Health department-based home health agencies are continuing to become more scarce, multiple closings and sales around the nation show. In Michigan: The Health Department of Northwest Michigan will close its certified home health and hospice programs on Sept. 30, Hospice of Northwest Michigan says on its website. The agency based in Charlevoix employs 16 workers, the Petoskey News-Review reports. “There are complexities related to Medicare reimbursement that everybody is finding difficult and agencies that are able to survive in that environment are the ones that are large enough to offset the costs,” a health department spokesperson said. “That’s the challenge we faced.” In North Carolina: The Halifax County Health Department expects to close and sell its home health and hospice agency this fall, reports the rrspin.com online newspaper for Roanoke Rapids, Weldon, and Halifax County. Increased expenses, declining revenues, and private-sector competition precipitated the move, Deputy County Manager Dia Denton said in a statement. Potential buyers have expressed interest in the agency founded in 1969, which employs eight full time staff and five part-time, according to Denton. In Kentucky: And health departments aren’t the only entities closing HHAs and hospices to stem losses. Pikeville Medical Center has announced it’s closing its home health unit, reports WSAZ News in Huntington, West Virginia. “It’s difficult to make the necessary investments to be able to grow this service line and to provide the equipment and all the support that our patients are entitled to,” PMC CEO Donovan Blackburn said of the agency with 30 employees.