Board of Commissioners - Regular Meeting

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August 17 stream test.

Good afternoon, everyone. We will now call the meeting to order. At the beginning, we will have the Pledge of Allegiance. We ask everyone to stand and please remain standing for invocation by Vice Chair Sophia Jackson.

Thank you, everyone, for being here. I invite you to stand or sit, whatever is comfortable for you. At this moment, I invite us all to take a breath and center ourselves on the work ahead as we open Let us embrace our collective ability to make tangible impact in the lives of Wake County. Let us move beyond just maintaining systems to more actively building a community where everyone, regardless of circumstance, can thrive, has the opportunity to thrive. May we prioritize our most vulnerable neighbors, our children, the elderly, essential workers, and those seeking a place to call home. Let our deliberations be guided by the faces unseen, the voices unheard, and the forgotten. We sit at this table and in this room with different voices representing a rich tapestry. May our discourse sharpen our ideas into solutions as resilient as the people we serve. And may our collective wisdom lead us to fair, forward-thinking decisions rooted in justice, compassion, and unwavering integrity. May we seek the wisdom available to all of us and find the courage to act upon it for the common good. With gratitude and for a shared purpose, let us begin.

Good afternoon, everyone, and welcome to today's meeting. We will begin today's meeting with the following items of business. The first item will be the approval of the agenda. So is there a motion to approve the agenda?

I move approval of the agenda. I second.

Okay, we have a motion by Commissioner Thomas to approve the agenda and second by Commissioner Evans. All in favor, please say aye.

Aye.

All those opposed, please say no. Not hearing any, the motion passes. Item number two will be approval of the minutes of the special call meeting and work session on June 8th, 2026, regular meeting on June 15th, 2026, and regular meeting on July 6th, 2026. Is there a motion to approve the minutes?

I move approval of the minutes. Second.

Who made the motion? Okay, a motion by Commissioner Waters and second by Commissioner Stallings. All in favor, please say aye.

Aye.

All those opposed, please say no. Not hearing any, the motion passes. The next we will have is a retiree recognition by our County Manager, David Ellis.

Good afternoon, everyone. We'd like to take a few moments to recognize six of our employees who are retiring between now and September 1st. You all want me to sing? All right, the first person we want to recognize is Shemeika Plum from the Wake County Sheriff's Office. She began her career in 1998 as a master detention officer. During that time, she earned a degree in criminal justice from St. Augustine University. She's dedicated over 27 years supporting the Wake County Sheriff's Office and has ensured efficient court operations through collaboration with judges, clerks, attorneys, and other detention and criminal justice staff. Up next, we want to recognize Cameron Lindquist, excuse me, Cameron Lilliquist. began her career at the sheriff's office in 1999, excuse me, began his career with the sheriff's office in 1999, received a Bachelor of Science in Criminal Justice Administration from the University of Mount Olive, served in the Judicial Patrol Special Operation and Criminal Investigations Division, and proudly fulfilled his lifelong dream of becoming a law enforcement officer and dedicated more than 27 years to the serving of residents in Wake County. Let's give him a round of applause. Up next, we want to recognize Haram Casebolt Jr. with Public Health. Began his career with Wake County in 1990. The job entailed enforcing state and county groundwater and well regulations while assisting residents with well issues and water concerns. Earned a Bachelor of Science degree in geology after attending Enloe High School, Gardner-Webb, and Campbell College, and took pride in helping educating and resolving problems for county residents. Let's give Haram a round of applause. Up next, we have Matthew Todd Sedell, who's retiring from the Wake County Sheriff's Office. Began his career in the Sheriff's Office in 2000. Earned an Associate of Arts in Criminal Justice from Wake Tech and completed basic law enforcement training in 1996. Later completed the Administrative Officer's Management Program at NC State University. Served in multiple patrol roles, the Warrant Unit, and Special Response Team. Proudly recalls his team placing fifth three years in a row, that should be first, placing first three years in a row at the state SWAT competition and competing twice in the world SWAT competitions. Let's give Todd a round of applause. Up next, we're going to recognize another Sheriff's Office employee, Gerald Jerry Ray, began his career in the office in 1997, served in judicial services, evictions, and the warrant unit during his 29-year career with Wake County. He has more than 32 years of total law enforcement service and proudly reflects on making a difference in his community through over 7,400 arrests during the course of his career. Let's give Jerry a round of applause. Thank you. Up next, we have the one and only Mark Forsteri. Mark began his career for Wake County in 1998 as a facilities project manager and became director of the department in 2013. So no one tells me anything. Come on up, guys. He earned a bachelor's degree from Miami University of Ohio, a master of architecture from NC State, and is a registered architect. Managed the design and construction of numerous county libraries, fire stations, and EMS facilities, as well as specialty projects including Wake Brook Health Campus, Marbles Kid Museum, Oak City Center, and the new Public Health Center. He's played a key role in transforming the former Coca-Cola Distribution Center into the Vernon Malone College and Career Academy and helped lead a long-range master plan with Wake Med and Wake Tech to create a health and education district. Mark, are you here? Can you come up? So, Mark, I was told by some folks you're a big Cleveland fan. And so what we'd like for you to do is now it's time to retire your hard hat. And we're going to have a Cleveland Guardians hat for you. Thank you. So.

I'm good. You sure? Yeah, I'm good.

Okay. Thank you, everyone. Thank you. Thank you.

thank you and congratulations and now we will move on okay now we move on to our next item on the agenda which is our recognition award for our plan and development services so Caroline loop Well, the whole team, come on down. You guys have been working so hard and doing great things here throughout the county. Welcome, Mike.

I want to say thank you to the members of the board for recognizing our team today. We're truly honored to receive the award from the North Carolina Builders Inspectors Association for Jurisdiction of the Year. The work our staff does every day is important to the community. They're highly trained professionals who work to make our homes, businesses, and schools, and other buildings safer for everyone who lives, works, and visits Wake County. They understand their responsibility that comes with the work, that they are committed to serving the community with professionalism, consistency, and strong commitment to public safety. One thing I will say that we do when I interview people and they come to meet with us to become an inspector or come into plan review or to our permit tax, The one thing I always tell them is the culture that we have not only at in our department but overall Wake County. I used to build houses in Wake County and did a lot of permitting with Wake County and the one thing I always used to like when I worked with the inspections and permits department was you felt like you didn't feel like you were dealing with a large government entity. You got customer service. You could call, you could get someone on the phone. You could get a meeting if you needed help. The inspections staff in the field, the leadership was very responsive. And I always enjoyed that as a contractor and that culture's always been here and our team has continued that culture that we have for the development community. We hear it from the contractors. homeowners and people that we deal with every day. And I've always said if you can get a general contractor to call an inspections and permits department and give you a compliment, you take that as a big reward. The other thing that I'd like to mention is just to give you a brief overview of what we do. with the Inspections and Permits Department for Wake County. We permit all the unincorporated areas for building and trade permits and code enforcement for Wake County. We also do the inspections for the contract towns of Knightdale, Wendell, Roseville, and Zabulon. um we do all of the wake county public school projects and the wake county public buildings regardless of where they are in the county and then we also do um rdu airport and when i mention that to people when they come in and they oh we have a section of a little small section of rtp i mentioned that to people when they when we're in meetings and i can see they look at us and they're like Wow, that's a lot. So I'm very proud of our team when I think about all the inspections. And when we look back over our fiscal year, we give them the numbers. We tell them how many permits we issued, how many inspections we did, how many code cases we did, because we want to see that recognition that they get. We give that information to them at their retreat. um so i want to thank the board um and the county commissioner's office and the entire planning and development services team for the support that you give us we get that from from you county manager's office and our team and the other departments that we work with at wake county without that support we would not be able to qualify for this award. So it's a team effort throughout not only our team, but the other departments that we work with. I want to congratulate and thank the permits and inspection staff. I'm very proud of what they've accomplished. and it's an honor to work with all of them. This award truly belongs to all of our team. It couldn't be done without the permit techs, plan reviewers, and the inspections field staff and the leadership. Thank you again for recognizing us and giving us this opportunity. Thank you.

Would you like for our staff to stand up?

Yes, please. Thank you. And the next item on the agenda is our fifth anniversary of the Wake County Public School System Proclamation. And the reading of the proclamation will be by Commissioner Terrell Waters and will be accepted by Title Swanson Chair of the Wake County School Board and Vice Chair Sam Hershey.

Good afternoon and thank you, Chair Mayal. I'm really honored to be able to read this proclamation, particularly as a graduate of the Wake County Public School System, class of 1996, Millbrook High School. I know we also have some other alum of the public school system in the building with us today. Also, I'm glad to be beside two of the hardest working elected officials in all of Wake County who serve over 160,000 children faithfully. It is my honor to read the proclamation recognizing 2026 as the 50th anniversary of the Wake County Public School System, whereas the Wake County Board of Commissioners recognizes the importance of strong public schools to the growth, prosperity, and quality of life of our community, and whereas on July 1st, 1976, approximately 20,000 students from Raleigh City Schools and 33,000 students from Wake County schools came together to form the Wake County Public School System, a unified district serving approximately 50,000 students, and whereas during the past five decades, WCPSS has grown from approximately 50,000 students to more than 161,000 students across 203 schools. And whereas the merger was a bold act of local leadership that advanced school integration and educational equity in North Carolina and reflected the belief that investing in every child strengthens the future of the entire community. And whereas the Wake County public school system has been vital to Wake County's extraordinary growth and success and the partnership between Wake County government and Wake County public school systems continues to support students, families, educators, and the broader community. And whereas the 50th anniversary offers an opportunity to honor the people who built and strengthened the Wake County public school system, celebrate shared progress and the inspired community to help write the next chapter of public education in Wake County. And now therefore be it resolved that the Wake County Board of Commissioners does hereby proclaim 2026 as the 50th anniversary of the Wake County public school system and urges Residents of our community and communities across the country to honor the people and history of WCPSS and deepen their support of public education. I adopted this the 17th day of August, 2026. And Chair Miles, that is my motion. I'll second that motion.

Okay, we have a motion by Commissioner Walters and a second by Commissioner Thomas. The motion has been seconded and the question is to the adoption of the motion to approve the fifth anniversary of the Wake County School System Proclamation. All those in favor, please say aye.

Aye.

All those opposed, please say no. Not hearing any, the motion carries. Congratulations. Thank you.

And I will yield to... give some remarks from our illustrious Chair Swanson.

Thank you, Commissioner Waters, and thank you, Chair Miles, Vice Chair Jackson, and members of the board. On behalf of the board, Vice Chair Hersey and I just want to thank you all for your partnership for Wake County Public Schools. This five-year decade, five-decade public partnership, excuse me, uh just shows our commitment to wcpss and when our state legislator has failed to invest in public schools and has diverted funds from public schools you all the wake county board of commissioners have quite frankly saved wake county schools with your historic investment when we needed it the most so thank you for putting our educators first thank you for putting our students first and this shows across the nation and the state what strong collaboration looks like between the Board of Education and the Board of Commissioners. And so this is a model that I'm proud that we all stand in, and that's the rich history that we all stand in. And so together, I'm confident that we will continue to advocate for our students, our teachers, and thank you for putting Wake County Public Schools first and center in your decisions, because when we invest in our schools, we are investing in our communities, we are investing in our economy, and we are investing in our workforce. So thank you for your partnership, and looking forward to getting into some good trouble together. Thank you. Awesome.

and chair swanson and uh vice chair it's a pleasure to have you guys before us today and as a proud graduate of wake county public school we certainly appreciate all that you do and i know uh commissioner ward is also a graduate of wake county public school so that tells you what wake county is doing y'all doing great stuff i appreciate it thank you And now we will move on to our consent agenda. As a reminder, all items on the consent agenda are considered to be routine and may be enacted by one motion. So is there a motion to approve each item as presented in the consent agenda?

I move approval of the consent agenda.

We have a motion by Commissioner Stallings. Is there a second? Second. The second by Commissioner Waters. The motion has been seconded. The question is the adoption of the motion to approve each item in the consent agenda as presented. All those in favor, please say aye.

Aye.

