FUSE Executive Fellow | Building Organizational Capacity to Expand Healthcare Access

FUSE Executive Fellow | Building Organizational Capacity to Expand Healthcare Access Join to apply for the FUSE Executive Fellow | Building Organizational Capacity to Expand Healthcare Access role at FUSE . Due to Medi-Cal updates, Fresno County residents can access healthcare from eligible community-based organizations. Fresno County partners aim to equip these organizations with the tools and knowledge they need to participate in this opportunity. The Executive Fellow will support this work by developing tools, education programs, and relationships necessary to build organizations’ capacity. As a result of this work, Fresno residents from all backgrounds will be able to access quality care through this community-based health model. Fellowship Dates: April 27, 2026 – April 23, 2027 Salary: Executive Fellows are FUSE employees and receive an annual base salary of $95,000. Fellows can also access various health, dental, and vision insurance benefits. Compensation for this year of public service is not intended to represent market-rate compensation for the experienced professionals in our program.

ABOUT THE FUSE EXECUTIVE FELLOWSHIP

FUSE is a national nonprofit working to expand social and economic opportunities, particularly for communities that have been limited by a history of systemic and institutionalized racism. FUSE partners with local governments and communities to more effectively address pressing challenges by placing experienced professionals within city and county agencies. These FUSE Executive Fellows lead strategic projects designed to advance racial equity and accelerate systems change. Since 2012, FUSE has led over 250 projects in 40 governments across 20 states, impacting the lives of 25 million people.

PROJECT CONTEXT

Fresno County serves approximately 4,300 households with community-based health programs (e.g., home visitation programs, community health worker programs, etc.) with an estimated need of 10,000 households. Community based organizations (CBOs) are critical for last mile public health delivery. While these organizations typically have small budgets and staff, they catalyze a large impact. The CBO community-based health workforce (e.g., community health workers, home visitors, doulas, promotoras) are especially effective, because they treat/support the whole person and have trust, connections, and insight related to their local communities. During COVID-19, many CBOs delivered lifesaving information, support, and supplies to families in Fresno County. While their public health work was effective, the pandemic revealed that CBOs frequently lack the administrative and operational capacity to manage, often administratively intensive, government funding requirements. This limits their ability to pursue strategic grants, scale up good work, and serve their communities through more diverse support. During the pandemic, the County of Fresno was able to make arrangements for financial and administrative oversight of the federal funding that went to local CBOs, but those resources were for extraordinary circumstances. CalAIM, a state program that expands healthcare definitions to include CBOs, presents an opportunity for sustainable, reliable, long-term funding for these services. To promote holistic, relevant healthcare services for all communities across the County, First 5 Fresno County, and its partners, aims to equip local CBOs with the skills, processes, and resources they need to properly secure and manage state, federal, and philanthropic funding. First 5 Fresno County will partner with FUSE Corps to build CBOs’ capacity to access and manage grants and healthcare funding. The Executive Fellow will develop strategies for CBOs to pursue CalAIM funds; create a funding matrix that maps out options (e.g., state, federal, philanthropic) and requirements; design tools for CBOs to calculate and demonstrate the true cost of their services; develop a CBO specific academy or certification program framework/curriculum to build organizations’ administrative knowledge and skills; and forge the relationships, connections, and insights necessary to foster long‑term collaboration and capacity building. As a result of this work, Fresno CBOs will be able to access sustainable, strategic funding and residents will benefit from community-based health services. Development of the academy/certification program framework curriculum will assist future implementation and assess logistical challenges that may need to be addressed prior to launching.

