How much do you care how your local government spends your tax dollars? A little? A lot?

If you’re the type of person who cares where your pennies go, you may want to pay attention.

On Monday, the Limestone County Commission will likely approve its budget for fiscal year 2019-2020. The new fiscal year begins Oct. 1.

The Athens City Council will hold budget hearings next week and likely pass its FY 2019-2020 budgets at its next meeting on Sept. 23.

The News Courier writes budget stories each year to try to give you, the reader, an idea about how your money is being spent. The stories are usually as much fun for us to write as they are for you to read, but we feel as though we are providing a valuable service to those who can’t attend meetings where budgets are being discussed. If you’ve missed any of our reporting, you can visit enewscourier.com to read our previous coverage.

One issue that’s been jointly funded since 2008, and has again been brought before both the City Council and County Commission, is the kidney-dialysis van. Limestone County claims its contribution to the van has risen, while Athens’ has declined over the years.

For those of you who are unaware of how the funding has worked, both governments provided money to Athens-Limestone Hospital so the hospital could hire and pay the driver of the van. Sidenote: The Limestone County Commission is still providing $150,000 per year to the hospital, which is matched by $350,000 in TVA-in-lieu-of-tax money for a grand total of $500,000 to the Huntsville Hospital System.

Another sidenote: A story contributed by Huntsville Hospital and published by al.com in 2017 claimed the system had a revenue budget of $1.4 billion. That raises the question, “Why are local governments giving your taxpayer dollars to an organization with a revenue budget of $1.4 billion per year so it can pay the driver of the kidney-dialysis van?”

The county has been contributing about $56,000 each year toward the salary of the van driver and to cover maintenance costs of the van. The city, which originally provided an equal share of $20,000, now pays only $5,000.

Earlier this year, the hospital informed the Athens Kidney Association it would not be responsible for hiring or paying the driver of the dialysis van. If the service were to continue, it would be the sole responsibility of the local governments.

The van currently has about 16 people it picks up, though there is some discrepancy about how many of those live within the incorporated limits of Athens and how many live outside the city limits. The van takes those patients to DaVita, which is a for-profit dialysis center.

According to an article in the Los Angeles Times, DaVita earned about $1.8 billion in pretax operating profit on $10.1 billion in dialysis revenue in 2017. Fresenius, a competing dialysis company, reported pretax operating profit of $2.3 billion on dialysis revenue of $11.7 billion for North America. Fresenius operates a dialysis office on Huntsville-Browns Ferry Road in Madison-annexed Limestone County.

During a recent pitch for funding to the Athens City Council, Janis Moore, president of the Athens Kidney Association, said the cost of the driver would be about $70,000. That cost would be less if the local governments chose not to offer insurance to the driver.

At a recent commission work session, commissioners agreed the driver and van maintenance should be equally funded and that the city of Athens should hire the driver. Commission Chairman Collin Daly and District 3 Commissioner Jason Black have been vocal in their support of the program.

The decision is ultimately up to the local governments, but it may be time to pull taxpayer funding from this program. We realize it offers a valuable service to the people who use it, but you could say the same thing about any number of other agencies that receive funding from our local governments.

Could churches step in and help? Are there senior volunteers who could pitch in? Are there students who need volunteer hours who could help? Has any effort been made to reach out to other organizations?

Considering DaVita’s large profit margin, why is it not footing the bill for the van? After all, it is the company making money off the patients.

Moore told the commission that drivers would not need to have EMT certification, so that basically opens up the field to anyone with a vehicle.

Maybe officials believe continuing to fund the service will buy some goodwill at the ballot box, but odds are good that if someone needs a ride to dialysis, he or she also needs a ride to the polling place. Perhaps the same organizations providing rides on election day could provide assistance to those who need dialysis.

Meanwhile, that $70,000 might be better spent elsewhere, in a way that would benefit all Limestone Countians.