In February 2026, I took my son to the emergency room after he stopped being able to hold a conversation. He was placed on a 72-hour 5150 psychiatric hold, discharged with a seven-day bridge prescription of medication, and released. Seven days later, I drove him to Turning Point Behavioral Health Urgent Care for his first monthly injection of long-acting antipsychotic medication. Within weeks, Sacramento County’s Full Service Partnership (FSP) system placed him with Capital Stars Community Services, a contracted provider operating a fully equipped office on S Street in downtown Sacramento, paid through Medi-Cal at the highest intensity level of community mental health care California offers.
My son is 20 years old. He has a dual diagnosis of schizophrenia and bipolar disorder. He spent three years living in and out of homelessness with his biological father before arriving at our door in acute psychiatric collapse, 50 pounds underweight. By June, he was stable. He attended every single prescriber appointment across the entire medication chain. He is living at home, present and engaged in ways he was not capable of four months ago. That progress is real, and it is extraordinary given where he started.
Capital Stars Community Services recently lost its funding. Staff have begun leaving for secure employment. The program’s ability to deliver regular services has been significantly impacted. And Sacramento County’s entire FSP system is currently mid-redesign, with FSP-level transfers paused county-wide while the new structure takes shape.
I wish I could say I was surprised by any of it.
In the months my son was enrolled in Capital Stars’ Transitional Age Youth (TAY) FSP, the program delivered no recurring classes, no peer groups, no vocational engagement, no family psychoeducation, and no structured day programming of any kind. He received his prescriber appointments and little else. When I raised this directly, I was told the intake and assessment process, which the program represented as taking one to two months, was still incomplete at 11 weeks. When I pushed further, a case manager responded to my documented clinical observations about my son’s severe avolition and executive dysfunction with…silence.
In the same period, my family built an individualized operational plan, a 30/60/90 day care framework, a partnership proposal grounded in the peer-reviewed evidence base for first-episode psychosis care, a comprehensive federal disability documentation package, and a formal grievance ready to file. We did all of this while working full time, moving our household, parenting our other children, and caring for a young man who cannot independently manage his morning hygiene routine without daily prompting.
When Capital Stars’ supervisor confirmed to us in writing that the agency had lost its funding, that staff had begun moving toward secure employment, and that the ability to provide regular services had been impacted for some time, he also told us that FSP-level transfers were paused at the county level because the entire FSP system is being transitioned to a new model. My son could not be transferred to another FSP program. Instead, we were offered a step-down to a lower level of care at one of the agencies I had already researched myself. My first thought was not anger. It was recognition. We had already known. We had been the services.
The FSP model was developed in California in the late 1990s as a response to a simple and devastating recognition: that the people most in need of mental health services were the least able to access them through office-based, appointment-keeping care. The model promised to meet clients where they are, with whatever it takes, for as long as it takes. It was funded by the Mental Health Services Act, passed by California voters in 2004, and has been a cornerstone of the state’s behavioral health infrastructure for two decades.
The state’s Commission for Behavioral Health, formerly the Mental Health Services Oversight and Accountability Commission, published a report in 2024 identifying significant opportunities to improve FSP programs. Sacramento County is now in the middle of a system redesign, rebranding the FSP system under a new structure. FSP-level transfers are currently paused county-wide as this transition takes shape.
What that means for families like mine, right now, in this gap, is that we are largely on our own. The program that was supposed to serve our son has lost its funding and its staff. The system that was supposed to catch him is mid-redesign, with transfers paused and a new model not yet operational. And the family that was never supposed to be the primary clinical infrastructure continues to be exactly that.
I am a law student. I have 25 years of experience in enterprise technology sales. For eight years, I served as editor, writer, and graphic designer on the California Medi-Cal contract, translating dense legal policy, regulatory changes, and payment and billing terms into clear, usable guidance for the 90,000 physicians across California who provided Medi-Cal services and billed the program for the care they delivered to their patients. I survived nine months of homelessness living in my car without any city, county, state or federal assistance. My husband Daniel survived the carceral system and came home committed to building something different. Between us, we have lived in the systems that fail people, and we came out with the knowledge of what those systems cost when they do not work.
That knowledge is not supplemental to my son’s care. It is, in many cases, the most accurate and complete clinical picture available. I know what his morning looks like when the medication is working and when it is not. I know what it takes to get him to a door and into a car. I know that the same neurological barrier that prevents him from completing his morning hygiene routine prevents him from independently managing a week-old appointment without a reminder call. I know this because I am there, every day, without a billing code, without a contracted scope of services, and without the option to move toward more secure employment.
The principle my husband and I have been building toward, through The Bedrock Initiative and Bedrock Wellness Collective, and through the legislative proposal we call Othman’s Law, is this: primary caregivers who have accumulated specific, sustained, lived knowledge of a loved one with serious mental illness hold clinical authority that behavioral health programs are required to acknowledge, integrate, and document. Not as a courtesy. Not as a supplemental perspective. As a clinical asset.
When a care team dismisses that authority, it does not protect its professional standing. It discards its most accurate source of information. And when it does that in front of the client, it fractures the trust that is the scaffolding holding the client’s stability in place.
My son is still stable. He is on his medication. He is living at home with people who love him and will not stop showing up for him regardless of which program holds the contract.
But there are families in Sacramento County right now who do not have what we have. Who do not have the education, the professional background, the healing, or the temperament to build a 30-page care plan when the contracted program does not. Who did not survive hardship with their integrity intact and their advocacy skills sharpened. Who are sitting in a chair right now watching a program close and wondering what comes next.
The FSP redesign, being rebranded county-wide for adults as RENEW (Recovery, Engagement, Navigation, Empowerment, and Wellness) is an opportunity. Sacramento County has publicly acknowledged the need for an FSP system redesign. The Commission for Behavioral Health identified significant gaps in FSP program delivery in its 2024 report. The state knows what is broken. The question is whether the new system will be built around the client and the family, or around the billing code and the schedule.
My son deserved the first one. He got the second. And I will be watching very closely to see which one the redesign delivers.
I hope the people making those decisions are paying attention too.
Anita Brazil-Paita is the founder of The Bedrock Initiative and co-founder of Bedrock Wellness Collective, a recovery and reentry organization in Sacramento. She is an MS Law candidate at McGeorge School of Law and the primary advocate for her son, who has a dual diagnosis of schizophrenia and bipolar disorder.
