mental Health Services Oversight and Accountability Commission (MHSOAC) has documented significant gains in housing stability and retention. A RAND multi-county evaluation found that participants were more likely to be employed or enrolled in school, and reported higher satisfaction with mental health services.

These outcomes show that FSPs are not only effective at reducing homelessness, incarceration, and hospitalization for those with behavioral health needs, but also at improving overall quality of life.