Building Organizational Capacity to Expand Healthcare Access

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: October 27, 2025 – October 23, 2026

Salary: Executive Fellows are FUSE employees and receive an annual base salary of $80,000. 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

PROJECT CONTEXT

Fresno County serves 4,300 households with community-based health programs (e.g., home visitation programs, community health worker programs, etc.). While this is impressive, the estimated need is 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 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.

The 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; launch a CBO academy or certification program 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.

PROJECT SUMMARY

Starting in November 2025, 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, 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, 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 funding. 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 health CBOs 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. This academy should walk CBOs through the practices, processes, and tools they need to eliminate barriers, streamline operations, 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.

To ensure sustainability, the tools and strategies the Executive Fellow develops should be durable, replicable, and scalable. Any ongoing County responsibilities to manage or update tools and the academy must be feasible under current budget and staffing patterns. In addition, Fresno County aspires to replicate and scale this approach with partners in other Central California counties. Thus, any features that are specific to Fresno County should be identified for adaptation to other contexts.

KEY STAKEHOLDERS

• Executive Sponsor: Fabiola González, Executive Director, First 5 Fresno County
• Project Supervisor: Joe Prado, Assistant Director, Department of Public Health
• Hannah Norman, Early Childhood Initiatives Director, First 5 Fresno County

QUALIFICATIONS

• Synthesizes complex information into clear and concise recommendations and action-oriented implementation plans.
• Develops and effectively implements both strategic and operational project management plans.
• Generates innovative, data-driven, and result-oriented solutions to complex challenges.
• Respond quickly to changing ideas, responsibilities, expectations, trends, strategies, and other processes.
• Communicates effectively verbally and in writing and excels in active listening and conversing.
• Fosters collaboration across multiple constituencies to support more effective decision-making.
• Establishes and maintains strong relationships with diverse stakeholders, both inside and outside of government, particularly community-based relationships.
• Embraces differing viewpoints and implements strategies to find common ground.
• Demonstrates confidence and professional diplomacy while effectively interacting with individuals at all levels of various organizations.

FUSE is an equal opportunity employer. We encourage candidates from all backgrounds to apply for this position.