Since 1979, Pierce County Public Health Department has offered home care service to local seniors and those with disabilities, allowing them to remain cared for in their homes.

But with the lack of increases in reimbursement rates and the recent depletion of reserve funds, Pierce County Board of Health voted to close the program at a May 8 meeting.

"This is a big decision that is on the table for us to make," Board of Health Chair and County Supervisor Ruth Wood said.

The end of this program in no way reflects the quality of the services, nor does it reflect on the dedication of the staff shown to residents, Pierce County Public Health Director AZ Snyder said at the meeting.

"This has been an incredibly difficult conversation to have. No one wanted us to get to this point where we had to have this conversation. It's been very emotional." Snyder said.

In part, the program is no longer sustainable due to lack of increasing reimbursement rates.

Medicaid reimbursement rates have not increased in over a decade and Veterans Affairs (VA) rates will decrease in June to match Medicare rates.

Beginning in 2015, reserve funds began to decline to cover losses in past years and were depleted last year, according to statistics from the Pierce County Public Health Department.

Staffing currently comprises 2.5 full-time registered nurses, one full-time home health aide, .5 full-time office specialist and .3 full-time public health nursing manager.

The department has also experienced recent registered nurse recruitment challenges and wage competition.

In 2016, Pierce County served only 7% of Medicare home care clients while others were served by other providers such as Adoray, Allina, Mayo (which has recently closed) and Interim.

To transition patients in the coming months, the county will be working closely with existing providers.

A majority of patients will not experience a cost increase when switching to another provider, as VA, Inclusa, Medicare and Medicaid do not allow home care providers to charge patients for covered services, Snyder said.

In the midst of county-wide mental health, child protection and substance use crises, it is vital to focus on services the county is best positioned to provide, Wood said.

"Public Health has a role in preventing more families from falling into this devastating cycle. We should not divert public health resources to a service available elsewhere in the community in the face of these other challenges and mandated services," Wood said.

Pierce County is one of five Wisconsin counties still providing home care.