• Elizabeth Bromley, Chantal Figueroa, Enrico G Castillo, Farbod Kadkhoda, Bowen Chung, Jeanne Miranda, Kumar Menon, Yolanda Whittington, Felica Jones, Kenneth B Wells, and Sheryl H Kataoka.
• Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences; Desert Pacific MIRECC Health Services Unit, VA Greater Los Angeles Healthcare System, Los Angeles, CA.
• Ethnic Dis. 2018 Jan 1; 28 (Suppl 2): 397-406.

ObjectiveTo understand potential for multi-sector partnerships among community-based organizations and publicly funded health systems to implement health improvement strategies that advance health equity.DesignKey stakeholder interviewing during HNI planning and early implementation to elicit perceptions of multi-sector partnerships and innovations required for partnerships to achieve system transformation and health equity.SettingIn 2014, the Los Angeles County (LAC) Board of Supervisors approved the Health Neighborhood Initiative (HNI) that aims to: 1) improve coordination of health services for behavioral health clients across safety-net providers within neighborhoods; and 2) address social determinants of health through community-driven, public agency sponsored partnerships with community-based organizations.ParticipantsTwenty-five semi-structured interviews with 49 leaders from LAC health systems, community-based organizations; and payers.ResultsLeaders perceived partnerships within and beyond health systems as transformative in their potential to: improve access, value, and efficiency; align priorities of safety-net systems and communities; and harness the power of communities to impact health. Leaders identified trust as critical to success in partnerships but named lack of time for relationship-building, limitations in service capacity, and questions about sustainability as barriers to trust-building. Leaders described the need for procedural innovations within health systems that would support equitable partnerships including innovations that would increase transparency and normalize information exchange, share agenda-setting and decision-making power with partners, and institutionalize partnering through training and accountability.ConclusionsLeaders described improving procedural justice in public agencies' relationships with communities as key to effective partnering for health equity.

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