All those opposed, please say no. Not hearing any, the motion carries. The consent agenda is approved. Next, we will have our general public comment. Now, as our general public comment period, at all regular meetings, the Board of Commission allocates time to hear from residents. Today, we also have two public hearings on our agenda. The hearings are related to a special tax assessment and the weight made combination questions. Those two items are later on the agenda. This public comment period is for all policy issues other than Wake Med or the special assessment. Attendees have an opportunity to sign up using our online sign-up app. We've also provided an opportunity to sign up here in person before the meeting began. I have the list of people who signed up. When I call your name, please come to the podium, give us your name, and if you would, share what part of Wake County you reside in. Then you will have two minutes to speak. When you have one minute left, the yellow light will go on. When your time has elapsed, the red light will go on. If you're still speaking at the end of your time, I'll ask you to complete your sentence. In the interest of fairness to everyone, I'm going to try to be consistent about that. Please know the commissioners will not respond to comments shared today. This comment period is time for us to hear from you. And please remember, if you are here to speak on Wake Med or the special assessment, please wait for those public hearings. Also, I would like to add that when you come up to speak, please speak to the board. We ask that no clapping, no applauding and things of that nature, and speak to the board and not to other members in the audience. So the first name on the list is Dwight Spencer. OK. Next one is Manzoor Chima. Next one is Kimberly McIntyre.

Good afternoon, members of the commissioners board. My name is Dr. Kimberly Mukhtarian, proud resident of Raleigh, North Carolina. I'm born and raised right here at Wake Med, but this is not a Wake Med issue. I am here to talk about one of the 13 Freedmen's Villages in the city of Raleigh that were removed during reconstruction. That location is called Lincolnville. of which I represent. Why? Because my ancestors are buried. And many of you may say, where is Lincolnville? Lincolnville is in the heart and the parking lot of Lenovo Center. Lincolnville is in the heart and the parking lot of North Carolina State Carter-Finley Stadium. And when they removed my ancestors and made them sell for $1, they built a prison called Polk Youth Center, Polk Camp, War Camp, and they pushed African American males inside that center. Today, in Wake County, the public school systems have five alternative schools with predominantly black males filling them. So when we applaud the Stanley Cup, the home of the hurricanes, it was a hurricane called racism that came through and pushed our communities down. And today, based off of our lack of ability to pay the same tax break or the tax bracket, we are treated less than human in the city of Raleigh, where there are the highest murder rates in southeast Raleigh. And anybody can think to build a data center, sanitation center, and all kinds of centers that do not profit or bill for us. Today, I am here because I am asking for a meeting. Why? Because Wake Med is, I'm sorry, Wake County.

Your time is up. I'm sorry, but thank you. Go ahead and finish the last sentence there.

Thank you.

Thank you. Okay, I think that was the last person there for our general comment. So thank you everyone who signed up to speak during the general comment period. That completes the list of names that I was provided. For the 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 have received for this meeting?

Yes, sir, Mr. Chair. You had about five comments. One of them was against Wake Med merger, and the other ones were in reference to the elections at the Talley Student Center at North Carolina State University. And I will share this information with you all in the morning in your morning package. Thank you.

Thank you, Mr. Giddey. We will now transition to our regular agenda. We have four items on our regular agenda this afternoon, two of which are public hearing. Before we begin, I want to clarify that these public hearings are separate from the general public comment period. Each public hearing provides an opportunity for comments specifically related to the item being considered. The first public hearing is for the resolution declaring cost and preliminary assessment role and confirmation of assessment for preserved at Long Branch Farms subdivision role improvement. The second public hearing is for potential amendments to Wake Med Articles Incorporation and Transfer Agreement. We will open each public hearing separately and receive comments specifically to that item at that time. Terry Nolan from the planning will walk us through our first public hearing. Terry, welcome.

Thank you. Good afternoon, commissioners. Before you today is the closeout of Wake County's fifth orphan road project preserve at Long Branch Farms. We are here in our timeline in which the county sets the assessments in order to recover the cost of the road project. But first, let me talk a little bit about orphan roads. Counties in North Carolina play a very limited role in subdivision roads in the unincorporated area. Developers are responsible for maintaining roads while they're building their subdivisions, and they are responsible for turning those roads over to the DOT once the homes are built for maintenance. and to be into the state-maintained road system. Now, orphan roads occur when developers fail to do that. We have approximately 150 to 200 miles of orphan road within Wake County alone, although this is a statewide problem. Technically, there is no legal entity responsible for maintaining the road. That means that Wake County has limited ability to intervene and the state will not fix that road. This is a safety issue. It also becomes a housing issue. And it is the property owners that must decide how to move forward. state law does allow counties to provide the upfront financing to fix the roads with the goal of getting them into the state maintained system we want to turn those roads over to the state so that there is a legal entity to take care of them in perpetuity and this law is very specific in how wake county and other counties in north carolina carry out this process Each property is assessed an equal share of the total project cost. The total cost of improvements is paid back to the county by each property owner through a special assessment or a lien on the property, which is what you're setting today. At least 75% of property owners who represent at least 75% of the lineal road frontage must submit a petition requesting this financing. In addition to state law, Wake County also has a board policy related to this that was adopted in 2015, and we've revised it a number of times since. And it's used to determine when the county considers public financing for this type of infrastructure. That policy relates to not only roads, but also private water systems and private sewer, although the policy has only been used for roads to date. This policy discusses how to set the terms of these projects It includes a formula for how to determine the payback period. And that formula means that the number of years that a project pays back is roughly equal to the amount that the average property owner pays in annual taxes in that community. that those terms are set at the beginning of the project. When this project was approved back in 2022, for example, that payback term was set as well as the interest rate. So Preserve at Long Branch Farms is a community that's in the eastern part of the county, off of Battle Bridge Road in Auburn Nightdale. If you're familiar with the Rand Lee property, it's right near there. And it was built in the early 2000s. The developer failed to turn the roads over to DOT. 31 of 41 lot owners signed the petition requesting county financing. And Wake County does hold some funds that the developer forfeited for walking away from this project and not continuing to do what he was supposed to do. So we hold roughly $30,000 that will be applied to the project Just a couple of photos of before the pavement was in fair to poor condition And then also there were some real drainage issues You can see here a lot of the drainage pipes They over time get filled with debris rocks sediment and that all has to be cleaned out so that we have proper drainage for these projects and So we have a long timeline here. This project started in 2022 when the board approved the financing project begins right away after that. And the project went as all projects do in standard form. We held a neighborhood design meeting in the fall, which is an opportunity to talk to the property owners about issues that they're having, give them a feel for what to expect with the project. And then we tried to go to bid. And we bid this project three times with no companies submitting a proposal. The fourth round, we received one proposal that was very, very high in cost. It was nearly a million dollars. And so we went back to the community in 2024 and held a second neighborhood meeting in which we were very honest with everyone about what was happening. We were seeing higher costs than what the original cost estimate was thought to be. We talked about rescoping the project and using a different pavement technique. that we thought would attract more companies. The original pavement technique that we were going to use needed specialized equipment. And through this process, we learned that perhaps there weren't a lot of firms that had this specialized equipment. And so we held that neighborhood meeting, and we presented kind of a plan B, if you will. And the neighbors were like, OK, this isn't great news, but let's move forward. And so we moved forward. in which we re-scoped the project and put out another bid. This time we got three proposals. And so back in March of 2025, the board approved a construction contract, and off we were with construction. And so construction occurred over the summer, and it was accepted into the NCDOT-maintained system in late summer. And so here we are. uh... today to set property assessments so originally the total cost estimate was five hundred and fifty thousand dollars that would have amounted to close to thirteen thousand dollars per lot and at the time uh... the the payment terms was a five-year repayment so roughly two thousand five hundred well our actual costs You see here is $704,798, roughly $150,000 more than what the cost estimate was. That equates to $16,000 and change per lot and roughly a $3,000 and change annual payment. The reason why we, oh, let me show you the after. It is done and it looks nice. We've got fresh pavement. We have proper drainage. So let me return here. So why is it $150,000 more? Well, we spent an additional $50,000 in engineering costs because we had to pay our consulting firm to go back to the drawing board and re-scope the project, drop new bids, you know, bid documents. And then just inflation was the other factor here. So that is the reason for the cost overrun. So here we are. So the special assessment, the total project cost is spread equally among all property owners. Property owners may pay the assessment upfront without a finance charge or finance over the multi-year term. Assessments stay with the property and transfer with the land during property transfers when the home is sold unless they're paid off at closing. and per board policy if there is a financial hardship then the tax administrator can arrange for alternative repayment plans this is true with regular taxes as well so in your packet we have a staff recommendation that instead of a five-year repayment we request the board set a six-year repayment this modification is allowable under the state law And this recommendation is consistent with board policy. And we are asking for this because it brings that annual installment close to what our property owners expected when the project was first approved. In a six-year term, this would be the basic breakdown. The loan amount would be the same, obviously. The annual payment would be $2,745 plus interest. And if someone paid on time for the entire six years, the total payment would be $17,751, if that makes sense. So in summary, property owners were mailed a notice of today's public hearing, which included details about the meeting, but also the project costs. The preliminary assessment role was made available at the clerk's office, and it was on the county website. After this meeting, there will be a letter that goes out that will talk about the next steps in the payment, how to pay, where to pay, what their options are. There will be a notice published by the tax administrator per state law. And then for those paying annually, the first bills will go out November 1st. And I'm happy to answer any questions.

okay thank you terry our board members are any questions okay thank you okay at this time then we'll go ahead and open it up uh for public uh comment anyone uh want to make a comment in reference to this item miss gilliot do you have any um thing that came in in reference to this item i do not mr chair okay not hearing any we'll go ahead and close that public hearing on this item okay uh board is there a motion to confirm the resolution and assessment for to preserve our long um branch uh farm subdivision road improvement and reduce the project budget appropriated by thirty six thousand eight dollars and ninety nine cents for their motion

Yes, Chair, I'll make the motion that the Board of Commissioners, having held a public hearing, now confirms the resolution declaring cost and preliminary assessment role and confirmation of assessments for preserve at Long Branch Farms subdivision road improvements for acceptance into the North Carolina Department of Transportation maintained highway system. and reduces project budget appropriation by $360,008.99 from the estimated $740,807 to the final cost of $704,798.01.

Okay, we have a motion by Vice Chair, Commissioner Jackson, and we have a second by Commissioner Evans. All in favor, please say aye.

Aye.

All those opposed, please say no. Not hearing any, the motion carries. Thank you, Terry, for bringing that forward. And we'll move on to our next item, which is the... is the amendment of approval of the Affordable Housing Home American Rescue Plan allocation. So Mark Perlman, our Deputy Housing Director, is here to walk us through this. Mark, welcome, and please go ahead with your presentation. And great to see you again.

Great to see you, Chair Miles and Commissioners. Thank you for having me this afternoon. As you mentioned, I'm here to present a substantial amendment to our Home American Rescue Plan allocation plan. So the Home American Rescue Plan, or Home ARP, was authorized by the American Rescue Plan Act of 2021 and issued to Home Investment Partnership Program participating jurisdictions, of which Wake County is one at that time. So these are home funds to be administered similar to the Home Investment Partnership Program. However, they more specifically target qualifying populations that are experiencing or at risk of homelessness. So this is a more deeply targeted program. Wake County adopted its allocation plan in March 2022. This was developed during the pandemic in response to community input and stakeholder recommendations. That plan allocated $2,511,550 to acquire and develop non-congregate family shelter and $1 million for affordable rental development. Since that time, our community has experienced an increase in non-congregate shelter and transitional housing capacity through our partners such as Families Together, Family Promise, and Raleigh Rescue Mission. At the same time, there has been increasing housing cost burden. At this time, 93% of renters earning $50,000 a year or less are rental cost burden, an increase since the adoption of the initial plan. And housing cost burden is related is strongly correlated to housing instability. And finally, we have a community focus on permanent housing. While our initial allocation plan was focused on non-concrete shelter, we are moving towards finding permanent housing solutions for our neighbors who are experiencing homelessness. This is exemplified through the Wake at Home initiative, through the continuum of care, as well as our Bridge to Home program, which builds community capacity transition individuals and households experiencing homelessness into stable, permanent housing. So what we are asking today is that the Board of Commissioners accept and appropriate some additional funding that was provided from HUD, and I do apologize. This should say that HUD awarded an additional $5,293 in April 2025. This funding was incorporated into the allocation plan, but it has not been appropriated and does not appear in the budget. We are also asking for authorization to reallocate funding to reflect current community priorities. Through this proposed reallocation, Wake County will address housing vulnerability through support of affordable housing development, as well as providing supportive services and building our community capacity. through the Bridge to Home program and specifically to support the Wake at Home initiative. So in the chart at right, you see the initial allocation plan. We propose allocating $2,516,843 to affordable rental development and $1 million to supportive services through Bridge to Home. And to summarize, we are pursuing this amendment because it aligns with community priorities. We are striving to move unsheltered households into permanent housing. We want to create more affordable housing opportunities. We want to support our neighbors who are exiting homelessness. And we want to continue to build community partner capacity through the bridge to home model, which has been proven very successful. I am happy to receive any questions. Thank you.

