Board of Commissioners - Regular Meeting

Good afternoon, everyone. We would now like to call this meeting to order. Before we get started there, we would ask everyone to stand for the Pledge of Allegiance, and then we will follow up with an invocation from Commissioner Cheryl Stallings. So please remain standing once you do the invocation.

Do I invite you all to remain standing and pray with me or have a moment of personal reflection or meditation? Creator God of many names, we give thanks for this day and for this opportunity to gather together to make decisions on behalf of our community. We give thanks for our residents, our community partners, our county staff and employees, and our commissioners. We know today's meeting involves very important information and very important decision making. Thank you for all the voices who have shown up in so many different ways to express their views and their love and gratitude for Wake M

Thank you, Commissioner Stalin, for the invocation. Again, good afternoon, everyone, and welcome to today's meeting. We begin today's meeting with the items of business, and the first item of business is approval of our agenda. Is there a motion to approve?

Motion to approve the agenda. I second it.

I have a motion to approve by Commissioner Thomas and a second by Commissioner Stallings. All in favor, please say aye. Those opposed, please say no. Not hearing any, the motion passes. Next, approval of the minutes of the regular meeting of August 17, 2026. Is there a motion to approve the minutes?

Motion to approve the minutes of the August 17th meeting. I second it.

We have a motion to approve the minutes of August 17 by Commissioner Waters and second by Commissioner Stallings. All in favor, please say aye.

All those opposed, please say no. Not hearing any, the ayes have it, motion carries. And the next thing is on our agenda, which I'm so proud for us to be able to do this today, is that we want to present a proclamation for our wonderful hurricanes. So I will be reading the proclamation and Brian Falk will be coming forward to receive it. So I'll meet you at the podium.

bring forth this proclamation for our wonderful hurricanes. So Wake County Board of Commission proclamation recognizing September 21st as Canes Day in Canes County.

Whereas the Carolina Hurricanes in Wake County's hometown hockey team, exciting local fans with their fast-paced play and incredible talent. And whereas the Canes clinched a Stanley Cup victory over the Las Vegas Golden Knights, making the Canes the champions of the 25-26 National Hockey Series. And where thousands of Wake County residents fill the streets of downtown Raleigh to celebrate the big win during the Stanley Cup parade, showing the world that this is truly Keynes County. And whereas the new hockey season starts on September 29th, and Wake County wants our reigning champs to know tha

Thank you. The next item on our agenda, Steve, and we refer to our county manager was retiree recognition. County Manager David Ellis. Great.

Thank you, County Manager Ellis. Next item on our agenda is the consent agenda. As a reminder, all items on the consent agenda are considered to be routine and may be enacted by one motion. So at this time, is there a motion to approve each item in the consent agenda? We have a motion by Commissioner Stallings. Is there a second? Second by Commissioner Evans. All in favor, please say aye.

Those opposed, please say no. Not hearing any, the ayes have it. Okay, and there we have come to our general public comments. And there are three opportunity for residents to speak today. If you are here to speak about the affordable housing report or the business incentive agreement, please wait for those public hearings later in the meeting. Now we will start the general public comment period. If you're here to speak about the Wake Med question, this will be your opportunity to speak. Attendees had an opportunity to sign up using our online sign up app. We've also provided the opportunity to

Thank you. Please silence your phones. I heard one going off there. Zickler?

Ms. Carter. After Ms. Cheryl Carter, then Kaylin Dean, Stu Ravine, Karen Ziegler, Catherine Martin, Brianna Miller, and Wayne Willam.

Thank you. Dean. Yes, Dean, last name Dean.

Vote no on the terms. Thank you. Thank you. Stu?

Okay, Catherine Martin, Brianna Miller, Wayne Wilhelm. And then we will go to Grant Welch, Terrance Dewberry, and Elady Reynolds.

Okay ma'am, your time is now. Thank you so very much. Wayne Willem.

Okay, sir. I hate to cut you off, but your time is up. Appreciate it. Thank you. Terrence Dewberry. Then Reynolds, Rebecca, Cerise, Satish, Garamello, Kelly Walton, Catherine Johnson. Go ahead, sir.

Thank you. Rebecca, then Satish, then Kelly, then Catherine, Charles, in that order.

Thank you. Kelly Walton. After Ms. Walton, then be Charles Putterman, Kimmy Shaw, Jasmine Everett, Roy Hawkins. In that order, please.

Thank you. Charles Putterman. Kimmy Camilla Shaw.

to live healthier lives please vote yes on this thank you thank you uh roy hawkin giselle torres margaret braxton jerome brown matt rodin nathan foster and clara norman and mary rusher good afternoon commissioners my name is roy hawkins and i have the privilege of leading operations across the charlotte area for atrium health

Thank you. Jerome Brown. Then Matt Roden. Then Nathan Foster.

Thank you. Matt Roden, then Nathan Foster, then Clara Norman, and Mary Rusher.

Thank you. Clara Norman. then Mary Rusher, Fernando Little, Manuel Biden, and Dr. Thad McDonald.

Thank you. And I know little. No, go ahead. I'm sorry. Yeah.

Thank you. Okay. I'm going to go out of order here and go back to someone that I missed earlier. What was his name? Putterman?

Thank you. Okay, Fernando, who's next up? Fernando? Yeah. Then I'm thanking Manuel Bynum, then Dr. Thad McDonald, then Brandon Newman, and then Maria Rouse.

