RALEIGH, N.C. — The North Carolina General Assembly gave final approval Wednesday afternoon to a $19 billion spending plan for the fiscal year that starts Thursday, and Gov. Beverly Perdue signed the budget bill into law.

"This year was tough, but next year will be tougher. This budget puts our state on firm ground as we head towards the challenges of next year," Perdue said in a statement.

The budget includes about $800 million in cuts and no tax increases, although some fees will go up.

The cuts affected most areas of state government. The Department of Health and Human Services, for example, saw its budget cut by $370 million, forcing it to trim services to thousands of people who receive in-home assistance.

DHHS officials raised the standards for people to qualify for aid under the Personal Care Services program. In addition to saving money, it helps the department cut down on waste and fraud. A recent audit showed that about 80 percent of those served by the PCS program were either ineligible or received too much assistance.

"We've had numerous audits that show half the people were not eligible for the program," Senate Minority Leader Phil Berger said.

Of the 38,000 people currently in the PCS program, as many as 22,000 could lose services by Jan. 1.

"I don't know where I'm qualified, but I know I need help," Pauline Hinnant said.

The 77-year-old retired minister said she never fully recovered from a 2005 back operation and needs the few hours of state-funded nursing services she receives daily at her Nash County home.

"Keeping that prayer line rolling, yes I am," Hinnant said.

"This is North Carolina's fallback service," said Tracy Colvard, director of government relations for the Association of Home and Hospice Care. "You eliminate this program, and the federal pushes and all the state pushes for home community-based services, it's gone."