Thank you, Mark. Are there any questions, members of the board, or comments?

Okay, not seeing any.

Okay, so is there a motion to accept and appropriate the addition of HUD funding and amend the home ARP allocation plan as presented?

Make the motion.

Okay, we have a motion by Commissioner Evans.

I'm going to read it.

Yeah, go ahead. You need all of it, don't you?

Yeah. I move that the Board of Commissioners accepts and appropriates $5,293 to reflect additional funds from the U.S. Department of Housing and Urban Development, increasing the county's total home ARP award from $3,500,000. and $11,550 to $3,516,843. And also that the Board of Commissioner amends the Home Art Allocation Plan to reprogram $2,516,843 from non-congregate shelter shifting $1 million to supportive services and $1,516,843 to affordable housing development and authorizes the chair to execute documents in any agreements necessary to submit to HUD and to carry out activities described in the plan. I'll second that.

okay we have a motion by commission in a second by commissioner thomas all in favor please say aye aye aye all opposed please say no not hearing any the motion care thank you mark next item on the agenda is the business development uh grant policy updates uh michael james assistant uh county manager

Thank you chair mile and good afternoon commissioners. You have in front of you several updates to your business development grant or economic development incentive policy. As you all know and recall and have been involved in, the board has been reviewing and considering the incentive policy really over the past year. First saw and discussed these changes back in March So what's in front of you today is really the culmination of all that work and the result of all those discussions? Including most recently at your work session last week where we discussed all these changes in detail So these are really before you for Final consideration and adoption if you're ready to do that today we are going to or I'm gonna review all of these changes along with Michael Haley again today, just as a kind of a final recap of all the changes that have been discussed. So I'll turn it over to him in a moment. Before I do that, I am just gonna share some information and responses to what I heard as questions or requests for additional context from you all as part of the discussions that we had at the work session last week. So just as a reminder, why do we have this policy? What's the whole point? Of course, you all are trying to attract and encourage new investment in Wake County. You're trying to create new jobs that are accessible to residents of Wake County, diversify the tax base, and promote economic mobility and sustainable business practices. One of the questions we got was just about the history of the policy. So it's been in place since 2005. And the first policy was actually modeled after a project with Credit Suisse, First Boston. It was adopted initially in 2005 and has been amended five times since its initial adoption. And so if you were to move forward today, this would be the sixth amendment. Another question that we heard from the board was just some indication of kind of performance or results from the policy, and so I just took a quick look this week at the active agreements that we have with companies. And so when you just look through those and pull out the commitments, so these are contractual commitments that the companies have entered into. what they have said they're gonna invest, but contractual obligations under the contracts for them to deliver in order to be paid. So over $5 billion committed addition to Wake County's tax base. So again, that's a commitment to increasing assessed tax valuation, which brings property tax base to the county and puts relief on property tax rates, helps with that. So if you were to look just at the company's plan, spending and investment in Wake County would be a bigger number than that. And then over 7,000 committed new jobs. One of the things I think it's always important to remind you all about, if the companies don't deliver on these, they don't get paid. So Wake County pays for performance, so it is an incentive for a company to come here, but they have to do their part before they're paid. So I think it's helpful just to walk through all the steps that a company has to go through in order to receive one of these grants. So first of all, they commit to a minimum number of tax base that they're adding as part of their investments in the project. and they have to meet that in order to qualify for payment. Of course, we look at that, tax office looks at that in order to certify that, so it's not just accepting the company to work for it. Similar on the jobs, they have to create the jobs that they've committed to as part of the project, and those are also independently verified. A lot of cases by the state, if the state's participating on the project, or by the county through documentation that we request on the contracts. They have to pay their property tax bill in full And then they have to attest that they have done all of these things in a performance letter every year to us. In the event a company initially qualifies and were to later fall out of compliance, all of our agreements also have clawback provisions. So every agreement we have includes recapture provisions that would be activated if a company were to say they had to add 200 jobs. They do that year one, and year two they fall below that threshold. and they do it to a point where they fail to meet those requirements for 50% of the total term of the agreement, the county is then entitled to recapture 50% of what would have been paid out of the grant. So that's just another additional protection that we have in our agreements. And sorry for the typo there. I left off a word there at the end. So just a reminder before I turn it over to Michael to briefly walk through and recap the changes again. This was discussed at the committee level really dating back a year now. And then the changes in detail were discussed with the committee in March. And then you all had a pretty in-depth detailed discussion about this at your work session last week. And so we're here for final adoption today if you're ready. So with that, I'll turn it over to Michael.

Thank you, Michael. Thank you, commissioners, for the time today. I want to thank you again for your continued commitment in support of economic development in Wake County. Very much excited to talk to you about these adjustments and updates to your proposal. As Michael said, we've been working on this. for a while now. I think it's really important. Economic opportunity and mobility is obviously something that this board cares a lot about and is focused on, and this policy is reflective of that focus as well. It continues to be a core element to our economic development efforts overall. Like Michael said, I want to reiterate that this policy remains performance-based. Again, a company doesn't receive a grant payment until their taxes and their performance threshold are met, continues to be targeted, focusing on key sectors here in Wake County, and obviously supports economic growth, opportunity, and mobility. So we're proposing a text change to the wage threshold language. The request is to change the policy to provide the commissioners with additional flexibility and discretion related to the wages by replacing the living wage floor with new language and adjusting the wage threshold from 110% of the county's average wage to 100% of the county's average wage. The overarching purpose of this request is to support entry level and early career positions. The commissioners still have discretion. If a project does not meet the updated wage threshold, the commissioners can expressly request in writing from the company the following information. that the company could qualify for the upward mobility bonus thresholds and requirements. Second, the company qualifies for a municipal incentive. Again, there's some circumstances in which a municipal incentive policy will have a lower wage threshold in the counties, and so understanding that would be important, or it may have a different type of wage threshold. It may be, instead of an overall average, it may be an industry average or a job average here in Wake County. And then finally, again, in writing, the commissioners can request how the company supports economic mobility and opportunity internally. So how are they promoting from within, if you will? There are several justifications for this wage threshold adjustment request. One, and we've spoken about this quite often, that wage inflation has occurred rapidly over the past several years. as the data here on this chart demonstrate. Second, the proposed change will allow the policy to support more entry-level and early career positions. These are positions that are often the first step in economic mobility, and these are positions that we want to see with clear pathways to economic opportunity. And then lastly, Companies obviously must pay market rates, and the labor market here influences those final wage levels. Wanted to also speak to Wake County Economic Development's role in this portion of the process. Wake County Economic Development, when speaking with companies about potential expansions in Wake County or relocation in Wake County, our role is to emphasize both the purpose of the policy and the thresholds. We want to provide local wage data to set a proper expectations for what salaries will most likely be based on the current wage labor rates. And then finally, we want to work with companies to best articulate how they plan to support economic mobility, again, how they plan to hire and promote from within. Obviously, it bears repeating, anytime we talk about our labor force or employment, how closely we're aligned with Capital Area Workforce Development and Wake Tech, and how critical they are to economic development overall. They are partners that are involved in literally every single project that Wake County Economic Development leads, and they offer us tremendous support, as well as the companies that we're working with in training data and much more, particularly around these entry-level positions. Next, we are requesting a simplification of our tiers. This is meant to just simplify the process. Most of these investment level distinctions of tiers were adopted at a very different time with very different levels of investments for projects. This is a bit easier to explain and follows. And honestly, the differentiation isn't significant enough anymore given the types of projects that Wake County's seeing. Next. is probably the most important policy change that we're requesting, and that's the establishment of a transformational project here. We've talked about this a lot, and we've seen this in our community. Projects are much more complex, much more competitive, and much larger than ever, but also, those same projects are much more impactful in terms of the follow-on economic impact that can be felt across Wake County and across our region. We are requesting the creation of a new transformational project here This would codify the type of flexibility that the commissioners have offered similar projects, projects with very large capital investments, in this case over $500 million, and significant job creation. The flexibility being requested in terms of the incentive percentage in years would allow the maximum flexibility during the incentive negotiation process undergone by the county attorney. and the Assistant County Manager, Michael James, when they are engaged, and would enhance Wake County's competitiveness. Again, I want to continue to be supportive of our municipal partners. They are continuously seeking new and creative ways to support very large transformational projects, so this is obviously something that the county would be doing in partnership. with our municipal partners. But given the scale and impact of these projects, this tier is critical. Next, we're requesting a decrease in the state match minimum. It's an important reminder that the state requires local participation from a local unit of government when a state incentive is offered. Now again, this is not a dollar for dollar match per se, but participation made in good faith. I also want to note, and I said this in your work session, that the county has been an exemplary partner in this regard over the years since this has become a state mandate. One trend that we've discussed often is lowered investment levels when it comes to office-related projects. Office projects have changed in size and scope, something that we've seen firsthand. There are very few office-related projects that would kick off a new building such as Bandwidth or MetLife's campus. Now, many of these projects are going into existing buildings, which is a good thing. and therefore don't require such a large capital investment. It's often the case with these state matching projects that the county's incentive unlocks a larger state investment and incentive if they are low capital investment, high job creation projects. Again, office is still a critical component of the tax base of Wake County. We want to continue to support investment across this asset class across the entire county. Next, it's been a long-standing aim of the county's economic development policy to support the creation, growth, or relocation of headquarters. We're requesting an adjustment to the investment minimum and how the investment is calculated. Under the current policy, a grant is based on a percentage of the net new ad valorem taxes generated. But when these projects go into existing space, investment levels, again, can be relatively minimal, and therefore the grant investment, the grant amount, is likewise minimal. The example here on this slide indicates the type of investment and the type of Project that we're discussing here. This new language would reduce the investment minimum as well as use a cash per job Structure with a shorter payout period again The purpose is to make the grant more impactful and increase Wake County's competitiveness for headquarters Again headquarters remain very important for a number of reasons Obviously jobs and investment are critical. That's the purpose of economic development here in Wake County but also Headquarters provide much more than beyond just the tax base that they provide. There's the philanthropic leadership that headquarters provide, as well as community leadership, which is really important. So again, this adjustment is being requested for really three primary reasons. It allows us to be much more competitive for these very important projects. The positives of headquarters extend beyond that tax base. And then vacant office space impacts overall property values and revenue to the county. Next, we're asking for a minor change in language and recommending a change of language from the county's use of targeted growth area to priority growth area. Economic mobility and opportunity remain pillars of our overall economic development strategy of the county and Wake County economic development. What we try to do is summarize the changes, as you can see in this chart. This chart summarizes all the changes that are being requested of you today. The consolidated tiers, the changes to the wage and investment thresholds, the creation of the transformational tier, the adjustments to the headquarters tier, and the text change to priority growth area. I want to emphasize that these changes add clarity and flexibility in your ability to respond to large, complex expansions of existing companies or companies seeking to grow in Wake County. The requested adjustments stay within the broader framework of the overall policy's intended goals, which have always been new jobs and new taxable investment. And then finally, the policy remains, as Michael and I said before, performance-based, targeted, focused on key sectors, and supports economic growth, opportunity, and mobility. Turn it over to...

to do now sure thank you michael for walking through those changes at this time i'll just turn it over to you chair and to the board if you have any further questions or comments on the policy otherwise we'll stand by okay thank you michael and michael uh board are there any questions uh before we move on yeah commissioner stallings

really just a comment chair thank you thank you michael and michael for bringing this forward and i really just wanted to emphasize really for the public that we as a board this is a real value of ours is really to continuing to always think about economic opportunities and economic mobility opportunities for our residents And we really want to try to create as many economic opportunities for our residents as we can, so as many people have opportunities to thrive as they can. And I just wanted to highlight, and you may want to say more or you may not, but just sometimes it's a misconception that the payout is at the front, but the payout does not occur until performance measures are met and that we do have callback opportunities. measures in place as well to really try to safeguard the dollars that we are stewards of. So I just wanted to reiterate that and to thank you for the work and thank you to my board colleagues as well for this work as we continue to try to be innovative and thinking about economic development opportunities for all parts of Wake County. Thank you.