Thank you. Manuel Bynum, then Thad McDonald, then Brandon Newman, Maria Rouse.

Excuse me, Dr. McDonald. Sorry to cut you off.

Thank you. Thank you. Brandon Newman. Maria Rouse.

Thank you. Maria Rouse, Mary Ann Conn, Artis Watkins, Reverend Dr. Rose Caniz, and Camilla Headley.

Thank you. Reverend Dr. Rose Cornelius. And then Jamila Headley.

Thank you. Okay, next up would be Christina Galvin, Hersha Millett, Rob Stephens, Jane Stephens, and Bud Kamazine. All right, Christina, Gavin. Yeah. After that, then be our Herschel Millett, then Rob Stevenson, Jane, and then Bud. OK, go ahead and proceed.

I'm sorry to cut you off, but your time is now up. Thank you.

Please do. Thank you, Ms. Stevens. James Stevens. Then Bud Kamazin, Harold Millett, and Dr. Lee Budd.

Thank you. Bud Camazine. OK, Ms. Millett. And then Dr. Lee Budd. And then Grant Walker. Kimberly McGee.

Thank you. Grant Walker, Kimberly McGee, Julia Peters, Anthony Pope. Go ahead, please.

Sorry to cut you off, but your time is up. That tells you everything you need to know. Thank you. Kimberly McGee.

Thank you. Julia Peter, and then Anthony Pope.

Thank you. Mr. Anthony Pope. And then Dinah Moore, William Howard, Reese Piller, and Timothy Jackson.

Thank you. Dana Moore, William Howard, Reese Piller, and Timothy Young Jackson. Go ahead, man.

Thank you. Let's tempt the young Jackson.

Okay, thank you to everyone who signed up to speak during this general comment period. That completes the list of names I was provided for this meeting. We also offer residents the opportunity to submit general comments online. This process is managed by our clerk, Ms. Gilead. Will you kindly share any online public comments that you received for this meeting?

Thank you, everyone. We have four items on our regular agenda this afternoon. Our first item of concern is the legal documents related to Wake Med's operation. Our county attorney team is here to make a presentation and answer any questions. Roger, please go ahead with your presentation. Thank you.

Hold on a minute, Mr. Attorney. The monitor here is not on.

Mr. Manager, is the presentation in our packet like it normally is? Since the monitor doesn't work, is there another way we can see it?

Okay. Thank you, Roger. Great presentation and great update. Members, are there any questions at this time? Commissioner Evans?

I just would like to note that there was one item on one slide that you neglected to mention, and that was what we negotiated around collection practices. So can you touch on that, please?

Thank you. Any questions from the colleagues? Yes, Commissioner Waters.

Thank you all for walking us through these significant changes that we've been able to negotiate. Could you spend a little bit more time talking about the revisionary clause, the threshold that would require that to kick in and if there will be any independent verification of compliance?

Is there any independent verification that these thresholds have been met? And also, where does the collection agreement fall?

I mean, does that fall under the revisionary clause or does that fall under the mediation or the process by which the board would determine? Because when you mentioned just a few minutes ago that the $2 billion doesn't fall under the revisionary clause, what about the collection practices?

But it doesn't fall under the revisionary? Okay, revisionary clause. And is there any independent verification of these?

Yeah, thank you for bringing this forward and I'm a little disorganized. I did four pages of questions this weekend and I didn't even, I wasn't even aware that we were going to have a PowerPoint till right now. So I have some questions on the PowerPoint and I had tried to do my questions by topic, but I'm going to have to jump around a little bit. Okay. So the first question is with the statutory requirements, I understand this is coming straight from statute. It says open to the general public, free of discrimination based upon race, creed, color, sex, or national origin. Do we have anywhere

But we could have put it in another part of the agreement if we'd have wanted to. We could. We could. Okay, thank you. I guess I had sent you a request 10 days, two weeks ago, because I've heard a lot from the public about the fact that their public records requests are not getting... I asked for a number of public information requests that had not been granted related to the Atrium Wake Med merger and when those were expected to go out. Do you have that data today?

So there's a possibility that if we vote on this today, there's people who've put in public records requests on this that will not have had them at this point?

All right, thank you very much. One of the things, and I'm an accountant by trade, and was a stay-at-home mom for 18 years, so I'm not a lawyer. And when I read this stuff, I think I know what it means, and I don't always know what it means. So when I read these and try to digest these documents, I think of a continuum, right? So currently right now, with control, currently right now, if you look at control where one, where atrium is gonna control everything, and where we're at now, which is like a 10, which says, you know, we control it based on controlling the board, right?

The first agreement we got that their board approved felt like about a one and a half to me. It was just a little above atrium control and everything. With all these changes we've done, where do you think we're at now? What level control do we have versus what atrium has?

Yeah, the board of commissioners, what control do we have? Because now we have pretty much complete control because we appoint the majority of the board of directors of atrium. I mean, I'm sorry, of Wake Med. Right. And the first agreement we got basically turned everything over to Atrium, except a few little things. So we had a little control, but not much. So as these documents have progressed, we get more and more control. So where do you think we're at? What do you think our level of control is versus what we have now?

