The distribution of power in society is “upstream of the upstream” social determinants of health, and community organizers redistribute power to change social and political systems that shape health. Power-building Partnerships for Health (PPH) was launched in 2018 and pairs local public health departments and community organizing groups to support transformational health equity work, prioritizing trust and relationship building as precursors for action. Through PPH, the Santa Barbara County Public Health Department partnered with 2 grassroots organizations, CAUSE and MICOP. This partnership led to their launching a Latinx Indigenous Migrant Health COVID-19 Task Force and to the passing of a first-of-its-kind Health Officer Order on safety in farmworker housing. This practice brief discusses the importance of relationship building and key activities within PPH, and the roles of both the health department and community organizers in taking action to advance health equity in Santa Barbara County during the pandemic.