Thank you. Okay, thank you. Commissioner Thomas.

Thank you. Thank you, Michael Squared, for all of this work. As chair of the Economic Development Committee, we've been talking about this for quite some time. Like Michael James, you said it's been almost a year since we started talking about this in committee. And you guys have been really good to listen to our feedback and make the tweaks and change some of the language. My question really is about the adjusted wage thresholds. When it says that the employer promotes economic mobility, and I heard you in your presentation, Michael Haley, talk about the employer would promote economic mobility. And I'm interested in what's the difference in promoting economic mobility and demonstrating that they already provide economic mobility.

Can I jump in?

Thank you for that question, Commissioner Thomas. I think this is an important aspect of what we want to show when we provide you with project summary forms and we're providing you information about the companies. We want to give as much, shine as much light on that as possible with real examples from the company. That's why we want to have these conversations with the companies in advance, and again, Appreciate Commissioner Stallings' point about the policy and our overall economic development here, because it ties into Commissioner Thomas' question, is we have such a strong policy and a strong history of supporting economic development and growth here in Wake County. A lot of that has to do with our policy and the strength of that. But also, in our workings with these companies, it's oftentimes that we're working with companies for months at a time, four, six, eight months before we bring those companies before you to talk about incentives at all. And so we're working constantly with Michael James and the county attorney. well in advance of anything so we can really understand fully, to your point, Commissioner Thomas, how are these companies supporting economic growth from within and supporting, again, these early career positions are really important, something that we've been talking a lot about and something that we feel this new policy can be very supportive of. So we want to see demonstrated examples and history of this by these companies.

Okay, and is Wake Tech and the Capital Area Workforce Development involved in every conversation that happens around economic mobility?

Yes, ma'am. Literally every project that we have, our key differentiator in this community is the people. It's the people that make Wake County great. one of the most highly educated, highly skilled communities in America. For us then, to be able to really accentuate that, we want to make sure that our partners, Capital Area Workforce and Wake Tech are a part of those conversations. They're delivering When it comes to things like the training and sourcing talent, they're the ones that are doing it. They're national leaders in this. So it makes economic development better for us and for our community that our workforce development educational partners are part of all these conversations.

Thank you, Michael.

Yes, ma'am.

Okay, Commissioner Evans.

Yes, thank you. Guys, I appreciate all the work on this. I know that this is a culmination of a lot of months of us going back and forth over a number of things, but I feel like we have made the dollars and the wage ranges relevant to current times rather than years ago, and that's reflected in as you indicated, the transformational projects as well, because that's just a whole different scope of project that we didn't even dream about seven or eight years ago when I got on the board. So being nimble and figuring out the best way to continue to attract huge manufacturing projects, things that will benefit our commercial office space that needs to be filled, as well as benefiting creation of jobs and encouraging headquarters is all very important, so I appreciate the balanced approach. One of the things in line with what Commissioner Thomas was highlighting is that I want to point out when we are reviewing a potential business that will come to this area when they are telling us that they will offer a certain number of jobs. We have y'all bring us the distribution of those jobs. So we've been very focused on economic mobility for years. We were known in this community for a long time as a high-tech area, and that's good. That was a good thing. But we also know that not everybody benefited equitably from our prosperity. So we've been really focused on, and you guys have helped us so much with this, and I want the public to know that piece. we look at the whole spectrum of jobs that this company is saying that they will bring and those will be some executive jobs some professional jobs some entry-level jobs sometimes that don't require anything beyond a high school degree some that require a little bit of training at wake tech or whatever and so i just wanted the public to know that we're we don't we don't ever want to attract a company that's gonna come in and pay just low wages. But if they have a few lower wages on the bottom of their spectrum, but they've got all these others as well, and those low wages reflect folks who will have the opportunity to move up the ranks in their business, then that equates to the mobility that we're looking for. I'm proud of all the work that we've done here and that we do, and I think that we have this policy in a way that encourages the right investments in our community, and I'm happy to support these changes. Thank you.

Thank you, Commissioner Evans. Commissioner Jackson?

Michael Squared, thank you so much for just being with us and hearing all of our questions and feedback and just being patient as we all work through the best option. I believe too that we've reached a place where we're balancing flexibility with our values and we're positioned to seize what is happening right now in our market. So thank you for all of your diligence. My question, and also thank you for bringing back the active agreements, 16 projects, $5 billion to our county's tax base. That is, thank you for bringing back that very specific number for us. It's good to keep that in mind as we're in this conversation. My question is around headquarters and appreciated you mentioning the value of headquarters bringing philanthropic contributions and community impact. Can you just talk a little bit about how we verify or ensure that that is part of the headquarters strategy?

Yes, ma'am.

Thank you for the question, and maybe before I answer it, maybe a quick comment. One of the things we appreciate, thank you, obviously there's been a lot of work put into this, but I think it mirrors the seriousness of your own deliberations, so appreciate the seriousness with which the board has taken this effort. Always focus on economic mobility, economic opportunity for the residents is really important. It's been hopefully reflected in what we've talked about today. So to your specific question about again working with headquarters just like every project as i mentioned commissioner thomas in my response to her our role is to work with with those companies very deliberately part of what we're doing is setting an expectation a community expectation of how companies will reflect the broader wake county economy and community and so when we're working with headquartered companies we're making sure they understand look we've got a great array of existing companies that are headquartered here that have been long-standing community advocates and supporters and one need not look but just you know you can kind of spin your head around and see companies around this community that have supported our performing arts the arts education etc that's what our expectation is as a community that our headquarter companies do that We relay that information to those headquarters so they understand. That's an expectation that we have as a community level expectation.

Excellent. Thank you. We love a good public-private partnership. Yes, ma'am. All right. Thank you. That's it.

Okay. Commissioner Adamson.

Well, I also appreciate your efforts. And I wanted to focus on the priority growth areas. And I'm always really excited when you find a company that's willing to go into one of our priority areas that offers living wage jobs, not just $18 an hour jobs, but living wage jobs that have full benefits. Because one, you didn't put this on the slide, but one of the big barriers for folks is transportation. If we can put the companies that offer upward mobility in their community, not only are they able to get there but it cuts down on traffic the closer you are to your job the less you drive to get there so it cuts down on everybody's transportation expenses in a traditionally low income area so thank you for prioritizing that and really working on bringing those jobs to where the people in wake county are any other questions or comment by the board

Not seeing any. Michael and Michael, thank you so very much for bringing this to us today. So is there a motion to approve the updated Wake County business development grant policy as presented?

Mr. Chairman, I move that the Board of Commissioners approves the updated Wake County Business Development Grant Policy to establish a transformational project tier, create a job-based payout structure for headquarters projects, and make adjustments to wage thresholds and the minimum investment for county participation in state match projects.

I'll second that.

Okay, we have a motion by Commissioner Thomas, and I guess we'll go with Vice Chair as the second on this item. So with that being said, we've got a motion and a second. All in favor, please say aye.

Aye.

All opposed, please say no. Not hearing any. Ayes have it. Motion passed. Thank you guys so much for bringing this to us. So now we have come to our final item, is a public hearing on potential amendments to Wakeman's Articles of Incorporation and Transfer Agreement, which will be presented by Tiffany Campbell and Allison Cooper with the County Attorney's Office. Before we begin, I want to briefly explain how we will proceed. We will first hear the staff presentation. no public comments will be received during their presentation. Following the presentation, I will formally open the public hearing to receive comments. Given the number of individuals we anticipate will speak today, we will call speakers forward in groups of five. When your name is called, please come to the front and remain there until it is your turn to speak. As each speaker finished, we will call additional names forward so that five speakers are prepared and waiting at the front at all times. Each speaker will be given two minutes to provide their comments. This process will help us to move efficiently through the public hearing and minimize delays. As individuals make their way from the back of the meeting room or the overflow, So please, no cheering, clapping, or being disrespectful of others. All comments should be directed to the board. I also want to emphasize that you have two minutes to speak, so please keep your eye on the buzzer there up front there. You got your green, yellow, and red light. The yellow light will come on when you got a minute left. So please keep your eye on that so that way I don't have to cut you off. I will be firm in trying to keep this on task here so we can move forward since we do have so many people that want to speak. So at this time, Ms. Cameron, Ms. Cooper, welcome and please proceed with your presentation.

Thank you, Jeremiah. Thank you for the introduction in today's briefing. Miss Campbell and I will cover as far as an overview of what we're going to cover. We're going to go over a brief history of wake med. We will also cover the 1997 sale and transfer of our hospital assets to wake med. And that is the year in which they converted from a public hospital to a private nonprofit hospital system. And then we'll close with an overview of the two governance agreements that you're being asked to amend as part of this proposed consolidation with Atrium Health. So as far as brief history, in 1955, Wake County voters authorized the issuance of bonds to fund and construct Wake Memorial Hospital. This hospital was first opened in 1961, and it was the first hospital in our region to be fully integrated. Shortly thereafter, in 1965, Wake County leaders determined there was a need to incorporate a nonprofit to actually operate and run this hospital system. They were originally incorporated with a seven member board of trustees. And for purposes of this presentation where you see WCHS, that is Wake Med, they went through an official corporate. name change in 1998, but WCHS is Wake Med. Shortly thereafter, over the next several decades, their articles of incorporation were amended several times, and we currently have a 14-member board of directors at Wake Med. Those articles of incorporation that were amended also expanded some of their corporate powers and powers as a hospital system. In 1988 and 1993, the county issued municipal bonds to fund facility expansions, renovations, and to purchase new medical equipment associated with the hospital system. And this is significant for reasons that I'll address later on in the presentation. In 1995, county leaders came together with hospital leaders and created a study commission to look at the future of the Wake Med hospital system. As a result of this study, it was a 22-month study. There was a series of public hearings, public forums. There were hospital experts that were hired. Lots of attorneys were hired to look at it. A plan to transfer assets from Wake County was developed. And that leads us to 1997, which is the year in which Wake County officially removed itself from the hospital business. In 1997, our board approved our sale of all interest it had in the existing hospital system to Wake Med officially converted to that private nonprofit hospital system. And as a result of that, the articles of incorporation had to be refiled and restated. We also conditioned our sale on a transfer agreement. This is a contractual agreement that still exists today between the county and Wake Med. What was not required by law but is a condition in this transfer agreement is that the county required that Wake Med come to us for consent if there are any changes in the Wake Med governance structure, meaning the board of director seats that we currently appoint. That transfer agreement also outlined that they could not change their management. structure or have a third party control day-to-day management of the hospital without our consent. What was required by law was that Wake Med guarantee the provision of indigent services, so services regardless of ability to pay, and they were also required to repay all the county issued debt from those 1988 and 1993 bonds that I referenced earlier. another statutory requirement was for the county to retain a reversionary interest and in the property that we conveyed and we did just that so what is you you can't really read the deed that's on the right hand of the screen but we originally conveyed five parcels of real estate now at the time wake med owned a lot more that was not subject to our control there was no from what we can tell and looking at title wake county did not hold an ownership interest in any of those five parcels. But the reversionary interest is a future interest that's triggered in the event that they are out of compliance with that transfer agreement, that contractual agreement, or in the event that they dissolve without a successor corporation to run the hospital system. Presently, there are only two WakeMed parcels that remain subject to this restriction. and it's Wake Med Cary as well as Wake Med Raleigh campus. However, because the county only originally owned a three acre portion of that Wake Med Cary campus, that is all that's subject to this reversionary interest. It is currently a 24 acre hospital campus and of course the Wake Med Raleigh campus is much larger as well. So what was the impact of this 1997 transfer and sale? The largest impact for us as a county was financially. Wake Med assumed approximately $100 million in hospital debt that taxpayers would have been obligated to repay. They actually deposited that money in an escrow account upon closing in 1997. They also began to operate independently from the county and subject, of course, to our board appointment powers that we still retain in the transfer agreement as well as the articles of incorporation. They also no longer had to come to us for annual appropriations. We were prior to the 1997 closing, we were annually providing them with payments for indigent care. They also had to come to us for certificate of need applications as they expanded facilities and wanted more hospital beds, they had to seek our approval. That is no longer required. And Wake Med really began expanding their footprint throughout the county. They of course have acquired additional facilities. They now currently own over 30 facilities that are not subject to our reversionary interest or our oversight. That concludes my portion of the presentation and Ms. Kimball's now gonna go over some of the governance documents.