Thank you. That's what I thought, but I wanted to make sure. I wanted to do a check-in on that one before I said it. The other question I had about the presentation, then I'll get to my questions I came up with this weekend. On the slide where it says that our appointees have to be Wake County residents, There it goes, the next one. I understand that's not true for atrium appointees. They could live anywhere, or do they have to be Wake County residents as well?

Okay, thank you. So I thought we would talk about process, the cap, the two billion, and then the charity fund. First, this is not our normal process, how we do work. And this is not a question for you. We're used to, if we have complicated documents, we do some type of work session, we ask questions, we get answers. And in my eight years on this board, I don't think I've ever been handed this complicated illegal documents on Thursday night and said I got to vote on it on Monday. And that's just not how we normally do business. And so I'm struggling a little bit with this because it takes me a

They don't, okay. Yeah. Are the September 19th letter, the governor's press release, is that legally enforceable? So we've got to put that in another agreement. But it'll be to what you think is acceptable, correct?

But the public or us won't get to see it before that's done?

That will be up to the Wake Med Board whether they show it to the public or not. Okay. Have you received proposed contractual language? So I guess you haven't done that with the price cap. You haven't seen what the exact language is going to be on that.

I saw one of the governor's attorneys here when I first got here. Did he send anybody today that can address these issues? I saw South was here when we were taking pictures with the cup. But he left. Okay, he didn't stay to answer questions. Is there any legal or contractual reasons why the vote must occur today?

That's up to the board. Okay. If we vote today based on what we don't have in the documents, then it's, I guess then that leverage that we have is your approval of the agreement between Wake Med and Atrium.

Oh, it'll be, so if we vote it today, then you still have to approve the cap?

Okay, thank you. So I had some more questions about the five-year cap. And if we could, I know you don't have the information now, but from Googling, I feel like I've gotten to be a master of Googling healthcare things. So I was trying to look at Medicare reimbursement rates. which I've never had a reason to look at. And there seems to be like all kinds of different ones, right? There's something called an inpatient IPPS update. There's an OPPS update, market-based, physician fee. So I guess when the document's completed, it will spell out which Medicare measure we're looking at. And the other

So there's no way for us to see the last five years what their rate increases were and what they would have been if we would have applied this Medicare 1.5 times the annual Medicare reimbursement increase. So we don't have that. We don't have it. So we can't see what it would have looked like before.

Sorry, let me read some of these. So I'm assuming this will apply to every commercial ACA insurer included self-funded employee in the state health plan. Now, And I'm assuming it'll apply not just to inpatient, but outpatient, their medical practices, everything as well. And is that, if they have a current contract, that has rate increases built into it. Would they follow those or would they go to the 1.5 if this passes today? We don't know.

Okay, so if those contracts have rate increases that are higher than the 1.5, then I guess those would be honored. Yeah. Okay. Independent. So what will happen if Atrium, and I guess we don't have this information, violates the cap? Can the county obtain repayment for patients and employers, monetary damages, injunctions? I guess we don't know what happens if they don't follow it.

And we don't know what happens at the end of five years? No. Okay. The two billion commitment. The governor's announcement said it would fully fund. The letter, the sources of the funds Could that also include, does that equivalently $2 billion from atrium, or could they play a shell game with Wake Med's revenue? Could they move it to an atrium source and then take a different source and move to us? Is there anything to make Wake Med's profits stay at Wake Med?

Because, you know, the devil's in the details. That's what we found with the first agreement. That's true. Right. I mean, you know, because we were told a bunch of stuff, and when I finally threw a public fit and got to see it, I was shocked at the difference between that and what we had been told. So with atrium sources, so that means they can't borrow money from and use any Wake Med as collateral, and then have Wake Med make the repayments of principal and interest out of their earnings?

So who's going to audit this and report it to the public? The board members?

Okay, so that's... Yes, I can allow someone else to ask questions and then I'll come back to mine. Okay. But I do, Mr. Chair, plan to, since this is our first time to do this, I don't want to be rushed. I want to have my full time for this.

Thank you. And I just wanted to expand on the recent development of the rate calculations or the rate caps. Do you have any information or specifics on how those rate calculations will be done?

And so those terms may still be in the process of being defined. Would that be a possible scenario?

Okay, and then I think it's already my question about what happens after the five years has already, I believe, been answered. And with the $2 billion, is there any, consideration over the 15-year period of the accounting of inflation? Because $100 last year is different than $100 this year. So over 15 years, $2 billion could look differently. Is there any accounting for inflation in this?

It absolutely is, and I just ask that question because I was among those that had a different understanding of the initial $2 billion investment and perhaps in my inexperience in hospital partnerships, I thought it would be like a $2 billion check or complete, and I think perhaps others had that thought as well. Is the language around the source of funds coming from Atrium, is that in your legal expertise a solid barrier to shifting perhaps to things that are related to like debt financing or other ways that the $2 billion could be calculated?

Yes. Okay. Roger, I just want to check my understanding based on the answer you gave earlier. In the presentation and in our previous conversations and long negotiations over these documents, I recognize this is not the first time, but just something that was said today led me to this question. So currently on our board, we appoint eight, another entity appoint six. In this case, it's Wakeman. Right. that remains the same.

Exactly, right. But the similarity is that we have had jurisdiction over eight. We can remove those eight. Our jurisdiction had always only been eight of 14.

Yeah, I remember this was the very first thing that we kind of negotiated on. Okay, so our jurisdiction, Our jurisdiction over the eight before and now is the same removal clause?

