The One Water approach offers tremendous opportunities for improving how water is managed within communities. Using water efficiently and taking advantage of diverse, locally available water supplies are important goals. It is also important that the approach support communities in assessing how their water use affects the health of waterways, both upstream, where water is sourced, and downstream, where other communities and aquatic resources may be impacted. This document shares preliminary findings from a survey that assesses whether the One Water approach is realizing its potential to meaningfully ensure healthy waterways. This report also shares findings on the current “state of practice” through a series of interviews with a cross-section of utility staff, planners, engineers, and scientists involved in One Water implementation.