Executive Fellowship | Designing Countywide Framework to Optimize Public Health Investments

FUSE Executive Fellowship | Designing a Countywide Framework to Optimize Public Health Investments

Join to apply for the FUSE Executive Fellowship | Designing a Countywide Framework to Optimize Public Health Investments role at FUSE.

Fresno County is working to strengthen the efficiency and equity of its public health services by aligning investments with measurable outcomes. The FUSE Executive Fellow will design and pilot a countywide return‑on‑investment (ROI) framework that connects spending to impact, improves data‑driven decision‑making, and guides equitable resource allocation. Ultimately, this project will enhance accountability, expand access to quality care, and improve long‑term health outcomes for communities across Fresno County.

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.

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.

Improving the effectiveness and equity of public health services such as maternal and child health programs is essential to advancing community well‑being and ensuring that all residents benefit from quality care. In Fresno County, CA, while individual families who receive county services frequently experience positive outcomes, these results often fail to translate into broader, population‑level improvements. For instance, African American residents continue to experience the highest rates of infant mortality and preterm births, and Latino and Southeast Asian families, who represent a growing share of births, continue to have limited access to culturally responsive services.

At the same time, ongoing reductions in federal and state public health funding have forced the Department of Public Health (DPH) to make difficult decisions about how to allocate limited resources. A clear understanding of which investments deliver the strongest returns is vital for Fresno to reduce health burden and improve health outcomes for its most vulnerable populations.

To address this challenge, Fresno County DPH has strengthened its data collection systems, refined charting processes, and built capacity to link financial data with health outcomes. The department maintains strong fiscal tracking tools and is working to improve its ability to analyze the relationship between public health spending and community impact. Further, DPH is collaborating with the California Department of Public Health (CDPH) and the University of California, Merced to identify best practices for measuring the return on investment (ROI) of its public health programs such as how the county can balance professional and paraprofessional staffing (e.g., nurses vs.

health education staff) to serve more families effectively. However, no standardized ROI methodology currently exists in California. This lack of replicable framework limits the ability of counties to evaluate program performance, compare service models, or make data‑driven decisions about resource allocation.

Beginning in May 2026, the FUSE Executive Fellow will partner with the Fresno County Department of Public Health (DPH) to develop and pilot a data‑driven methodology that measures the return on investment (ROI) of public health programs.

The fellow will begin by conducting a comprehensive listening tour with internal and external…