Just picking up where Allison left off, I'm going to go over the two documents that you are being asked to approve. The first is the Articles of Incorporation, and that is Wake Med's governing document. And together with the bylaws, that defines the purpose, the member structure, distribution of assets on dissolution, and some other things. The proposed new Articles of Incorporation would make Atrium Health the sole controlling member of Wake Med and recast the county's role that were in the original terms of the Articles of Incorporation. The second document you're going to be approving or not approving is the transfer agreement. And that, as Allison has already described, is the 1997 contract between the county and Wake Med. And those conditions of the transfer, she's already talked about the reversionary interest. And the conditions of this agreement runs with the deed of the property that was conveyed at the time. So it's not an ordinary contract by its own terms. Currently, any proposed amendment to these documents require Wake County approval, and that's why we're here today. The next slide is just a list of general key categories of different changes to the county's authority or role in this process. This slide's pretty text-heavy, but just to hit the high points, the first category is local control. Of course, now Wake Med is a local independent nonprofit entity. If this combination is approved, then Atrium Health will become the single controlling member of Wake Med. So by its terms, Atrium Health and then Advocate Health through the enterprise will assume a significant amount of the financial and governing decisions after that point. The second change would be to the county's board appointment and removal rights under the current Articles of Incorporation. this board has the authority to directly appoint 8 of 14 of those wake med directors the proposed changes would have that this board making the final approval of those directors but it would be subject to nominations produced from a slate that is approved by the full board of directors of wake med the next area is indigent care and currently the Wake Med is obligated to provide 4.8% of its total adjusted revenue towards indigent care in the county. That formula and that amount would remain the same under the proposed terms of the second transfer agreement. And then there would also be a requirement that Wake Med comply with any IRS debt collection regulations. including screening for financial assistance eligibility before pursuing more aggressive collection efforts. So while Wake Med would have to comply with that by federal law, it would also be a contractual term as well. The next area is county protection and debt. Currently, the county has some oversight of what liens and debt can be incurred on county property. That would continue but into a more limited realm because it would be concerning the restricted property that Allison has already described to you. And then the last thing is, what would we be able to do if Wake Med fails to meet its obligations? Currently, if those obligations and the transfer agreement and state law aren't met, the rights of that property that was conveyed in 1997 automatically revert to the county. And that does not change under the proposed terms. Under the proposed articles of incorporation in the transfer agreement, reversion would apply to the defined restricted property, triggered by failing the community hospital or indigent care commitments, or dissolving without a qualifying nonprofit successor with a 90 day period that Wake Med can cure any deficiencies. Also, another change would be that Atrium would become a third-party beneficiary to our transfer agreement, which means practically that they could enforce Wake Med's rights against the county, but they would not be a signatory or a guarantor, and our recourse against Wake Med would remain with Wake Med only. The whole reason why the county is here today and a part of these discussions is because of two things. The first is state law. 131E-8 requires certain things remain in place upon a county's transference of these hospital facilities. One is that the hospital continue to operate as a community general hospital, which means that it is access to all without ability to pay, free of discrimination. The second is indigent care obligations that is required by state law. But our contract with Wake Med in 1997 set the 4.8% indigent care requirement, and we would want to make sure that that continues. And then the third requirement from state law is the reversionary rights. The additional rights that the county now enjoys, which includes the board appointment rights and the right to consent to certain structural changes, that came about as additional terms of the transfer agreement that were in addition to the minimums required by state law. I know that there's been a lot of concern about some of these documents and why we can't discuss them and why they are secret. And that is because of state law. That is not a decision that this board or the county has made. Any terms of the agreement between Wake Med and Atrium are confidential pursuant to state law under the competitive healthcare information statutes. And that's 131e-97.3 and other related statutes. Any agreements between Wake Med and Atrium Health, and that includes their proposed bylaws and the authorities of each entity, are protected by state law and the commissioners have a duty not to disclose that information. Now, any resulting agreements between Wake County and Wake Med will be public record and fully transparent. The county's ultimate decision and what we have to make sure happens with any proposed combination is we have to ensure that any changes comply with state law and the contractual obligations of the 1997 transfer agreement. The county also has to ensure that any changes maintains those services to indigent patients at a level equal to or greater than provided in the 1997 transfer agreement, which is, as we've already said, 4.8%. And then lastly, we have to ensure that any changes preserve Wake Med's role as a nonprofit community general hospital open to the general public, free of discrimination based upon race, creed, color, sex, or national origin. And that is the conclusion of the legal briefing.

Okay, thank you so much. Ms. Campbell and Ms. Cooper. At this time, the public hearing on potential amendments. Of course, this public hearing to receive comments and no votes is planned during this meeting. So at this time, I'd like to go ahead and open up the public hearing. And again, I will call five people at a time to come forward. Remember that you have two minutes limit. And I will stay firm on that. So if you can see that, I will cut you off because we have two minutes. So starting out, the first five that we will call will be Dwight Spencer, Rob Stevens, Jamila Hiddenly, Helen Spoken, and Dixon Capps. So please, those five, please come down first.

Good afternoon, commissioners, and good afternoon to our favorite county manager, David Ellis, the best one in the state. I want to first of all say thank you for delaying this process proceeding with Wake Med and Atrium to allow the citizens of Wake County to share in and to allow Wake Med to share more and the citizens to learn more and share their own perspectives. so thank you so much and very quickly i think that wake man has done their part in going into the community and reaching as many citizens as they possibly can within 90 days to share about this more but citizens can learn more about this merger and to give the community and uh of every city intact every town in wake county an opportunity to ask questions insuring their perspective okay uh... this is not one community hospital i want to make that very clear this is the people's hospital awake county and i want to ask that you the county commissioners please put politics aside And think about health. Think about the health care of every citizen in Wake County. I think this is a good partnership. I think it would be a partnership that would increase the health care technology so that everybody will receive the best health care that Wake Med and Atrium can provide. And I know without a doubt that Wake Med will stick to that health commitment to every citizen in Wake County. Thank you so much and have a great day.

Thank you, Mr. Spencer. Rob Stevens.

Good afternoon. I didn't know there was a zero number because I was number one, but Brother Dwight did it. My name is Rob Stevens, a member of the men of Southeast Raleigh and the Patients Union. We appreciate the county commission deciding that this sort of transfer of power requires a public hearing. However, we're having a public hearing on a document, a deal that none of the folks, or at least none that I know behind me, have seen. A deal in terms that you all have only had five hours to review. The community's questions have not been answered. Instead, we have been told to trust us. And trust us, it's not enough. More information is coming in every day, it seems. Just last week, a report came out that Wake Forest Baptist Atrium, since its takeover from Atrium, has risen 8%, its price is 8% more than the rest of North Carolina's hospitals. And it was only a few days ago that I learned that you all will actually not appoint the members of the Wake Med board, but instead you will get a slate from Wake Med, just like it happens in Charlotte Mecklenburg, and you get to decide whether to approve it or not. And if you don't approve it, then the current board continues. And so this will be like it is in Mecklenburg, a self-handpicked board, and of course the atrium members are not meeting any of those same requirements. This is a marriage, as people have said, except it's a marriage circa 1700. It's a marriage where one party literally owns the other, given over to the other, except the dowry you are receiving on surface is certainly below market value, and the service has no teeth in enforcement. In return, Atrium is getting a massive real estate portfolio, a profitable hospital, and even more leverage to inflate prices. If it's such a good deal, Show it, redact the trade secrets. You all can't reveal it, but Atrium and Wake Med can. If it's such a good deal, do an open bidding process, and this deal will win if it is. They have money, they have billboards, they have YouTube ads, they have all sorts of mailers, but we have you, and that's more powerful. Please protect our healthcare.

Okay, and Jamila Headley.

Good afternoon, commissioners. My name is Jamila Headley and I'm the executive director of the Patients Union, a national membership organization for patients. There's a lot that I could say today, but yesterday I spoke to Michael Whitley, a Wake Med patient with pancreatic cancer who reached out to our team this weekend. He asked me to share his story with everyone here today. His story makes the states clearer than any technical argument that I could offer you today, so here's what he had to say. My name is Michael Stewart Whitley. I am a 68-year-old pancreatic cancer patient at Wake Med who receives 100% charity care from Wake Med. Corporate executives claim that the proposed Wake Med atrium combination will improve regional affordability My current life and death experience as a patient shows the exact opposite. I have an aggressive tumor in the head of my pancreas. Given its location, extraordinary risks to my life and quality of life, surgery is not a safe, realistic option for me. Instead, my Wake Med oncologist urgently referred me to Atrium Health in Charlotte. the region's only protein beam therapy center, an intervention they believe offers the best chance to treat this tumor safely. Despite a direct urgent clinical referral from Wake Med, Atrium has completely stonewalled my care. The staff refused to schedule and take consultation because I'm considered self-pay When I asked to apply for Atrium's financial assistance program, I was told I could not apply until I was already an established patient. I was told that their charity care policy excludes proton therapy. If Atrium is already denying access to specialized oncology care before the merger papers are finalized, how can this community trust Atrium to manage Wake Med's assets and uphold its public mission? Those are Michael's words. Atrium, I don't know if anyone from Atrium is in the room, please fix this as soon as possible. Schedule Michael's consultation and let him apply for financial assistance before it is too late. Michael should be spending his strength fighting cancer, not fighting to get through your doors. Commissioners, you do not have to guess how Atrium will treat vulnerable patients after this merger. Michael's experience shows how it treats one now. Okay, ma'am, I'm sorry, but your time is up. Do not hand over Atrium even more power on who he believes differently.

Ma'am, your time is up.

Thank you.

Okay, let me call Nathan Foster, Emma Free, Aaron Dawn. Thomas Finkel and Artis Watkins will be the next group. So Helen spoken.

Thank you all for letting us speak today. I'm Helen Sporkin. I'm a member of the Patients Union and a Raleigh's resident, but I'm also a concerned mother. I moved to Raleigh two years ago and got pregnant with my son not long after. I decided to go with UNC Rex for my care because it was a few minutes closer to our house than Wake Med and I wanted to be as close as possible to the place I was going to give birth. Because UNC Rex is not the flagship hospital of its system, it offloaded high risk maternal fetal care and high acuity NICU beds to Chapel Hill to save money after it was bought out. I didn't know this until I was a good ways through my pregnancy and got preeclampsia. Mergers and acquisitions are lucrative for hospitals because it draws in a region's patient space for high reimbursement services like outpatient procedures and offloads high acuity care to understaffed hospitals to extract as much money as possible. I gave birth to my very premature son who was in a brief position with no pain relief or C-section due to the lack of beds and staffing at UNC Maine. I nearly gave birth on the side of Highway 40 because I had to drive all the way to Chapel Hill just to be seen. My son was in a doubled up NICU bay for over a month where another mother and I had to take turns pumping and holding our babies due to overcrowding. he needed a surgery after his discharge we went with wake med because we heard they provide excellent pediatric care i was very happy with this treatment there and plan to go there for the rest of my children's care the loss of high level care focused in southeast raleigh would be devastating atrium and advocate are not interested in improving care in wake county they want to expand by any means necessary wake med is the last of a dying breed and time and time again hospitals have seen this kind of merger lead to understaffing higher patient loads and worsening patient outcomes. Women and babies, especially those from vulnerable communities, die due to understaffing and closure of essential but unprofitable services. Do not believe these promises that Atrium has broken before. Vote no.