Okay, just checking. And then the last is because we've always had appointment ability over eight, ability to remove calls for eight, we've always had a majority, we being appointing body of this Wake Med Board have always maintained a majority then of ability to ensure what happens on that board. And that also remains the same.

Yes, right, and that is in line with many boards that we appoint in terms of receiving recommendations from the sitting board who understands what they're going through and what skills they need. That's in line. Okay, thank you. That confirms and verifies what I understood had been a long-standing change in our documents.

Okay, Commissioner Thomas, then Commissioner Stallings.

Thank you so much, Roger and Allison and Tiffany for all the work that you've done and the hours that you've spent helping us understand for this presentation today. I'm gonna ask a question that I literally, I truly do not know the answer to this question. When we talk about rates, Are the rates that hospitals use, are they shared with each other at this point in the negotiation, or does the FTC actually prohibit the rates from being shared with the public and with the hospital that's being negotiated with?

So the questions we've been asking about rates and about increases in rates and how rates could change and rates related to Medicare, we don't know what the actual rates are, do we?

Thank you, Chair. I've got three questions for now. Back to the $2 billion. Could you all give our residents an idea of, if this is approved, what might we expect with capital projects in about 15 years? I know it might be on the exact timeline, but could you give us an idea of what we could expect?

that and i know one concern we've heard from the wake med board of directors is the concern about renovations for big wake med on new burn avenue with its age and the concern about not having the debt capacity to make the renovations needed for that for that facility which is such a anchoring facility of wake man thank you for that so my second question is Finances and affordability are clearly on everybody's minds, understandably. I want to talk a little bit about the indigent care floor is now in the proposed agreement to be changed from 4.8%, and that's of operating revenues of Wake Med, an

Could you share a little bit for our public to understand that, please?

because I think it's important just for the public to hear there are financial policies and those would clearly be a part of this proposal as well if it moves forward. So thank you for that. And the last question has to do, going back to the price cap negotiation that the governor helped with over the weekend, I spoke with one of his attorneys this morning just to get some assurances about the binding nature. If this motion is approved, it's a contingent. Maybe you can just explain the motion one more time, if you don't mind. And what's binding? What's enforceable? It's my understanding from t

It's not official until you get the language and you approve the language.

Okay, Commissioner Jackson, then Commissioner Addison.

Just to pick up on the protections, Roger, one, I appreciate the opportunity here to lift up. I mean, there was a lot that you all covered, and I want to say thank you again for what you've done. It's a lot of information. I want to just highlight the protections and the guardrails. So there are three documents that will be legally binding and enforceable. the two we're voting on and the member agreement.

Okay. Um, IN ADDITION TO THOSE THREE DOCUMENTS, THERE ARE BOARD APPOINTEES WHO WOULD HAVE THE MAJORITY, AS WE JUST DISCUSSED, TO ENSURE THAT THE MEMBER AGREEMENT AND THESE DOCUMENTS ARE, THAT THINGS ARE GOING ALONG WITH WHAT THEY'RE SUPPOSED TO BE GOING ALONG WITH, THAT THEY'RE IMPLEMENTED AS DESIGN. WE HAVE OUR PUBLIC REPORTING, OUR AUDIT, WHICH I read our January one, so we will continue to get that one annually. The enforceable charity care. And then the reversionary protections that Commissioner Waters was asking about earlier. Does that summarize the protections that we have built in from

I thought that was a really good chart by the way. Yes. Okay.

I only have one page left. Mr. Chair, so you'll know where I'm at. I've done three pages. So, So at this point, and thank you for all your work. I know this has been nights, weekends, and a lot of work. So at this point, we talk about these municipalities that are gonna get hospitals, the main campus is gonna get renovated. But there's no specific projects in the agreement, it just says $2 billion. And then at some point we should, if this is approved today, at some point we'll get a schedule of when these things are gonna happen. When will we know when hammers are gonna start hammering at the

Right, thank you all for that. Now the charity care and the community fund. the 8% instead of the 4.83 or whatever's in the agreement now. And I understand that Wake Med normally does 12% now. How is that defined? Is that like, can they do like bad debt, Medicaid shortfalls? Can they count any of that as, as charity care, or is that, I understand charity care is an IRS term. Will they use the IRS definition for charity care?

Okay, and so do we know if that applies to just emergency care or general services? I think we talked about that in the work session. If I need my knee replaced and I can't afford it and I'm not an emergency, can I get Charity Care to get my knee done?

So with the medical debt, I assume that there's no protections beyond what's under the federal law, the IRS standards.

Okay, thank you. So there's guardrails around the whole health program. So can they veto any of our, as long as it's not a competitor, right? Can they veto any funding? Like let's say we wanted to fund a community health clinic.

Okay, thank you very much, that's good to know. And competition would be like getting UNC to run the clinic. That's pretty straightforward, right?

Thank you. Roger, I sent you an article that I found about, it was from the beginning of, I believe August, September, where the FTC turned down a hospital merger strategic partnership. In Ohio. And I saw the article and we confirmed that it was legitimate.

Yeah, right. we found the press release the FTC put out. And they stated that the hospital had not done due diligence in looking at a partner. And that means they had not done some kind of RFP process, they had not looked at any other partners. and they rejected it and said, you basically go back to the drawing board. And one of the quotes in the press release from the FTC was the director saying he wasn't gonna approve any where due diligence wasn't done. So we've been assuming the FTC is a given, but since there was no competitive process year, there was data looked at on other hospitals, bu

There'll be null and void. So there's no, we don't have to have a provision in there that says if the FTC, is there something in there about regulatory has to approve it?

