One year ago today, Ronald Reagan officially began his plan to change the direction of the federal government.

Oct. 1, 1981, the day the Reagan administration's first budget and accompanying regulatory changes took effect, was to be the opening day of a revolution. The government was supposed to reverse decades of growth by cutting spending on health, welfare, education, employment, transportation and the arts without destroying what Reagan called the "social safety net" aimed at protecting America's poor and needy.

Critics painted a doomsday scenario. But in the Washington area the result has been neither the dramatic change forecast by the Reagan administration, nor the devastation predicted by its opponents.

In the past 12 months there have been substantial cuts, primarily affecting the working poor, in welfare, food stamp and Medicaid programs. Other threatened programs, however, remain largely intact, as called-for reductions in Social Security, many student loan programs, the national arts budget, Saturday mail service, and other targets did not materialize at all, while other cuts were less severe than expected.

The District of Columbia government, for example, in its first fearful reaction to Reaganomics, initially predicted a loss of $69 million, more than one-sixth of the city's entire federal aid. Then last October D.C. officials downgraded their estimate to $46 million. Now, as the fiscal year ends, they believe the District's loss has actually been negligible because Congress did not go along with some cuts and because dozens of federal categorical grant programs continued during the year despite the administration's plans to convert them to so-called block grants.

"We assumed the worst" in early budget estimates, said D.C. budget analyst Diana Carsey, "but a lot of it didn't happen . . . . It seems like a case of a bureaucracy that runs in spite of its masters."

The changes that did take place, however, hit the poor hardest in Maryland and Virginia as well as the District. The cuts in welfare, the abolition of the Community Services Administration and the Comprehensive Employment and Training Act public service jobs program, along with cuts in the Legal Services Corporation, came at a time when the deteriorating economy has heightened the need for job placement, housing assistance, and legal representation, according to advocates for the needy.

The damage done to individuals by cuts in entitlement programs has been direct and painful, if somewhat less widespread than first feared. The welfare cuts, which most often affected single women heading households, dropped 19,500 persons, or 9 percent of the total welfare rolls, in Maryland; 7,500, about 11 percent, in the District; and 10,700, about 6 percent, in Virginia.

But a larger number have been affected indirectly by a broad spectrum of cuts in health and social services resulting from the loss of federal aid under the new block grant process, in which more than 30 different grant categories have been lumped into five blocks with funds cut by 10 to 30 percent.

In many instances, the Maryland and Virginia legislatures and the D.C. City Council have spent local money to compensate for the loss of federal aid. Nonetheless, scores of health agencies, alcohol and drug abuse programs, social service programs and other government-funded activities have begun feeling the pinch of the cuts.

While the full impact of the cuts is difficult to assess, the reduction in services has already had a a tangible effect on the lives of the middle class as well as the poor.

In Virginia, 4,000 children were dropped from the crippled children's program as part of the effort to compensate for the $7 million reduction in the federal maternal and child health block grant, a 25 percent cut. Children with uncorrectable diseases were dropped from the program. "We're focusing on kids who can be rehabilitated," said Dr. Dale Hunsacker, director of the Virginia division of family health services. "We're not taking care of the long-term kids." In the Arlington orthopedic program, for example, 45 children with "mild to moderate" cases of twisted spines were dropped from state-provided services.

In order to save about $630,000, the state also stopped paying for the hospital costs of children before they were accepted into the program, imposed a 21-day limit on hospital stays and dropped children whose parents were over the income guidelines, which in Northern Virginia is $19,189 for a four-person household.

Virginia's 13 child development clinics were forced to impose fees July 1 for the first time, with a maximum charge of $249 for an evaluation. The Arlington County clinic, for example, lost one social worker and its part-time psychiatrist and pediatric neurologist under the reduced block-grant funding. "Our referrals have dropped off as the referring agencies are a little nervous about the fees," said director Bill DeVore.

The state also closed a burn program for children at the Medical College of Virginia in an effort to save $100,000 yearly.

In the District of Columbia, the United Planning Organization, once the main arm of the War on Poverty, lost more than $4.5 million last year and laid off more than 200 of its 500 employes because of the ending of both CSA- and CETA-funded positions.

