Rising costs and rising water bills are inevitable. For customers, the problem of water affordability may result in increased arrearages, late payments, disconnection notices, and service terminations. Utilities, under increasing pressure to respond to affordabilty and disconnection problems, generally prefer assistance-oriented programs in cooperation with social agencies over rate structure modifications. In this article the author reviews available options including financial counseling, arrearage forgiveness, payment discounts, income-based payments, lifeline rates, targeted conservation, disconnection moratoria, and flow restrictions. Includes 31 references, tables.