Yeah, and I guess something that I've, and Mr. Chair, this is my last question, but I do have comments before I vote, but they are short. My questions were long, but my comments are short. You know, this has felt, this whole process has felt uncomfortable to me, because I'm so used to what we get from y'all being so orderly, and here it is, and ask your questions, and here's the final document, you've got them a week in advance to ask questions. Well, as we know, this has been a moving target, and Last week, you and the county manager's office decided to bring this forward for a vote today, ev

So it wasn't an atrium date. It was our date.

Can you help me understand, just from a procedural standpoint, the significance of voting before the language is finalized and cleared up?

So you would ultimately be deciding if you like the language around the rate cap when it comes back?

On the, you know, what's the phrase that you used on condition of the county attorney?

Right, so if the language then comes back from the governor around more defined terms related to the rate caps, then is there an opportunity for the board to consider those things? I'm just kind of lost in the process.

Okay, but there would not be any more input from commissioners in that process to say, well, hey, could we strengthen it here? Because there's been a lot of strengthening done by this commission because what we initially were given is completely or significantly different than what is presented here today. And just acknowledging that the Wakeman board unanimously agreed to the initial terms and we've made some significant concessions over time. And so, and I applaud my colleagues for the efforts that have led to a significantly different document. And I was just trying to understand once it co

I have the most respect for you and your team. You have worked so hard and diligently. You've been excellent with communicating. I'm just a layperson just trying to understand the process and what this looks like. Thank you. I really appreciate all the hard work you've done to digest this.

Okay, thank you. And then also, in talking about just the structure or the leadership of Wake Mid currently, if there was an org chart around Wake Mid and how it's currently established, what would you say is kind of at the top of the org chart? Would you say the board? Okay, and then the Wake Med president and CEO under that?

And then the proposal moving forward, who would you say is at the top of the proposed org chart? Would it be Atrium as the sole member above the board? How would you describe that?

So that's a change, because right now the weight and med board is at the top of the org chart, but it would shift to atrium or advocate being at the top of the org chart.

And based upon what is available publicly, then that entity has its own authority at the top of the org chart. Yes. Which has a different level than where the board of directors' authorities and powers sit. Is that a fair characterization?

Okay. And then also, when we talk about the... board of directors, can you just once again, for clarification, because we've been talking about how things are similar with, you know, we currently having eight appointments and then shifting again to eight, but there are some significant differences. So it's not the exact like same as the current process of having, we still have eight appointments, but the way that those eight are seated is significantly different. Would you say that?

And then just for understanding, so on the initial board, it'll be six atrium appointees, the ones the atrium decides, and then five from the board that unanimously supported the initial documents.

Right, but they would still be among the ones who voted unanimously. So it would be six atrium appointees and then five that voted unanimously. So that would start off with 11.

Okay, so that would be three appointees that, okay.

Okay, Commissioner Evans and then Commissioner Jackson.

I want to ask a clarifying question around the first topic that Commissioner Waters was highlighting, and that has to do with how it came about that we got this on today's agenda, but that not everything is in the documents. Okay. You spoke about this and asked some questions. So I just wanted to say, is it a correct statement? I mean, I felt like you polled the board members and on midweek that we were ready to go ahead and put this on the agenda. And for the public's understanding, we are required under public meeting laws to post our agenda, is it 48 hours before our meetings at a minimum?

So I just, you know, it's an odd situation, but we had already said, put the wheels into motion to put the item on the agenda and certain details and then some of these other negotiations happened basically over the weekend. And we didn't even know they were going to happen. So I just don't want the public to think that we were trying to you know, be secretive or whatever. So I wanted to help them better understand the context around why we have to put this clause in the motion, if it gets made, that we see those statements that will go into the member agreement around the $2 billion and how i

Roger, one other thing and I can't believe I forgot this in my four pages of questions that y'all gave me lots of homework to do over the weekend. Is the CEO of Wake Med, my understanding is that currently the board hires and fires the CEO. How does that change with the new agreement? And that's the board where we sorta kinda get to appoint the members, the majority going forward.

But Atrium can just wake up one day and say, we want a new CEO and switch them out.

Okay, not seeing any other questions. Did you have another one, Commissioner?

Yeah, I just wanted to make a quick comment circling back to how things got on the agenda. I think that might be worth having clarification around. I'll just say, and I can only speak for myself, we did have some initial conversations around the vote coming on 9-21, but when it initially, and I was looking for the email, I can't find it now, I was told that it was going to be on the agenda under rule one, which gives the county manager authority to put things on the agenda. So there is some discrepancy, because I was told, I was not asked, I was informed. And so there may be some different lev

Okay, well, thank you. I think you guys have brought forth a lot of great information. So Rodney, you and your team, we appreciate all that you do. So at this time, commissioners, I think each one have prepared remarks. So we will go by district. So we'll start with district two and go two, three, four, five, six, seven, and then I'll close out. So commissioner. Jackson.

