New York state is laying off 10,000 workers. Los Angeles has stopped hiring new police officers even though street crime is getting worse. Maryland halted a program that buys medicine for the poor.

Across the nation, state and local officials are making tough choices. Squeezed by falling revenue, they are balancing the books the hard way, by cutting back on what government can do."I guarantee you we won't be able to care for as many foster children, mentally ill and so forth as we did last year of the year before," said Roger Wilson, a state senator from Missouri, which faces a projected $70 million shortfall.

At least 26 states face deficits or budget shortfalls this fiscal year. Nearly all have made spending cuts and face more as the economy worsens.

"It becomes a political decision. Do you want to let people out of jail early or do you want to pay a higher sales tax? Do you cut education or cut health care to the old and indigent?" said Marsha Howard, research director for the National Association of State Budget Directors.

Dozens of cities have resorted to layoffs or freezes.

Los Angeles and Louisville, Ky., have closed neighborhood health centers. Vermont and Maryland are putting off programs to help the old and poor pay for prescriptions.

Maryland health advocates say the cuts will affect 300 people with AIDS, although state officials say help is available through other programs.

After several years of belt-tightening, services once considered untouchable now face cuts, including schools, Medicaid and prisons. On average, 25 percent of state budgets go to education, 14 percent to Medicaid and 5 percent to prisons.

Options are even more limited for local officials, who rely heavily on federal and state aid. Federal funds have dried up and some states, such as Massachusetts, New York and Minnesota, have cut local aid.

"We're the last government on the end of the rung," said Paul Rouis, administrator for Sullivan County, N.Y., which raised property taxes and froze salaries. "We've been successful at cutting our spending, but the sponge is dry."