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If middle-class pocketbooks already are aching at the prospect of next winter's heating bills, consider the poor and elderly on fixed or pinched incomes.

Social service agencies that provide heating assistance to the needy say they are worried clients will be forced into making troubling choices.

"They are having to make choices like, 'Do you stay warm, or do you eat?'" said a concerned Jonathan Carlson, executive director of Self-Help Inc.

Self-Help's Fuel Assistance Program provides assistance with heating costs to more than 9,000 households annually in 31 cities and towns across Southeastern Massachusetts, including Attleboro.

People in need already have been contacting Self-Help in preparation for winter, which is unheard of in past years, Carlson said. "Elderly people are especially nervous," he said because many are on a fixed income, trying to pay for medical expenses, and faced with increasing costs of living beyond fuel prices.

The program is funded federally, but those funds have proven inadequate to meet recent demand.

"Something significant has to change," said Carlson, who hopes the federal government will increase funding.

Self-Help already has asked for $15 million from the state to help cover the rise in fuel costs, said Carlson, who encourages citizens to address the situation with their local and state representatives.

The Attleboro Energy Fund is not waiting around, either. "We can't wait until fall - we need your help now!" reads a flyer sent out by fund organizers to local businesses in search of donations.

The Attleboro Energy Fund was created as another option to Self-Help to assist the elderly and disabled on fixed incomes and low-income and working poor families who are unable to meet rising fuel costs.

What is particularly frustrating, Carlson said, is the number of middle-class families struggling to pay for fuel costs and other goods, yet are just outside the range to qualify for assistance.

"A huge percentage of people in Attleboro fall outside the 200 percent poverty level needed to qualify for Self-Help," said Julie Fleishmann, outreach manager the city health department.

That's why other funds and programs have been established to assist those in need, she said.

With oil price up from $2.50 a gallon a year ago to more than $4.50 now - and with no end in sight, Madeline McNielly, director of the Attleboro Council on Aging and leader of the Attleboro Energy Fund, wanted to reassure those in need. "It is important that people know that there are people in the community who care and are working very hard to prepare for winter," she said.