The Wake County Board of Commissioners heard public comments about the potential strategic combination of WakeMed and Atrium Health at their Aug. 17, 2026, regular meeting. The meeting agenda and full meeting video are available online.
Public hearing for potential WakeMed/Atrium Health Strategic Combination
The County Attorney’s Office presented the board with an overview of WakeMed’s history, governance and relationship to Wake County. The Board of Commissioners heard 89 comments from Wake residents, as well as stakeholders from across North Carolina and some other states.
Background:
- WakeMed opened as Wake Memorial Hospital in east Raleigh in 1961. Construction was funded by bonds authorized by Wake County voters, and it was the first hospital in the region to serve all patients regardless of race.
- In 1997, the Wake County Board of Commissioners approved the sale of its interests in the hospital to Wake County Hospital System, Inc., and it became a private, nonprofit hospital system. It was renamed WakeMed in 1998.
- The sale created two documents – an updated articles of incorporation and a transfer agreement – that outline Wake County’s relationship with WakeMed. The Wake County Board of Commissioners appoints eight of 14 members of the WakeMed Board of Directors. Wake County required that WakeMed guarantee services regardless of ability to pay, and provide charity care (free to those who cannot pay) that totals at least 4.8% of its total annual revenue. If WakeMed does not comply with those requirements or is dissolved, then ownership of its properties would revert back to Wake County. The county must also consent to any WakeMed governance changes.
- At the May 4, 2026, Board of Commissioners meeting, WakeMed leadership requested an amendment to its governance that would allow it to undergo a strategic combination with Atrium Health, Inc., which is part of Advocate Health, Inc., a hospital network based in Charlotte. On June 8, 2026, the board received a presentation from WakeMed and Atrium staff about the request.
- The proposed changes include adjusting WakeMed’s board composition to include six Atrium directors and eight directors appointed by the Board of Commissioners. It would also shift WakeMed from a nonmember private nonprofit – run by the WakeMed Board of Directors – to a sole-member private nonprofit in which governance is shared by the Board of Directors and the Atrium Health corporation. Atrium has also committed to investing $2 billion in capital improvements for WakeMed’s facilities.
Action Taken:
- The board took no action on the proposed changes at the Aug. 17 meeting.
- The item will be placed on a future Board of Commissioners regular meeting agenda.
Board adopts changes to business development grant policy
Staff from Wake County and Wake County Economic Development presented proposed changes to Wake County’s business development grant program.
Background:
- Wake County created its first Business Development Grant policy in 2005 and has amended it five times since then. The policy lays out how the county pays incentives to companies expanding in or relocating to Wake County when they meet set requirements for infrastructure investments, jobs and company policies.
- The county currently has 16 active project agreements, including $5.3 billion of committed additions to the county’s property tax base and 7,238 committed jobs.
- Grants are only paid to companies after they complete the agreed-upon property and infrastructure investments, and provide proof of job creation. If the company fails to comply with the agreed-upon benchmarks for half of the years in the agreement, the county can take back 50% of the incentives provided.
- The proposed changes include: adjusting wage thresholds so the county can consider projects that include jobs with a lower barrier to entry; reducing the number of project tiers in the policy for clarity; decreasing the state minimum match requirements for a project; and adjusting the headquarters policy to lower the infrastructure investment requirements and increase the focus on high-paying jobs.
- The proposed changes also create a new Transformational Project Tier for large-scale projects that would invest $500 million or more in infrastructure and create at least 100 jobs with a salary average that matches the county average. In 2026, Wake County’s average wage is $80,616.
- The Board of Commissioners also received information about the proposed changes at its Aug. 10 work session.
Action Taken:
- The board unanimously approved the changes, which are effective immediately. The updated policy is available on Wake County Economic Development’s website.
On the consent agenda
Items placed on the consent agenda are considered routine or recurring and are approved by the board together with one motion.
- The board appropriated more than $331,000 of opioid settlement funds and adopted changes to the spending resolution for the Wake County Opioid Settlement Funds.
- The board awarded a $1.5 million construction contract to rebuild the North Wake Household Hazardous Waste Facility, which has been closed since 2025 when a fire damaged the facility beyond repair.
- The board appropriated more than $420 million of funds to construct, repair and renovate school facilities in the Wake County Public School System and reallocated additional funds for capital improvements.
- The board approved the Wake Technical Community College capital improvement plan for fiscal year 2027.
Resident Advisory Boards and Commissions
The Board of Commissioners appoints qualified residents to serve on 53 local advisory boards and commissions. Residents can learn more about advisory boards and commissions and apply for openings online.
- The board appointed residents to the following boards: Board of Adjustment, Capital Area Workforce Development, Energy Advisory Commission, Fire Commission, Historic Preservation Commission, Industrial Facilities and Pollution Control Financing Authority, Juvenile Crime Prevention Council, Library Commission, Open Space and Parks Advisory Committee, United Arts Grants Panel and the Water Partnership.
- The next round of appointments will be made at the board’s Sept. 8, 2026, regular meeting. Applications for those positions are due Aug. 20, 2026. Possible appointments include: one reappointment for the Adult Care Home Community Advisory Committee, one reappointment for the Cary Board of Adjustment, one reappointment for the Cary Planning and Zoning Board, one reappointment for the Juvenile Crime Prevention Council, and one reappointment and one resignation for the Water Partnership.
Recognitions and proclamations
- Wake County’s Inspections Division was recognized for recently winning the 2026 NC Building Inspectors Association’s “Jurisdiction of the Year” award. Interim Director of Planning & Development Services Caroline Loop and Building Inspections Director Michael McLamb accepted the award.
- The Board of Commissioners approved a proclamation celebrating the 50th anniversary of the Wake County Public School System, which was accepted by WCPSS Board Chair Tyler Swanson and Vice Chair Sam Hershey. The district was created when Raleigh City Schools and Wake County Schools merged to create WCPSS on July 1, 1976. In the past five decades, the district has grown from 53,000 students to 161,000 students across 203 schools. The proclamation urges residents to “honor the people and history of WCPSS and deepen their support for public education.”
Upcoming BOC meetings
The Wake County Board of Commissioners’ next regular meeting will be Tuesday, Sept. 8, at 5 p.m. in the Board Chambers at the Wake County Justice Center. The meeting agenda will be posted online by Friday, Sept. 4.
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