Yes. Okay. I have many thoughts and considerations and things that I want to say about this moment before us. I can't say them all here. I offer brief remarks now and welcome continued opportunities to share my thinking, my process, my lens and my reasoning. First, I wanna say thank you to the dozens of speakers who have shared their personal story about life-saving care at Wake Med, both today and previously. I want and we need Wake Med to remain a reliable source of healthcare in our county for the most vulnerable. I wanna say thank you again to our attorneys, Roger, Tiffany, Allison, for sh

We know well that this is not an echo chamber at this bench. While we share core values, we are seven individual personalities that process differently and held different views along the pathway of this process. In the end, I am thankful for the open dialogue with each of you. I'm thankful you trusted me with your positions and you inquired about my positions. No matter how this vote lands, it's undeniable that relationships were strengthened and that when we are presented with a significant decision, Wake County can count on us to work together to find some type of majority consensus. I want

Thank you. Vice Chair Jackson, District 3.

You're just taking comments and not votes? No, comments. Okay. Well, Vice Chair, that was amazing. Thank you so much for such a comprehensive response. You covered some things that I don't need to cover. I was going to talk about the financial and the capital, so thank you so much for such a wonderful overview, insightful and passionate response. I appreciate you. So Wake Med is an incredible, valued resource in our county, region and state i think that's one thing we can agree on this proposal understandably is very important to our community and i appreciate so many people who have invested

Thank you, Commissioner Starland. District four, Commissioner Evans.

Thank you. This has been quite a journey. I'll start by saying that in the past six months I've learned more about hospital systems and the realities of the operating environment for hospitals than I never wanted to know. But all joking aside, it's really been a daunting experience for me. And I want to give a little context around my evolution. When our board was initially made aware of this potential combination by the Wake Med board, it was... my impression that the decision rested with the Wake Med Board of Directors and executive staff. We were initially guided by our legal team to an und

Thank you, Commissioner Evans. District five, Commissioner Waters.

Thank you, Chair Myall. And I'll start with a loud and known appreciation for our attorney, Roger Askew, and the team. I'm so honored to have the opportunity to work with you all. And these are my remarks. It is a privilege to serve on the Wake County Board of Commissioners and to represent District 5. District 5 is rich in history, culture, and advocacy. It is the district of Dr. Anna Julia Cooper, author, educator, scholar, and advocate for racial and gender equity. It is the home of Shaw University where Ella Baker studied and where in 1960 the Student Nonviolent Coordinating Committee was

Thank you. Thank you, Commissioner Waters. Please refrain from clapping. District 6, Commissioner Thomas.

Thank you, Chairman. Thank you, Roger. Thank you, Allison. Thank you, Tiffany, for all the time and the effort that you have put into this. Much has already been said about the agreement, the process and the investments before us, so I want to focus on what I am carrying into this vote. I have read your emails. I have listened to the public comments and the private conversations. I have considered the research and the articles that you all have shared with me. Some of you supported this combination and some of you strongly opposed it. I appreciate all of it because listening to the public does

Thank you, Commissioner Thomas. Commissioner Addison, District 7.

Well, I didn't get the memo we were supposed to write a speech, but I spent my weekend struggling with documents. But I'm sitting here and I'm just going to share my thoughts from the heart because I want to serve from the heart because I am one of you. When I listen to the song, I have friends in low places. That's who I want to have friends with, with working people, with real people, not corporate executives. But I feel like today will go down in history as a very sad day in Wake County when we turned our taxpayer-built community hospital over to a corporate conglomerate. And I just don't s

Please refrain. Thank you, Commissioner Addison. I'll go ahead and close out with my statement. Good afternoon, everyone. Today has been a long time coming. Being a member and chair of this board has been one of the most rewarding and yet one of the most difficult things that I've ever been a part of. After many sleepless nights, many phone calls, and emails, I, along with my colleagues, have been asked to decide on weight, med, atrium, strategic combination. I also realize that no matter which way we vote, someone is not going to be happy with our decision. I also realize that it's easy to do

Mr. Chair, I have a motion. Chairman Myall, I move that the Wake County Board of Commissioners approve the amendments to the Wake Med Articles of Incorporation as set forth more specifically in the amended Articles of Incorporation attached to today's agenda item. And I further move that the Wake County Board of Commissioners approve the second amendment to transfer agreement attached to today's agenda in connection with the proposed combination between Wake Med and Atrium Health. And that the chair be authorized to execute a second amendment to the 1997 transfer agreement subject to the terms

Thank you. A motion has been made by Commissioner Thomas. Is there a second? I second. A motion has been seconded by Commissioner Jackson. Clerk Gidget, would you please take the vote?

Please reframe. Please reframe. Please reframe, or we're going to have to ask you to leave. Please. Order. Order. If you cannot follow direction, please leave out. Please leave out. Please refrain. Please refrain. Would you please clear the room if we have to? Please refrain, sir. Please refrain, sir. We're trying to give everybody a chance. Yeah. Madam Clerk, will you? If we have to clear the room, deputies, will y'all please clear the room? Deputy, will y'all please clear the room? Madam Clerk, will you continue with the vote?

Deputies, please clear the room. Please clear the room.

You can watch it across the hall or outside.

Let me ask you, can you speak to the policy related to clearing the room as individuals are asking for clarification?

May I finish my question? So to the question that was asked from the floor, for someone who was not speaking during that time, are they required to leave?

After we take a vote, we will take a break. For those that's not being disruptive, they will be able to come back in.