Thank you. Dixon Capps.

Dixon Capps, Raleigh. As a consultant with Ernst & Young, Southeast Division, I've worked with each of these corporations. Carolyn's Medical Center before it was Atrium, Novant before it became part, Baptist, and several others, including Rex Hospital. Every one of these hospitals have intimidated subspecialty physicians on their staff to leave their private practice and become hospital employees. Every one. I've watched it. They aggregate market share of hospital beds and subspecialties to have more power when they negotiate with managed care companies. Multiple researches, Johns Hopkins, Medical Economics, unknown others, Kaiser, have determined that site of care for a service has more to affect on the cost of the service than anything else. between 12 and 15% increased costs are passed along to the community when you have a hospital own the facility. Often a patient will get two bills, one from the professional and the other for the facility of the hospital. They're different co-pays, different deductibles. And quite often the hospital, you won't know it, you'll go into a physician's office, the x-ray machine is in the radiology department operated by the hospital. So with all of that, bottom line, if you vote for this, you're gonna aggregate another monopoly in your market and your people are gonna pay more for it. And it's easily proven. I have 10 seconds and this is a toss away. Your healthcare program that you offer for your employees is illegal. And I'll leave my card with that lady over there, because I'm sure that Primus Health, Michigan, et cetera, will want to talk to you.

Thank you, sir. And if you have any information, please leave it with the clerk. Thank you. Okay, Nathan Foster.

Thank you, commissioners. My name is Nathan Foster. I work for the Healthcare Advocacy Project of the North Carolina Justice Center. Commissioners, you face a choice, a choice between affordability and corporate greed, a choice between local control and one of the largest and most expensive quote-unquote non-profit hospital systems in the country spread across six different states headquartered both in Charlotte and in Chicago. You can choose Wake Med as it currently exists as one of the best and most affordable hospitals in the state, or you can choose Atrium. We know that this takeover will raise prices because the state employees health plan has said that atrium charges 15 to 40% more than Wake Med for the exact same services. We know that Atrium will not treat the community right because between 2017 and 2022, Atrium was responsible for 40% of all medical debt lawsuits in the state of North Carolina, 40%. And as recently as two years ago, in 2024, Atrium had more than 11,000 liens on people's homes for nonpayment of debt. In that same year, in 2024, Atrium CEO Gene Woods paid himself $25.8 million, a salary which is unusually high even in the context of American healthcare. You don't make $25.8 million a year by treating the community right, by being affordable. You make that much money by raising prices, by cutting services, and by expanding constantly, buying up new hospitals. That is the atrium that you will get in Wake County if Atrium is allowed to take control of Wake Med. I also want to reference something that your lawyers said. They mentioned that the bylaws of Wake Med are part of this secret agreement between Wake Med and Atrium that you are legally not allowed to release to the public. The bylaws include Atrium's powers as sole member of Wake Med. So you would be voting on this deal without being able to reveal the exact powers given to Atrium. You can ask the hospitals to release this before voting.

Thank you very much. Thank you very much. Next, Emma Free.

Good afternoon. My name is Emma Freer, and I'm a senior fellow for healthcare at the American Economic Liberties Project, a nonprofit, nonpartisan research and advocacy organization focused on the problem of concentrated economic power. I also help lead the Break Up Big Medicine Coalition, whose 26 member organizations support dismantling healthcare conglomerates. The proposed merger here today would exacerbate big medicine's harms in Wake County, and I urge you to block it. The harms of hospital mergers are extensive and well documented. They include higher prices, stagnant or worse quality of care, lower wages and worse working conditions, closures of essential service lines like labor and delivery and entire facilities, and increased pressure on independent physician practices to sell. There's even evidence that hospital mergers by increasing employer healthcare costs result in lower wages, layoffs, and increased deaths from suicide and drug overdose among non-healthcare workers at the county level. North Carolinians already know this. For-profit HCA's 2019 acquisition of the nonprofit Mission Health in Asheville was a cross-market merger also pushed through behind closed doors. A January 2025 analysis by Professor Mark Hall of Wake Forest University found that it is difficult to point to any concrete lasting improvements that HCA brought to Mission Hospital. Because Wake Med began as a county-owned hospital, you have the rare authority to block this merger. I urge you to do so rather than deferring to antitrust enforcers who face significant challenges when attempting to block illegal mergers or expecting Wake Med to unwind its own sale if Atrium breaks its promises. Each offer is likely aimed less at benefiting your constituents than at recouping its investment at their expense. But you can stop this, and you should. Thank you.

Thank you, ma'am. Okay, Aaron Dunn.

Good afternoon, commissioners. My name is Aaron Daum. I've been a resident of Wake County for the past seven years, and I'm here today as a staff representative of the Triangle Central Labor Council, a democratically elected body that represents 9,300 union members here in Wake County, many of whom count on Wake Med as a quality, affordable regional authority on health care. i want to start by thanking the commissioners for opening this important decision-making process to the public working people deserve to have a say in their living conditions from wages and workplace safety to the ownership of their local hospital system unfortunately atrium and its parent company advocate have proven to be low road low road employers that seek to minimize worker input and maximize corporate profits Following the integration of Atrium and Advocate Health in 2022, the International Union of Operating Engineers Local 399 has observed concerning actions at Chicago area hospitals. After workers responsible for critical building systems, infection control infrastructure, and life safety equipment and advocates Good Samaritan and South Suburban Hospitals exercised their right to form a union in 2024, Advocate engaged in a pattern of intimidation and retaliation against its own workers. Most recently, the National Labor Relations Board issued a formal legal complaint against Advocate Good Samaritan for illegally suppressing union organizing, and the NLRB rejected Advocate's attempt to overturn a union election victory at Advocate South Suburban. Hospital workers aren't just looking out for themselves. They want to make sure that patients are getting safe and quality care too. If Advocate won't bargain with these essential workers, How can we expect them to bargain a fair deal with Wake Med? Commissioners, I urge you to vote no on this deal. Any proposal for Wake Med must come through an open, transparent bidding process and include binding protections for workers' rights. Thank you.

Thank you, sir. Okay, next up, Thomas Finkel. And the next five would be Ron Pringle, Crystal Brady, Technor, and I'm hoping I'm pronouncing this correctly, last name Montgomery, and then Harold Millett. and Kristen Derange. Okay, Thomas.

Good afternoon and thank you, Commissioners. My name is Tom Fink and I am a member of the Atrium Health Foundation Board. And I'm also a recent heart patient. That second role is why I am here today. Like many patients, I've experienced moments when access to excellent health care is not just important, it's personal and life-saving. As an Adrian patient, I witnessed firsthand the skill, compassion, and dedication of the physicians, nurses, and caregivers who make health care more than just a service. They make it a source of hope. As a board member, I've had the opportunity to see the investments and commitments that support the care and help ensure it remains available for future generations. What has impressed me the most at Atrium is the focus on patients and community. Every decision ultimately comes back to improving care, expanding access, in strengthening the communities we serve. The commitment is one of the reasons I support this opportunity. My perspective is shaped both by governance and personal experience And I truly believe Wake County patients will benefit from an organization that remains focused on quality, innovation, compassionate care, and access for all in the community. Thank you for your time.

Thank you, Ms. Finkel. Next, Artis Watkins.

Thank you commissioners for the opportunity to speak to you today. My name's Artis Watkins and I'm executive director of the State Employees Association of North Carolina representing 46,000 active and retired state workers. They are very opposed to any takeover of Wake Med by Atrium and I don't care, I've heard it called everything from a marriage to a merger to a buyout to a takeover. The bottom line is this. We do know costs would go up. Always when there's consolidation of hospitals, costs go up, always. This is not something that you take, it takes a doctorate in this to know. If you read the literature, it always goes up. And we know it in North Carolina, we know it in Asheville, and we know it in New Hanover County, and we don't want it in Wake County. State employees and retirees, Wake County's their main home base. and they don't wanna pay 15 to 40% more like atrium charges compared to Wake Med. They want Wake Med. They don't want you to have meetings of three of you at a time with hospital executives so you can evade the public records laws that would make it subject to us knowing what you're doing. Come on, this cannot be a good deal. Little tiny meetings to keep from having to be accountable to the public? And when I emailed y'all in the first place about this with the opinion of the State Employees Association, I got one response out of any of you representing state employees, atrium, hospitals. I don't know if you're fearful of them or you're starstruck by them, but neither is what we need from you. We need you to be leaders for the people who live and work here. Workers will not benefit from this. Their costs will go up. And Atrium has 10 billion in reserves. The state of North Carolina has 4.2. How do you get to 10 billion in reserves? More than twice the state you're in.

Your time is up. Thank you.

Thank you.

Next, Ron Pringle.

Good evening. Thank you, commissioners. My name is Ron Pringle. I'm the president and CEO of Interfaith Food Shuttle. And we've had a very long, strong relationship with Wake Med, expanding over a decade, where food and health intersect, whether it be in food as medicine or nutrition education.

And with that, I'm here today because I believe there is a compelling strategic case for the proposed combination between Wake Med and Atrium. Healthcare is changing rapidly, and the resources required to expand access, strengthen specialty care, invest in technology, address behavioral health, and continue serving our most vulnerable neighbors would only grow in the coming years. I understand why Wake Med believes that finding the right strategic partner now from a position of strength can help protect the mission for generations. So I certainly understand the strategic pathway Wake Med is pursuing. But I also believe that the support for this direction should come with the confidence and the protection surrounding it. As commissioners, you have the important responsibility to ensure that the promises being made today are not simply intentions, but durable commitments. I would encourage you to be confident that the agreement clearly answers several questions. How would Wake County residents be protected from unnecessary increases and costs of care. How will meaningful local governance and decision making be preserved over the long term? How will Wake Med's commitment to charity care, Southeast Raleigh, and historically underserved communities remain protected and enforceable? And how will the promised investments in Wake Med and this community be measured and held accountable over time? These questions should not be viewed as arguments against the partnership. I believe they are necessary to making the partnership stronger. Wake Med is an extraordinary community institution. Atrium brings tremendous resources, scales, and opportunities.

Okay, sir, your time is up, sir. Thank you.

Thank you.

Okay, Krista Brady.

Good afternoon, Commissioners. My name is Krista Brady. I'm a family physician here in the Triangle. I care for patients from all walks of life. My background is in rural medicine and I run a fellowship with the goal of retaining rural primary care providers in their communities of choice. I recently changed clinics and I've been fortunate that many of my patients chose to follow me. They've had to navigate not only my new location but new billing structures. Having worked for many years in the safety net community health center setting, many of my patients are forced to choose between medication and food, between a doctor's visit and gas, and between their own care and the care of their children. These are devastating choices and yet they are not uncommon. We know that currently Wake Med provides about 12% charity care financial assistance to the community that they serve. This is a wonderful service to the community. We know that 12% of these patients are at 250% or below the poverty line, virtually ensuring that they've had to make those same devastating choices with their family at some point in their care. What will it mean for those patients if their healthcare costs increase by an average of 17%? We know from a study from Brown University that costs increase in these same state mergers by about 17%. It will mean deferred care, deferred treatment, and unnecessary suffering. It is important for us to remember that when we talk about issues of affordability in medicine, we're talking about the differences between life and death, suffering and wellness. Colon cancer screenings, non-urgent hernia repairs, screening mammograms, and preventative life-saving services would potentially be deferred. This is not a hypothetical. Just last week, I was discussing a $10 medication with my patient, whether or not they could afford it. These are issues that affect everyday people in our community. I've seen families delay and defer care when it no longer becomes affordable. Thank you for your time. I urge you to vote no on this takeover.

Thank you. How do you pronounce your first name? To Shaver. Shenavia. Okay.

We'll get it right.

Thank you.