PROJECT SUMMARY

Starting in May 2026, the FUSE Executive Fellow will develop deep relationships with a broad range of stakeholders, including County partners (e.g., First 5 Fresno, Department of Public Health), community partners (e.g., Fresno Cradle to Career, Sierra San Joaquin Jobs), local CBOs, local health plans and members of the public. When arranging conversations with CBOs and members of the public, the Executive Fellow should ensure they speak with organizations and communities that represent the County’s geographic, economic, cultural and linguistic diversity. The Executive Fellow will seek to understand the resources, opportunities, and aspirations these partners have for holistic, sustainable community-based healthcare access in Fresno County. In addition, the Executive Fellow will review best practices for building CBO capacity in communities similar to Fresno. Finally, the Executive Fellow will work with their Executive Sponsor and Project Supervisor to develop and approve specific project goals and deliverables. While these goals and deliverables will likely include the ones listed below, they may differ based on situational changes and the Executive Fellow’s specific skills and experience. Next, the Executive Fellow will develop strategies to address the barriers CBOs face in accessing Medi-Cal and other funding sources. This could include HIPAA compliance and analysis of covered entity vs. business associate status; IT infrastructure to streamline operations and comply with HIPAA standards, align with grant requirements, and properly secure data; or shared contracts for accounting and legal services. If successful, these strategies should help small, cash‑strapped CBOs implement sustainable, financially viable practices and systems that set them up for long‑term success in scaling operations and accessing new funds. At the same time, the Executive Fellow will create a funding matrix that identifies the major types of funding that CBOs providing community-based health services can access, the eligibility requirements for each type, and considerations CBOs should evaluate when they encounter funding opportunities. This matrix should help CBO leaders understand what funding they can access now, what they need to do to access new kinds of funding (e.g., expand from state to federal grants), and the advantages and disadvantages of pursuing those new funds. In addition, the Executive Fellow will design tools that support CBOs in calculating the true cost of their services. This tool would allow CBOs to accurately bill Medi‑Cal for their services in compliance with regulations without losing money in the process. It should include methods to calculate indirect costs (i.e., overhead), developing “weighted hourly rates”, information on de minimis cost recovery options, and guidance on the cost and benefits of pursuing higher indirect rates. Equipped with these analyses and tools, the Executive Fellow will create a CBO academy or certification process for future development. This academy should walk CBOs through the practices, processes, and tools they need to eliminate barriers, streamline operations, track costs consistently to meet standard audit and single audit requirements, secure new funding, and manage those funds appropriately. A CBO that graduates from the academy should have the ability to manage appropriate grant funding on their own or in a partnership, without additional oversight from Fresno County. Finally, the Executive Fellow will engage government and community stakeholders to evaluate and implement the deliverables discussed above and identify opportunities and plans for future collaboration. This could include developing partnerships and blended funding from multiple sources to amplify impact, and identifying opportunities for local and statewide policy/systems change to increase funding for and access to critical community-based health services.

PROJECT DELIVERABLES

By April 2027, the Executive Fellow will have overseen the following: Conduct a Stakeholder Listening Tour – Develop relationships with County government, local partners, CBOs, and members of the public to understand the resources, constraints, perceived opportunities, potential threats, and aspirations affecting community-based health access from CBOs. Conduct best practices research on equitable, accessible CBO funding in similar communities. Develop MediCal Strategies – Identify ways to remove barriers to accessing MediCal funds related to the CalAIM expansion. Create Funding Matrix – Map out funding sources for CBOs providing community-based health services and the requirements and considerations to access them. Design Cost Tools – Create tools that support CBOs in accurately demonstrating the cost of their services, benefits of developing “weighted hourly rates”, including indirect costs, in compliance with regulations. CBO Academy Development of Curriculum – Design an academy or certification that equips CBOs with the knowledge and practices necessary to sustainably access and manage new sources of funding. Engage Stakeholders – Facilitate relationships between government and community stakeholders to evaluate progress and plan for future iteration and expansion, including blended funding and programs.

KEY STAKEHOLDERS

Project Supervisor – Joe Prado, Assistant Director, Department of Public Health Project Supervisor – Hannah Norman, Early Childhood Initiatives Director, First 5 Fresno County Seniority Level Director Employment Type Full-time Job Function Strategy/Planning, Consulting, and Project Management Industries Civic and Social Organizations, Government Relations Services, and Non-profit Organizations #J-18808-Ljbffr FUSE