Does that apply to waiting until after the vote for clarification, the policy? Because some have asked why they were asked to leave if they were not being disruptive. I just want clarification on the process before we vote.

So how do you recommend we let people back in since we threw them all out? Or do we have the opportunity for them to, since that we have it, so they can watch it right outside the door or in the other room? I'm just asking for clarification.

And then also to Commissioner Adamson's question.

A lot of people have probably left the buildings. Should we put the vote off until the public can watch it?

No, we can't do that. We've already started to vote.

Again, I asked for the rule that allows for individuals who are not being disruptive to be allowed to stay. I know there were some. That question was specifically asked. I think this is one of the most consequential votes that we'll ever take. And I understand the need to clear the room because there were disruptors, but that didn't apply to everyone. And so I just want to follow the policy.

Well, let's go ahead and take a break at this time then, Roger, and that way those that's not been disrupted, we'll let them back in. Okay. Okay. Yeah.

Thank you, Mr. Attorney, and also I'd like to add that this is not something that we want to do and nothing that we have ever had to do before in order to have to clear this room in order for us to have a meeting. We understand that this is a very concerning issue, but all we ask is to give us an opportunity to complete our meeting and follow what we are elected to do, and that is to vote and move items along. So again, we apologize, have to clear the room. So please refrain. Thank you so very much. Madam Clerk, would you start with roll call, please?

okay thank you uh clerk gillian i want to thank the residents who have joined us today to share the feedback and i want to thank the entire wake county community for their patient and input in this complex decision i also want to thank the county attorney team for helping the board navigate this issue we greatly appreciate your service moving on our next item is public hearing on the affordable housing 2025 consolidated annual performance and evaluation report That's only if they ask, I haven't.

Thank you so much for that great presentation. We will now open it up for public hearing. We have a couple of people that have signed up for it, so I will call the name. I don't know whether it's still in or not. Maria Anderson and Katherine Johnson.

Yeah. Well, go ahead and start in that way. That would make sure. There we go. Okay.

I really appreciate that. I know you guys do so much more over there.

Absolutely, thank you. Okay, and we will go ahead and close the public hearing comments. Madam Clerk, are there any comments received to date?

Okay, then we will go ahead and close the public hearing. Commission, any discussion or questions before we close this item? Yes, Commissioner Jackson.

I just wanna say every time we talk about housing and the work that our staff is leading with our community partners, it always fills my heart and you make us look so good because we are investing in the lives of people in very tangible ways. So thank you for this review. I know we work hard to stretch the little bit of dollars that we can and ditto to Kathy. Every time we're in the housing conversation bridge to home, remains a staple. And when we look at how many people we're reaching, it is a program that is reaching lots of people. And that little bit of help is what helps many times just

Well, this is not one we need to vote on. Oh, okay. That's okay. Anybody else want to make a comment? Commissioner Starler, I know you're ready to go. I mean, it's a good topic.

Just echo what Vice Chair said. Just thank you all so much for this life-giving and really life-saving work that you're doing. And I just appreciate you all so much. But with the ARPA running out, what's going to be the negative impact, you think, or the impact from the ARPA funding? Since that's going away, it sounds like.

Maybe hope our federal partners will find some creative funding, maybe. Thank you.

Thank you. Anyone else have a comment? Did you have a comment? Manager Ellis?

And do we have the data on what that declined prediction would be yet? Or maybe that's something you could follow up with us so we would know maybe that would be helpful if you don't have that data now.

Thank you. Commissioner Jackson had another comment.

Yes, just as Commissioner Stallings has raised this topic and Manager Ellis, you've added to it. For anybody who's listening and tuned in, the reality is that supporting the housing needs of our neighbors is not a mandated service. And the more that we feel pressure from state and federal funds, the more we are forced to make very difficult decisions between what we're mandated to do and what we have chosen to do to ensure that Wake County is a great place to live, work and play. And so for as long as we have these dollars, for as long as we can continue to invest. But this is just a great opp

Thank you. And thank you, Diane. And so I bring this great information to us. So we're moving on to our next item is a public hearing to consider a business development grant agreement. Michael James from our county manager office is here to walk us through that. So Michael, welcome. Please go ahead with your presentation.

Thank you. We will now open the public hearing. When I call your name, please come forward, but I don't have anyone on my list at this point. Then Madam Clerk, do you have any comments received to date?

Okay, well now we will go ahead and close the public hearing. Commissioners, any discussion or question before we close this item? Okay, no comment. Is there a motion to approve the agreement?

Mr. Chairman, I move that the Board of Commissioners, having held a public hearing, approves a business development grant agreement with Novartis Innovative Technologies, Inc., subject to the terms and conditions acceptable to the county attorney.

Okay, we have a motion made by Commissioner Thomas and a second by Commissioner Evans. The question is the motion to approve the business development grant agreement with Novartis Innovative Technologies. All those in favor, please say aye. All those opposed, please say no. Not hearing any, the motion passes. Thank you, Michael. And now, our last regular agenda item for today is the submission of proposed schedule of values, standards, and rules to be used in the 2027 Real Property Revaluation. Nicole.

Okay, thank you so very much. We have never received the 2027 schedules of value standards and rules. Is there a motion to instruct the tax administrator to publish a public hearing notice and schedule a public hearing for october the fifth? Yes.