All right, I've been a resident of our great state since 92, Onslow County being my home before planting roots in Mecklenburg in 2001. As a licensed social worker, I have provided care to our state's most vulnerable residents and those who remain on the margins of our healthcare system. Today, I'm in the business of compassion as the President and CEO of Caring, Mecklenburg County's oldest safety net organization serving the uninsured and underinsured, and where I was once an underinsured patient. My decision to speak to you today is supported by three quarters of a century of evidence around Atrium and Care Ring's intentional partnership, which includes hundreds of millions of dollars in charitable care to patients just in recent years. They were there in 1955 when our founder, a community health nurse, to close the gaps on heart disease and today where we serve 10,000 patients annually who entrust us with their care. Working families, seniors, pregnant women, infants, all who face barriers to care. Whether it's financial support, professional resources, access to their providers and innovation, employment to justice-involved persons, or guidance for simply me as a leader, they are present. Wake has never been without a sense of responsibility for those who struggle with access to healthcare, and having grown so dramatically, it has shaped your needs of your residents and your decision on how they are served, decisions we don't take lightly. Like us, your population has become larger, more diverse, older, increasingly dispersed across your county and beyond. Lastly, your county's vision is written as being compassionate, proactive, and purposeful, and I cannot think of better adjectives to describe what this shared partnership and investment could be for all of those who benefit and those you serve. Thank you and Godspeed.

Thank you. Next, Mr. Harold Millett. And the next five would be Sam Hassell, Bob Winstead, Jessica McDonald, Carol Hardison, and Mary Ann Baldwin.

Good afternoon, Commissions. I may need less than two minutes. Let's go with it quick. First of all, I got a statement. Wake Med is not the issue for us here, okay? It is this strategic partnership. We salute Wake Med. They saved my life, my daughter's life, my grandson's life. We are not concerned in a fight with them about this issue, okay? Our concern is with Atrium and what the strategic partnership will mean. We've already seen over, I guess, two or three of the flyers that said it's a local loss of control. Why would we want to give it up? Why would you give it up, okay? It has worked so far, right? It's one of the best hospital systems in the nation. So why give it up, okay? Statement number two. If it is giving up and you remain in politics, we will not forget. We will not forget the decisions you make today will have an impact on you tomorrow. Thank you. Thank you.

Kristen Duranje.

Thank you, commissioners, for the opportunity to speak with you today. My name is Kristen Duranje. I'm a resident of Raleigh. I recently retired as executive director of Safe Child, Wake County's only child abuse prevention agency for the past 34 years. And when I reflect in two decades of ensuring that Safe Child's programs thrived and were vibrant for this community, Wake Med immediately comes to my mind as a key essential partner that made this goal possible through the years. For example, in 2010, after several years of statewide and national research, Wake Med asked Safe Child to open a children's advocacy center for Wake County. This transitioned the non-acute medical care for child abuse victims to Safe Child in a community-based center specially designed to prevent victims of child abuse from being re-traumatized while receiving the care they critically need to heal and recover from their trauma. Wake Med then and ever since has stood by Safe Child financially and allocates physicians to provide child abuse medical evaluations. In March of 2020, when good news was a rarity due to COVID's arrival, Wake Med stepped forward and offered a long-term ground lease and a five-acre parcel of undeveloped land at the annual cost of a dollar to help Safe Child develop a new facility that expanded our reach and eliminated a six-week wait for our services. I fundamentally believe that Wake Med's leadership with this community enhancing project is what convinced our Wake County commissioners at the time to also invest $2 million in the project. I'm speaking about the importance of trusted partnership when significant steps need to be taken. There are significant steps that need to be taken now. And I trust you as leaders of our community to help create Wake Med's partnership that is going to secure, expand, and enhance their admirable loyalty to our community. Thank you very much.

Thank you. Okay, next, Sam Hassel.

Thank you very much, Sam Hassel. Liv and Kerry, I think one of the most important things that I saw here today was what the county commission is charged with from the district attorney's office, or the Wake County attorney's office, saying that you're charged with making sure that Wake Med continues to do what Wake Med needs to do and that the county continues to have control over it. It didn't say that Atrium had to do that. Atrium doesn't have to do anything other than present to you a deal, and I have to wonder what they have presented that makes you consider this for even a moment, because I've not heard a single thing that makes this sound like a good deal for the citizens of Wake County, who, by the way, built that hospital, right? And the bond paid for the land that is essentially being given to Atrium if you approve this deal. So just looking at it from a business perspective, it makes absolutely no sense. Looking at it from a community perspective, I find it very interesting to see that there has not been a single, and I've been to several meetings now, a single proponent who is not financially interested in this deal speak on behalf of this deal. I've not seen a single community member come up and say, this is a good thing. not a patient other than one, but he's also financially invested in this deal, as best as I can figure out. So I think that is very telling. You guys are stewards of this land. You are stewards, temporary stewards, of Wake Med, and I think it's very important that we understand that Wake Med is a fair estimate worth anywhere between 1.6 and two billion dollars. So unless they are writing a check somewhere in this agreement, made payable to the people of Wake County, I don't understand why anyone would do this deal for $2 billion, right? This is just a power grab. It is a mega hospital grab. Atrium is the largest mega hospital nonprofit corporation, third largest in the United States. And their interest is not in... preserving health care in Wake County. We already know all the negatives. I don't need to quote the statistics on that, but the only thing that Wake County is saving from is aging, so I ask you to vote no. Thank you.

Appreciate you.

Thank you.

Next up, Bob Winstead. Is Jessica McDonald? Is she? Okay, go ahead.

Yes, I'm Bob Winstead, a lifelong resident of Wake County. Before we give up local control of one of Wake County's most important institutions, I believe we need to ask the basic question, is will the people of Wake County and the people of North Carolina be better off? I don't believe we will be. My first concern is cost. The North Carolina State Health Plan has reported that Atrium currently charges 15 to 40% more than Wake Med for the same services. And those higher costs don't simply disappear. Somebody has to pay them, us. Based on the state healthcare plan estimates, if Wake Med prices rise toward atrium's levels, the potential premium impact translates to roughly 81 million a year in additional premiums for state health plan members. That's 81 million coming out of the pockets of people who serve in North Carolina. Our teachers, first responders, other public employees and their families, as well as retirees who spent their careers serving the state. My second concern is local control. Wake Med was built by this community. Under this proposal, Atrium will become Wake Med's sole corporate member, giving a massive Charlotte-based healthcare system significant control over an institution that has served Wake County for more than 60 years. And finally, Wake Med is not a failing hospital system looking for someone to rescue it. The state treasurer has pointed out that Wake Med reported approximately $176 million in net income last year and has substantial borrowing capacity of its own. So before we surrender control of a successful community institution, we should be absolutely certain.

Okay, sir. Your time is now up. Thank you. I hope you'll vote no. Thank you. Okay, next up is Carol Hardison. And the next five will be Woody Washington, Jim Brennan, Mary Ryder, and Karen DuBois.

Good afternoon. My name is Carol Hardison, and I serve as the Chief Executive Officer of Crisis Assistance Ministry in Charlotte. Every year, our organization works with over 15,000 families facing financial hardship, housing instability, and unexpected life challenges that can put them at risk of eviction. Established in 1975, one thing has become clear in my 26 years as CEO. Healthcare and housing security are inextricably linked. Being healthy enough to work, being able to access healthcare when you need it, and having a safe and stable place to live are clearly interconnected. I have watched Atrium Health emerge as a vital partner in addressing housing stability over the last two decades by recognizing and understanding this interaction. Let me give three brief examples. First, Atrium's community health workers, located widely throughout our county, are in direct partnership with our caseworkers. They can access our customer database to connect their patients to emergency rent and utility assistance, public benefits, clothing, and counseling, while we benefit from the trusted relationships that their health workers have throughout the community. Together, we address the needs of the whole person. Second, I've watched as Atrium recognizes that its own lower compensated employees can face financial security as cost of living continues to rise. Paying attention to the financial stability of its workforce is another area of partnership that we have expressed together. And third, Atrium provides thousands of volunteer hours to Crisis Assistance Ministry each year. This helps us deliver our services more efficiently and allows more of our limited resources to reach the people who need them. Thank you.

Thank you. Mary Ann Bowen.

I'm not used to being on this side of the table. Bear with me. Thank you commissioners for opening up time for everybody to be able to speak. I just want to say that during my time on the Raleigh City Council and as Raleigh Mayor, I had many opportunities to see first hand how Wake Med provides excellent care to patients in Raleigh and Wake County. I've also had the pleasure of working with and meeting numerous leaders at Wake Med. I can say this about them. They're committed to their mission. They are servant leaders. It's evident in any interaction I've ever seen between them, the staff, the patients, and the community. And I've also watched miracles take place there. The way they've cared for our first responders, I can't even begin to tell you how some of the lives they've saved and transformed, nothing short of miraculous. And I'll never forget the care they provided during the Headingham mass shooting and during COVID. When I learned that Wake Med was seeking a partner in Atrium Health, My immediate thought was, so this is what it's going to take to ensure that Wake Med continues to grow and thrive. I want to see that behavioral health hospital built in Gardner. It is critical. I want to see the campus thrive. I thought about this a lot, and I really believe, I trust the leadership team and the board of directors for seeing the big picture, for understanding the challenges on the horizon, not just for Wake Med, but for all hospitals. And I believe this decision on Wake Med's part demonstrates responsibility and good stewardship. I'm going to ask all of you to please support making the changes to let Wake Med and Atrium move forward in partnership.

Okay. Thank you.

And I want to say thank you for your service.

Thank you.

I know it's not easy.

Next up, Woody.

Good afternoon. It's good to be with you today. My name is Woody Washam, and I had the privilege of serving many terms as mayor of Cornelius from 2017 to 2025. And throughout my years in public service, I also learned that communities thrive when government, business nonprofit organizations, and health care providers truly work together. I witnessed this firsthand. with the positive impact that Atrium Health had when it expanded service in northern Mecklenburg County to my hometown, Cornelius. That included the opening of Atrium Health Lake Norman in Cornelius, and we didn't have a hospital until then. Those investments improved access to care, supported local growth, and strengthened community partnership. What impressed me the most was that Atrium Health maintained and retained and engaged in long-term opportunities within our community even after opening its facilities. They became a true community partner and that was important to me as mayor. That experience gives me confidence in the organization's commitment to serving communities for the long term and I believe Wake County can certainly benefit from that same approach. Good luck in your decision.

Thank you. Jim Brennan.

Hello. I see you guys as being between a rock and a hard place. Seriously. Wake, when I was looking at this, my biggest problem is the lack of information that's out there. The best information I got was when your legal team actually did a presentation. What the concerns that I've been hearing, and I think they're valid, is that it's not being transparent. And I think there's something wrong, let me say this, the perception I get is something's wrong when you can't be more transparent. I understand when some information might want to be confidential. But to the degree it is, where you're having closed meetings so that information isn't shared, just doesn't pass the smell test. Now, I see where you've had the state or University of North Carolina come and compete. really by buying wrecks, and that's occurred. And I think I don't envy the decisions that you have to make, but I would say more information, not less, would be helpful. Thank you.

Thank you. Mary Ryder. And while she's coming up, Jasmine Everett, Clara Norman. Jerome Brown, and Adwa Asante, and Elijah Reynolds. Okay, go ahead and proceed, ma'am.

Good afternoon, commissioners. I'm gonna talk fast. I have a lot to say. My name is Mary Ryder. I've worked as a home health social worker based in Wake County since 1991, and as the mother of eight children, you better believe I've been in a few hospitals over that time. Throughout my career, I've traveled extensively across the region visiting patients in more than 20 counties. I can tell you firsthand that residents far beyond Wake County benefit from Wake Med. Many of my patients rely on Wake Med for excellent medical care because of its commitment to serving everyone regardless of identity or ability to pay. Having worked with individuals experiencing homelessness, uninsured patients, Medicaid recipients, older adults, and families in crisis, I know that healthcare access is about more than a dot on a map. It is about whether people can actually receive treatment, afford their care, and be treated with dignity. It is also about having enough nurses to notice when a patient's condition declines. Wake Med is a vital safety net institution for people who have nowhere else to go. I also know from personal experience that Wake Med provides excellent care and staffing is a major reason why. During my husband's recent stays at Wake Med, nurses on a regular floor cared for four patients a piece. A friend of mine at a local hospital, a nurse at another local hospital, described regular assignments of five or six patients a piece. That difference matters. Every additional patient means less time to notice a medical change, prevent a fall, or update a worried family. My concern with this takeover is that Atrium would control Wake Med's operations and budgets. When a larger system controls the finances, staffing and healthcare access can easily become business decisions instead of community commitments. In fact, as you've already heard, Atrium is the third largest mega hospital enterprise in the United States.

