This session will feature the experiences of two California sites in developing and implementing multi-sector Accountable Communities for Health that aim to advance equity and improve community health through targeted systems changes. Representatives from the Fresno County Health Improvement Partnership and the East San Jose PEACE Project will share their journeys in advancing equity through system transformation within local health care ecosystems. Practical solutions for initiating impactful and sustainable changes to “level the playing field” among community partners will be shared, including how to initiate “difficult conversations,” address historical power dynamics, and build trust among health systems (e.g., health plans and hospitals), public agencies, community based organizations, and community members. The session will present both evaluation findings and site-specific examples of effective governance, data, and programmatic strategies to advance equity and systems changes.