This report describes the evaluation of phase two of the California Multi-County Full Service Partnership Innovation Project. The evaluation provides evidence that the second cohort of counties successfully implemented intended changes, including standardized metrics and guidelines. However, on-the-ground providers did not always feel the impact of these changes. Additionally, outcomes for participants improved during the project and after.

Evaluation of the California Multi-County Full Service Partnership Innovation Project

Cohort Two

Wendy Hawkins, Jaimie Shaff, J. Scott Ashwood, Alejandro Roa Contreras, Stephanie Williamson, Nicole K. Eberhart

ResearchPublished Jun 23, 2025

California’s Full Service Partnership (FSP) programs are designed to address barriers to attaining sustained wellness and recovery for people experiencing serious mental illness, including co-morbidities, access to care, and housing instability. The California Multi-County FSP Innovation Project was launched in 2020 to establish a shared understanding of the core components of FSP programs, improve consistency across FSP programs, and develop or refine data-driven and outcome-oriented operational processes. The nonprofit Third Sector provided technical assistance to help counties define key populations and track process and outcome metrics. In addition to these two core innovations, participating counties chose which innovations to work on, according to their individual needs, such as eligibility requirements and graduation or step-down guidelines.

The first phase of the project involved six counties across California. This report examines phase two, which included three additional counties: Lake, Napa, and Stanislaus. With Third Sector, the participating counties developed a collaborative model that promoted peer learning and facilitated cooperation among counties to strengthen FSP programs.

The evaluation provides evidence that the second cohort successfully implemented intended changes, including standardized process and outcome metrics and guidelines for enrollment in and graduation from the program. However, on-the-ground providers implementing FSP programs did not always feel the impact of these changes. Additionally, outcomes for FSP participants improved during the FSP Innovation Project and after. Looking forward, there is an opportunity to enhance the dissemination of the innovations to providers. This approach could take many forms, from involving providers in the design and implementation of the innovations to building FSP guidelines into provider contracts.

Key Takeaways

  • The second cohort of three counties participating in the California Multi-County FSP Innovation Project successfully implemented key improvements: The counties identified and standardized measures and metrics for tracking process and outcome measures, defined graduation and step-down guidelines, and revised their enrollment guidelines.
  • The extent of on-the-ground implementation of the innovations varied by county and innovation area.
  • Outcomes for FSP participants improved during the first 12 months after enrollment. Participants experienced increased days of stable housing, decreased justice system involvement, and reduced psychiatric inpatient admissions.
  • FSP participants experienced a bigger decrease in psychiatric inpatient length of stay after the Innovation Project. The improvement in other participant outcomes was similar before and after the project.

Recommendations

  • The early successes of the FSP Innovation Project in this cohort of counties, as well as the first cohort, suggest that spreading the innovation activities to more counties throughout California may be beneficial.
  • There is an opportunity for better dissemination to providers, which could include involving providers in the design and implementation or could include building FSP guidelines into provider contracts.
  • In doing so, counties should consider lessons learned from the current evaluation, particularly with respect to the need for strong communication to providers about the innovations and the availability of step-down care options.

Topics

Document Details

  • Copyright: California Mental Health Services Authority
  • Publisher: RAND Corporation
  • Availability: Web-Only
  • Year: 2025
  • Pages: 24
  • DOI: https://doi.org/10.7249/RRA3105-2
  • Document Number: RR-A3105-2

Citation

Chicago Manual of Style

Hawkins, Wendy, Jaimie Shaff, J. Scott Ashwood, Alejandro Roa Contreras, Stephanie Williamson, and Nicole K. Eberhart, Evaluation of the California Multi-County Full Service Partnership Innovation Project: Cohort Two. Santa Monica, CA: RAND Corporation, 2025. https://www.rand.org/pubs/research_reports/RRA3105-2.html.
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This evaluation was funded by the California Mental Health Services Authority (CalMHSA) and carried out within the Access and Delivery Program in RAND Health Care.

This publication is part of the RAND research report series. Research reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND research reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

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