In FY 2004 LIHEAP will provide close to $2 billion in heating and cooling assistance to more than 4.9 million low-income households throughout the United States. The National Energy Assistance Directors' Association (NEADA), representing the state directors of the Low Income Home Energy Assistance Program (LIHEAP), contracted with APPRISE to conduct a national survey of 2,161 LIHEAP recipients to collect information on the choices made by households in FY 2003 when faced with high energy bills. Among the findings of the study: -The majority of households have at least one member who is disabled (43%), elderly (41%), and/or have a child under the age of 5 years old (18%). -LIHEAP assistance reduces the percentage of household income spent on total residential energy costs from 14% to 11%. -In FY 2003, 17% were unable to use their main source of heat due to discontinued utility service or an inability to pay for fuel, and 8% had their electricity shut off due to nonpayment. -In the past five years, 22% went without food for at least one day, 38% went without medical or dental care, 30% went without filling a prescription or taking the full dose of a prescribed medicine, 21% became sick because their home was too cold, and 7% became sick because their home was too hot. The study clearly documents that low-income households spend an inordinate amount of their household income on energy; households that receive LIHEAP face significant hardship in attempting to pay their energy bills; and yet LIHEAP makes a significant difference for recipient households.