Doctors, advocates, service providers, and others who work with Virginia's poor, elderly, and disabled residents are bracing for steep cuts in services as the state attempts to close a projected $2.5 billion shortfall in its two-year 2009-10 budget. Advocates for those who rely on such services said the cuts would be particularly devastating because Virginia spends relatively little on such programs compared with other states, and many have not fully recovered from the last economic downturn.