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BOC meeting highlights: Wake County Commissioners Approve WakeMed/Atrium Health Strategic Combination

The Wake County Board of Commissioners approved amendments to the legal documents needed to move the WakeMed/Atrium Health strategic combination forward at their Sept. 21, 2026, regular meeting. The meeting agenda and full meeting video are available online.

WakeMed Atrium Health Strategic Combination

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 transfer 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 transfer was consummated by 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 currently 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 adjusted 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.
  • At the Aug. 17, 2026, Board of Commissioners meeting, the Board hosted a public hearing where they heard 89 comments from residents, as well as stakeholders from across North Carolina and other states.
  • Following negotiations, WakeMed and Atrium made significant modifications to the articles of incorporation to, among other things, continue to allow commissioner appointment of eight of the 14 directors and give commissioner-appointed directors oversight and enforcement authority to ensure that Atrium meets its promised obligations. These amendments will also shift WakeMed from a non-member 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 Atrium Health.
  • Atrium has also committed to investing $2 billion in capital improvements for WakeMed’s facilities and $15 million a year over 10 years to fund a new Wake County Whole Health Program.
  • Read more about the amendments to the documents here.

Action Taken:

  • The Board of Commissioners voted 5-2 to approve amendments to the legal documents to move the WakeMed/Atrium strategic combination forward.

Public hearing for Wake County's Affordable Housing Reports

  • The Affordable Housing and Community Revitalization Department and the Board of Commissioners hosted a public hearing as required by the United States Department of Housing and Urban Development (HUD).
  • The Board of Commissioners heard two comments.

Background:

  • The Consolidated Annual Performance and Evaluation Report (CAPER) is an annual performance report required by HUD.
  • The report evaluates Wake County’s use of federal funding for the goals listed in the 2025–2030 Consolidated Plan and 2025 Annual Action Plan.
  • The goals are to:
    • Increase and preserve affordable housing
    • Reduce obstacles to housing affordability
    • Support low-to-moderate income communities in need
  • The County assisted 4,952 households, exceeding its one-year goal of 2,325 households.
  • Following the public hearing, staff will finalize the 2025 CAPER documents and submit the reports to HUD.

Action Taken:

  • There was no required Board action.

Public hearing for Business Development Grant for Novartis Innovative Technologies, Inc.

Background:

  • Novartis is a Swiss-based company that develops treatments for rare neurological genetic disorders.
  • They have existing manufacturing and research operations in Durham.
  • In November 2025, the company announced plans to create a new flagship hub in Durham and Morrisville called Project Titan.
  • The flagship hub will manufacture treatments for U.S. patients.
  • In March 2026, the Board of Commissioners approved a business development agreement for the portion of the project in Morrisville.
  • In April 2026, the company announced plans for a second facility to be constructed in Morrisville called Project Maple Oak.
  • This agreement consolidates both projects into a single agreement.
  • In the combined Morrisville expansion, the company plans to bring $451 million and 180 jobs to Wake County.
  • The business development agreement grants 50% of new tax revenue generated by the company each year for eight years.
  • The grant requires the company to meet certain requirements and pay their taxes in full each year.
  • The requirements are:
    • $200 million increase in assessed valuation by 2029
    • 180 new full-time jobs by 2029 with salaries of at least $116,000
  • The company plans to qualify for a 5% upward mobility bonus by doing all three of the below requirements:
    • Having robust non-discrimination policies
    • Offering health insurance at an affordable rate for employees and dependents
    • Providing generous leave policies
  • To qualify for the upward mobility bonus, the company must also do two of the following:
    • Offer financial support or policies to support employees, including:
      • Childcare
      • Transportation
      • Tuition or other educational expenses
      • Second-chance hiring practices
  • The total grant, including the upward mobility bonus, is estimated to be $4.7 million over the eight-year grant period.

Action Taken:

  • The Board approved the business development grant with Novartis Innovative Technologies, Inc.

Schedule of Values, Standards and Rules for the 2027 County Property Revaluation

Background:

  • North Carolina Law requires that before each county-wide property revaluation the tax administrator has to prepare the schedule of values (SOV).
  • The schedule of values is a document that outlines how county appraisers determine the market value of residential and commercial properties.
  • North Carolina law requires all counties revalue property at least once every eight years.
  • Wake County has moved from a four-year revaluation cycle to a more frequent cycle.
  • The next revaluation will take effect on Jan. 1, 2027.
  • Starting in 2029, future revaluations will happen every two years.
  • The more frequent cycle allows for more stability, transparency and fairness.
  • North Carolina law requires tax administrators to advertise the SOV, host a public hearing about the SOV and then allow time for residents to appeal the SOV.
  • The SOV adoption schedule is as follows:
    • Sept. 21: Submission of the SOV to the Board of Commissioners
    • Sept. 22 & 23: Advertise notice of public hearing on the SOV
    • Oct. 5: Hold a public hearing on the SOV
    • Oct. 19: Consideration of SOV adoption order by the BOC
    • Oct. 20, 27; Nov. 3 & 10: Advertise adoption of the SOV
    • Nov. 17: Last day to appeal the SOV to the State Property Tax Commission
  • You can read more about the agenda item here.

Action Taken:

  • The Board accepted the proposed SOV, scheduled a public hearing on the proposed SOV and directed the tax administrator to advertise the submission and the public hearing.

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.

Recognitions and proclamations

  • The Board of Commissioners adopted a proclamation to recognize Sept. 21, 2026, as Canes Day in Canes County. The proclamation celebrated the Carolina Hurricanes recent Stanley Cup win. It was accepted by Carolina Hurricanes CEO Brian Fork and Stormy the Ice Hog.

Upcoming BOC meetings

The Wake County Board of Commissioners’ next regular meeting will be Monday, Oct. 5, at 5 p.m. in the Board Chambers at the Wake County Justice Center. The meeting agenda will be posted online by Friday, Oct. 2.

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