One Vision to reduce services
Will end hourly support, internal nursing services
Trending
People with disabilities in Webster County who receive hourly support from One Vision will face a change in services in early February 2027, when the nonprofit ends its hourly support and internal nursing programs because of what officials describe as inadequate Medicaid reimbursements.
The Clear Lake-based agency, formerly Opportunity Village, serves people across multiple counties, including Webster, Hamilton, Calhoun and Sac counties. One Vision's Traditional Daily Services and Smart Living programs will continue.
Janet Johnson, One Vision's chief development officer, said the decision follows years of advocacy for higher Medicaid reimbursement rates.
"The Medicaid reimbursement rates for hourly support services do not adequately cover the cost of providing those services," said Johnson. "One Vision, along with many other providers, has advocated higher reimbursement rates for many years. Despite these efforts, the funding gap remains, making it impossible to sustain this service model."
According to Johnson, continuing to absorb those losses would divert resources from other essential programs and threaten the organization's ability to maintain its broader services.
"We have continued providing hourly services as long as we responsibly could, but the current funding model is no longer sustainable," said Johnson.
According to Chief Operating Officer Kelly Hinds, One Vision will help individuals receiving hourly support to determine their next steps. Planning will involve each individual's care team, case manager and family or guardian, as appropriate, with discussions focused on their needs, preferences and available services.
Options may include moving to another hourly support provider or exploring self-directed supports through the Consumer Choices Option. One Vision's Daily Services, including Smart Living where appropriate, may also be considered if a person's care team determines a different level of support is needed.
"There is no predetermined service model or expectation that individuals transition to another One Vision program," said Johnson. "Our priority is to support informed, person-centered decisions that reflect what works best for each individual."
One Vision CEO Dr. James Williams said the organization is collaborating with other community providers to help people transition their hourly support. The changes do not alter an individual's evaluated support needs or eligibility for care, he said.
Hinds said announcing the decision months in advance gives individuals and their families time to consider their options and prepare.
"Our priority is to ensure that individuals and their teams have the information, time, and support needed to make informed decisions," said Hinds.
In response to questions about staffing in Webster, Hamilton, Calhoun and Sac counties, Hinds said approximately one employee works in hourly support and two work in nursing "in our region."
Affected employees have been encouraged to explore and apply for other jobs within One Vision, said Hinds. Williams said comparable positions will be available to all hourly direct support employees who want to remain with the organization. Leaders are working individually with nursing employees to identify potential alternative roles.
"The services being discontinued represent a small portion of One Vision's overall operations; however, we recognize that the impact is meaningful for the individuals and employees directly affected," said Hinds.
With internal nursing services ending, Johnson said individuals will access health care through their established community providers, including primary care physicians, specialists and clinics.
Medication-related oversight, staff guidance and operational support will continue through One Vision's leadership structure and existing on-call processes, she said. Nurse advice lines offered through Iowa's Medicaid managed care organizations may serve as an additional resource when appropriate.
According to Johnson, One Vision is reviewing existing responsibilities, identifying additional staff training needs and ensuring processes are in place for accessing health care resources.
"Our focus is on maintaining continuity of support while reinforcing the use of community-based health care services and resources already available to the individuals we support," said Johnson.