A study was conducted to determine whether increased water and sewer user fees have generated increases in payment delinquencies and service cutoff rates and whether they have created other problems such as increased health hazards. Another objective was to examine the varied user-charge structures, billing procedures, and methods of debt collection in small utilities to identify procedures and policies that might minimize any negative impact of sudden fee increases on low-income customers. These data will be used to assess the impact of any rate increases that may occur as a result of small utilities raising rates to pay for new technology mandated under the Safe Drinking Water Act. Three separate studies were undertaken. The first was a survey of management procedures and policies in 30 utilities. The second study consisted of a survey of selected low-income customers in these utility service areas to evaluate customer awareness and attitudes toward billing and debt collection techniques, to assess any possible health hazards connected with service cutoffs, and to prepare a socioeconomic profile of families likely to be adversely affected by sudden fee increases. Finally, monthly aggregate data from three utilities that had experienced fee increases were used to test the hypothesis that fee increases generate increased delinquency and cutoff rates. Water supply was concluded to be very price inelastic and no relationship was demonstrated between rate increases and customer cutoffs.