As a result of the layoff of "neighborhood workers," UPO has undergone a change in emphasis, said Lillian Durham, director of field operations. The antipoverty agency now spends much of its time on emergency assistance in needy neighborhoods rather than its original focus of up-by-the-bootstraps community development.

For example, at Friendship House in Southeast Washington, a UPO-assisted agency, eight counselors who helped tenants fight evictions or assisted parents in finding education for handicapped children have been fired. "

In Maryland, the deepest of the cuts in the health area came in preventive care. Among the results were the closing of two hypertension clinics, in Baltimore and Cecil counties. "Essentially, it's fallen back to the private sector," said Dr. John Southard, director of the state's hypertension program, which was cut 19 percent.

Statewide, preventive health services, which includes county health departments, health education, rodent control and many other programs, was cut 30 percent, to $1.6 million from $2.3 million.

Aside from cuts resulting from the new block grant process, other programs have been singled out for substantial cuts. Neighborhood Legal Service, closed two of its seven Washington offices, reduced its 89-member staff by 25, and has periodically been forced to turn away cases at its five remaining offices after its budget was cut by roughly 25 percent, according to William Martin, the assistant director.

Legal Services and other legal programs serving the poor in Washington have been cut more than $800,000, cuts that have only partially been offset by lawyers and firms donating time and money. "In Landlord-Tenant Court or in Small Claims Court, you start to see an awful lot of clients who just don't have an attorney to represent them," said Martin.

D.C. officials have pledged no reduction in drug treatment, but some drug-counseling programs have suffered cuts. The Capitol East Drug Abuse Education and Prevention Center, started in 1968 in Southeast Washington, shut down for six months this year and has reopened with a reduced budget because of federal community service funding cuts, according to Francine Agurs, its director.

The counseling program, which employs young people to help other youths, will now have four part-time counselors instead of the maximum of 10 it formerly employed. Its operating hours will also be reduced so that the agency will counsel about 20 youngsters monthly compared with 30 or 40 last year, Agurs said.

"Almost every child out here has experience with drugs, marijuana or 'lovely,' which is PCP, and they haven't gotten into hard stuff," said Agurs. "But some of them have tried them out, and the budget situation limits me from reaching them."

Education funding has been cut in a variety of categories. For example, the Refugee Education and Employment Program of Arlington, facing a $97,000 cut in federal money from its $364,000 budget, laid off three teachers and reduced the salary of 10 other instructors. Housed in an old school, the eight-year-old center assisted 1,100 refugees, mostly Vietnamese, Laotian and Cambodian, in 1981. Last October, the center reduced its classes to 20, instead of 25. Starting today, that number will be reduced to 14.

"Now the waiting time is one month to six weeks" for the 12-week-long classes that help refugees learn English and job skills, said director Inaam Mansoor. "At the end of the year, we predict it will be down to nine classes. It's just another roadblock to achieving a normal life."

The pinch on local school budgets forced Baltimore County to double the cost for reduced-price lunches, to 40 cents, in 1981 because of the federal budget cuts, said Shelley Terry, director of child nutrition programs for the Maryland State Department of Education. The higher priced lunch tickets are sold only on a monthly basis, putting the cost out of reach for some families, especially those with more than one school-aged child.

Federal employes have also not escaped the budget axe. They are paying 31 percent higher health-care premiums because of Reagan administration cost-containment measures, but have also had benefits reduced. Blue Cross, for instance, which covers about half the 350,000 federal employes in the region and their families, on Jan. 1 cut off payments for alcoholism treatment that can cost up to $275 a day.

As a result, federal employes are forgoing alcoholism treatment because they can't afford it, according to several area hospitals that report drops of roughly 20 to 30 percent in alcoholism patient load. Blue Cross will still pay for detoxification of acute alcoholics, but patients then leave hospitals because they cannot afford rehabilitation, hospitals report.

Roughly 10 to 15 prospective patients per month do not enroll in Providence Hospital's 37-bed alcohol unit because of the insurance change, said Patricia Drennan, the unit director. "I think that the shift in treatment coverage was capricious and ill-advised and costly in terms of dollars and in terms of human lives, and you can make that a direct quote," Drennan said. "To have to turn people away hurts, and it hurts a lot."