In the United States, programs over the past 40 years to improve water qualityhave been nothing short of exemplary. This has been made possible by the passageof strong state and federal pollution control legislation, backed up by thelargest environmental public utilities construction grants program in thenation's history, the associated and subsequent expenditures of state and localfunds, the construction of industrial pollution control works and improved landmanagement practices. From this effort, water quality has improved to the extentthat fish kills resulting from ambient water quality conditions are not common,but relatively rare. In many waters more robust aquatic communities havedeveloped and economic benefits from increased recreation use and landsidedevelopment has occurred. However, as a nation, we have reached the "knee of thecurve" plotting water quality benefits against cost, utilizing our regulatoryapproaches (laws and programs) of the latter half of the 20th century. Statedsimply, building and/or achieving higher removals from sewage andindustrial treatment plants is not the flagship approach for the future. Indeed,it is widely understood and accepted that the strategies appropriate andnecessary to move us forward in any significant way must involve a watershedapproach that embraces integration, collaboration, coordination, partnering andcreativity. Two developing programs that will require the application of thesecharacteristics are the Total Maximum Daily Load (TMDL) Program under section303d of the Federal Clean Water Act and the Source Water Protection Programrequired by the most recent Amendments to the Federal Safe Drinking Water Act.Implementation of the TMDL, Source Water Protection, and other emergingstrategies on interstate streams in the U.S. will present particularlyinteresting and difficult challenges. The experience of the Ohio River ValleyWater Sanitation Commission (ORSANCO) in working with the agencies of the U.S.Government, state agencies, water users and wastewater dischargers along the OhioRiver permits a good to-date case history of what has been done, what needs tooccur and the role of water utilities. Includes figure.