I just wanted to take a moment just to acknowledge the hard work that comes out of this office, and I have to say, Marcus, you've got to be the most popular tax administrator in the history of the world, and so thank you for all you do, your patience, and really your outreach, particularly in Southeast Raleigh. I know you all have really, really been active and listening, and so it does not go unnoticed, and I hear the feedback, and I'm always shocked in a good way, so thank you.

Thank you, Commissioner Waters. I think Commissioner Addison had a comment.

Yeah, thank you for bringing this to us today. One of the things we started a couple years ago with the final budget is we put it at the reference desk in our libraries. I don't know if the public is interested in this enough that I don't know how many copies you have, if you could get a copy to the reference desk in our library, so if somebody wants to see it, a hard copy, they don't have to come downtown, they can go to their library. And with the reference items, they can't check it out, but they can view it in the library.

Okay, any other question or comments? Yes, Commissioner Jackson.

Yes, just a question. I know today we're just receiving and agreeing to talk more about it on October 5th. I thought the Monday was the 6th, but maybe I'm confused with that. But my question is, Would now or then be the time, or maybe in between, to get some of the questions asked? I know it was shared during the agenda review. So I just don't know, would it be better to ask them now, later?

Oh, okay. Well... about the process of the schedule of values and how they're determined. Specifically, my question that I shared at a gender review, and again, we've had a long day, so I'm good with just, I just wanted to know when, but one of the first questions was based on actually a lot of the work in Southeast Raleigh and the appeals process, I wondered how, what we've learned from the appeals process that influences or shapes these values, if at all.

awesome thank you I'll just have one more question and then I'll save the questions for later so this is a question I recently received from a real estate agent so I didn't know how to answer it so I'm passing it along and she said that in her work as a real estate agent she's seeing in certain areas this was in my district district to that some that homeowners that the values of homes are well not the value, the sale of the home is decreasing. So I wondered how do we account for values that are set maybe when prices are falling or the value of the home is falling? Like how does that experienc

Oh, well, I knew that. I thought it was a trick question. And this is why we're going toward every two years. And so, okay, thank you.

All right, awesome. Thank you. Now, we have now received the 2027 Schedules of Values standing in the room. Is there a motion to instruct the tax administrator to publish a public hearing notice and schedule a public hearing for October 5th Board of Commission meeting? Okay, we have a motion that's being made. Go ahead. You got to read it, don't you? I'm trying to get out of here. It's been a long day. It's a long one, so hold on.

I move that the Board of Commissioners receives the proposed 2027 Schedule of Values, Standards, and Rules and instructs the tax administrator to... to publish a public notice indicating that both market value and present use value schedules have been received by the board for review and are available for public inspection both in the Wake County Department of Tax Administration and on the Wake County website and that They will schedule a public hearing on the proposed schedule of values at the regularly scheduled Board of Commissioners meeting on October 5th, 2026.

Thank you, Commissioner. We have a motion by Commissioner Evans. Is there a second? We have a second by Commissioner Jackson. All in favor, please say aye. All those opposed, please say no. Not hearing any, the motion passes. Thank you. Okay, that's everything for our regular agenda today. Now we'll move on to other business. Commissioners, would anyone like to share an update from an advisor or regional board that you have been appointed to? Commissioner Waters.

just wanted to share that the wake county housing authority meeting has been rescheduled and will meet on wednesday the 23rd at 12 30 if anyone is interested it will be at the wake county commons building all right thank you uh anyone else uh commissioner uh addison

Thank you, I just wanted to say that Interact had their 50th anniversary celebration last week, and it's hard to believe they've been around for 50 years. From the Visitors and Convention Bureau Board, we had a meeting, and Denny Edwards, the longtime CEO, has announced he's retiring as of 12-31.

This is quick. I mentioned this last time, but I would like to remind the community and the board members that Wake County Smart Start is having its 30th anniversary celebration gala this coming Saturday at Marbles Museum. Google Wake County Smart Start and please buy a ticket. Thank you.

Thank you. And now other reports from commissions. Anybody have anything from other reports? Yes, Commissioner Thomas.

Just really quickly, thank you Mr. Chairman. I just wanted to remind my colleagues that the NCACC is starting their legislative goals process steering committee meetings are underway. Commissioner Evans and Commissioner Jackson participated in the public education steering committee today. So kudos to both of you for having an extra long day as you looked at legislative goals around public education that all 100 counties can advocate for. Thank you for that. But general government is tomorrow, justice and public safety on Wednesday, health and human services on Thursday, along with tax and fin

Thank you. Anyone else? Commissioner Stallings.

Just real quick, we're honoring a lot of our first responders, and so several of us attended the event with the Raleigh Chamber, and then Apex had a first responders event that I was able to go to this past week. I was also able to spend some time with the Apex Rotary Club, which was a lot of fun for early, early morning breakfast, and then several of us went to a One Wake event on Saturday and had a really good, I thought, event with them as we continue to think about partnership with affordable housing in Wake County.

Thank you. Any other comments? Okay, not seeing any. Mr. Askew, is there a need for a closed session today? No, Mr. Chair, there is not. Amen. Thank you, everyone. That concludes our agenda for today. The board next regular meeting is scheduled for Monday, October the 5th at 5 p.m. Do I have a motion to adjourn?

Thank you. I got a motion from Commissioner Thomas and a second from Commissioner Waters. So again, thank you. The meeting is now adjourned. All in favor?