The second in a four-part series that Shift is hosting on Reimagining Equity focused on shifting from community engagement to community accountability. The session kicked off with one of the core driving questions of the series: what would your healthcare system/organization look like if patients and communities you served were calling the shots? Participants deepened an analysis of how their current community engagement efforts are situated on a continuum, using the Spectrum of Community Engagement to Ownership tool, particularly reflecting on the experiences of community residents when engaging with healthcare institutions. A panel of guest speakers brought unique insights into why and how healthcare might further interrogate it’s own role in advancing more participatory community engagement practices and in fact, establishing accountability mechanisms to ensure community residents are informing and driving health equity efforts. Guest speakers included Artair Rogers, PhD Candidate in the Harvard University School of Public Health, Leigh Caswell of Presbyterian Healthcare Services, and Felipe Tendick-Matesanz of Cook County Public Health. Speakers offered insights into the harms and costs of not moving toward shared decision-making with communities, as well as creative opportunities to engage communities more fully, such as through a Community Ambassador program and positioning public health in support of community organizing. All touched on trust, reconciling harms, and creating accountability feedback loops that position community members and patients in roles to hold health systems accountable to health equity goals. Finally, participants reflected on obstacles and solutions to influence greater community accountability within the health sector.