Okay, ma'am, your time is up.

Will I ask you to please vote no and to stop the takeover. Thank you.

Thank you. Karen DuBois.

Hello, commissioners. I'm Karen DuBose from Charlotte Redress Movement, and you need to hear what happened to us when we were trying to negotiate or understand atrium in Charlotte. The Pearl, big school there now, medical school, research, and in 2021, Atrium said that they would provide some affordable housing in that area. And the Pearl is actually right in the middle of Brooklyn neighborhood, which in the 1960s and 70s was decimated. It was a thriving black community. with their own doctors, dentists. Some people are just even realizing that that has happened. And so we're like, the Pearl, what a great place to have something there. And we found out it was going to be 5% affordable housing in a luxury tower. 5% for 20 years. And we wanted to meet with them to find out, we don't understand with all the resources that you have, how is it that you cannot... put 20% affordable housing, and for 50 years, because 20 years is not even a North Carolina, it doesn't even meet that quality. They said we don't have any power to do that. These are said as the Board of Health County Commissioners. So we thought, well, maybe we'll get some other commissioners on board that aren't just very attached to Atrium, don't have healthcare or elected officials or community involvement. So Mark Durrell of the Mecklenburg County commissioners did not approve the slate for the first time about who they put on their boards, and they're just ignoring it and doing business as usual. What you do need to know, three of our members went to the Pearl for a meeting, and they were met with eight armed guards. Eight armed guards.

Your time is now up.

And they were escorted out, and they had to leave early. And we really need you to know that. Thank you so much.

Okay, Jasmine Everett.

Hello, everybody. My name is Jasmine Everett, and I serve as the Associate Vice President for all of our community clinics at Atrium Health. And I would like to share a bit of a personal perspective. Earlier in my career, I completed my administrative fellowship at Wake Med under the mentorship of Donald Gissick and the entire Wake Med leadership team. And that experience shaped me personally and as an upcoming healthcare leader and gave me tremendous respect for Wake Med and an important role it plays in this community. I saw firsthand the unwavering commitment to serving patients and investing in the people in the communities of Wake County. And Wake Med helped set a foundation that no matter what, always serve patients first. I took that foundation with me as I went on and served in leadership roles across several health care center systems before joining Atrium Health. And today, I have the honor of to lead Atriums Health Community Clinics, serving the most underserved neighborhoods throughout Charlotte, the same communities that I myself grew up in. We care for patients who often face challenges beyond managing a medical condition. Some struggle with transportation, food insecurity, housing instability, language barriers, or access to regular primary care. Yet every day, I see Atrium Health invest in programs, partnerships, and services designed to meet patients where they are and help remove those barriers to better health. Having worked for both organizations, I do not simply see two healthcare systems. I see two organizations with a shared belief that healthcare should be accessible, compassionate, and focus on improving health for all. And that is why I believe this opportunity offers meaningful potential for patients, families, and communities across Wake Med. Thank you.

Thank you. Next, Clara Norman.

Hey, Bill.

Good afternoon. My name is Clara Hazlett Norman, and I grew up here in the triangle where I live today. I'm here urging you to use your power to reject this takeover and vote to keep Wake Med accountable to the people of Wake County. My family is from Western North Carolina, and we already know and we've seen from Mission Hospital that takeovers like this increase pricing, reduce staffing, and lower the quality of both working conditions and patient care. Atrium is a multi-billion dollar entity. They already charge between 15 and 40% more for the same services as Wake Med. I've also been in contact with someone who works at Wake Med who asked me to share part of their remarks for fear of retaliation at their job. This is an excerpt of what they wrote. I am writing to you as an employee of Wake Med Hospital and a Southeast Raleigh resident for 15 plus years. I am against the atrium merger with Wake Med. I am proud to serve our community members here in Raleigh as part of Wake Med and am deeply troubled by the lack of transparency. Moreover, I am deeply alarmed by the reporting on Atrium as being the most aggressive hospital system here in North Carolina to sue patients over medical debt, which I feel is counter to Wake Med's mission to open its doors to everyone, regardless of economic status, immigration status, or color of one's skin. Cuts to health care access federally will only increase the burden on emergency visits and stretch our staff thin. We are proud to operate one of the busiest emergency departments in the nation, but increasing visits under an atrium umbrella while simultaneously forcing people into astronomical medical debt will devastate our communities. This financial exploitation of people's medical crises, coupled with a historic salary of over $25 million for Atrium's CEO, makes me very nervous about healthcare access and the financial health and cost to our communities here in Southeast Raleigh.

Okay, ma'am. Your time is now up. Thank you so much.

This merger will come at a cost.

Thank you.

Thank you.

Okay, Jerome Brown.

Thank you. My name is Jerome Brown. I reside here in Raleigh. Chairman Myle and to the rest of the Wake County Commissioners, I thank all of you for providing this opportunity to the community that allows us to give all of you our thoughts on the Wake Med Atrium Health merger takeover. I speak to you this afternoon on a personal level and a community involvement level. The personal level is that on April 21st, 1983, Our daughter was born at the Wake Mid Hospital at 9.30 p.m. She weighed in at 7 pounds and 9 ounces. Fast forward to now, 2026, she earned her doctorate degree in December 2025. Wake Mid doctors and nurses were in our lives in 83. Our special thanks to all who assisted in our initial parenthood experiences. On the county involvement level, I'm the chairman of the Wake County Voter Education Coalition. While voting and education are our primary objectives, the Wake Med Atrium Health Matter cannot be ignored. I ask today that the Wake County Board of Commissioners resist making any changes going forward that would allow the atrium health entity enter into any agreements at this time. Please review my detailed email message sent to each of you dated August 9th, further expressing my concerns about this matter. Again, I ask that all of you adopt a no compromise approach to the Wake Med atrium health merger takeover. Wake Med and the community deserve better. I thank all of you for your time.

Thank you. Next, Adwo Asante. And the next five will be Anthony Troutman, Stephen Morris, Braxton Winston, David Spook, and Lucy Mitchell. Go ahead, please.

Good afternoon, commissioners. My name is Adjua Asante, and I am here because people I love are alive because Wake Med was there when they needed it. When my husband was in high school, his mother suffered a massive stroke, and Wake Med was just about five minutes from their home. She survived. The stroke changed her life, but the speed of that care helped preserve her life and help preserve a young man's relationship with his mother. Years later, a dear friend was badly injured in a car crash, and she broke several bones, needed multiple surgeries at Wake Med, and her nurses knew her by name. They welcomed the church community that helped sustain her, and they cared not only for her body, but for her mind and spirit during recovery. That kind of care cannot be reduced to a balance sheet. Wake Med matters because when people are in crisis, it is there. It is there for strokes, it is there for trauma, it is there for surgery, recovery, and the long road after the emergency. My concern is that this atrium takeover puts that local accountability at risk. When a massive hospital system takes control, decisions about staffing, supplies, budgets, and services can be made farther away from the patients and families who live with the consequences. Atrium and Wake Med are promising investment, but promises do not staff a trauma unit. Promises do not make sure nurses have the time and resources to care for patients as whole people. Promises do not protect the kind of care that saved my family and friends. If this deal is truly good for patients, then every protection should be public, specific, and enforceable. If it is not, then commissioners should not approve it. In the past, Wake Med has been there for our families and for your families as well. Now we need you to be there for us and for Wake Med too. Commissioners, please block this merger. Vote no on this takeover. Thank you.

Thank you. Reynolds? Thank you.

Good afternoon, commissioners. My name is Ailey Reynolds. I'm here today to request that the deal may be public and to speak about why you should vote no to protect our community. I've lived near Raleigh for most of my life, and during that time, Wake Med has been central to both me and my family's care. Last year, I was called a stroke alert at Wake Med Raleigh's main campus. Their staffing ratios meant I got the care I needed extremely quickly. I subsequently had a mental health emergency due to the loss of mobility, and the wonderful mental health team at Wakebrook was the lifeline I needed after three other services in the area failed to help. After my recovery, Wake Med's PT and OT rehab team supported me for months and helped me navigate the new world I found myself faced with. Importantly, I relied on Medicaid for all this care, not just emergency care, but mental health care and rehab too. When an acquisition like this happens, staffing cuts soon follow. This has immediate and far-reaching consequences on patient outcomes. Additionally, support for the uninsured and those with Medicaid and Medicare is also dropped for non-emergent services like rehab. Expensive programs like mental health care and obstetrics are often cut. ER wait times go up, costs go up, insurance coverage suffers. These changes will affect the already oppressed populations the most, the local black and brown community, the disabled, the unhoused and uninsured, women and expecting mothers. All of these populations already have discrimination to contend with, and now this. As we've seen before in Charlotte, Atrium will not hesitate to take away power from the community. Wake Med is not in a financial crisis and has hundreds of open jobs. Not to mention, Atrium and Wake Med's CEO tried very hard to keep this deal hush hush. Wake Med sent out an email to their staff forbidding them from talking about the deal publicly. This speaks even more to how this deal is not in the community's best interest. Commissioners, I ask you for three things. Do not sign away your power. Ask to make the deal public and vote no. Thank you for your time.

Thank you. Anthony Troutman.

All right. Good afternoon, County Manager and Board of County Commissioners. My name is Anthony Troutman. I'm the proud CEO of the Katie Blessing Center in Charlotte. The Katie Blessing Center is a comprehensive pediatric behavioral health facility being developed to provide urgent care, acute inpatient treatment, and residential services for children and adolescents experiencing mental health crisis. Building a facility of this significance requires strong and committed partners. From day one, Atrium Health has leaned in to support the Katie Blessing Center through Epic Community Connect, clinical consultation, and much more. That partnership is helping us build the infrastructure needed to provide high quality care of children and families across our region. Atrium Health's commitment to the community is also reflected in the leadership of its CEO, Gene Woods. As a former deputy county manager in Mecklenburg County, I witnessed Gene's leadership firsthand during COVID-19 and as we developed strategies to address and end homelessness. He constantly showed up, listened, and brought leaders together around solutions. Gene is truly a leader amongst leaders, and I'm proud to serve alongside him in our community. Based on my experience with Gene and Atrium Health, I believe Wake County can expect that same commitment to partnership, service, and long-term community investment. Thank you.

Thank you. Stephen Morris.

Good afternoon. I'm Steve Morris, current mayor of Concord and former Cabarrus County Commissioner. I want to share my history with Atrium Health because it's really the history of my family and community. I was born at Cabarrus Memorial Hospital in Concord. Both of my children were born there, too. For my entire life, that hospital, now part of Atrium Health, has been our family's primary center for care. There were concerns in our community when our small hospital merged with a larger system years ago. I remember as chairman of our Chamber of Commerce in the early 1990s, being called to a meeting where the administrator told us they had exactly one doctor enrolled to see patients. Just one. Look at where we are now. Specialists on staff drawing patients from across the region. That transformation didn't happen by accident. It happened through real investment in our community. I've watched that growth from several vantage points, 12 years on the county commission, and now as mayor of Concord. Throughout, I've had a genuinely collaborative relationship with our local Atrium Hospital. We've worked together on mental and behavioral health issues that matter deeply to our residents. Atrium has been a real partner in our new behavioral health center and urgent care facility, present at the table, not just supportive in name. I've also worked alongside Atrium staff on our local Board of Health and Mental Health Advisory Board. In every setting, they've shown up as a serious partner in the health of this community. So I simply want to say thank you and to affirm that from where I sit, Atrium has served our community well. Thank you.

Thank you. Braxton Winston.

Chair Myall and members of the Commission, I am Braxton Winston, President of the North Carolina AFL-CIO, located right on Hillsborough Street, and I'm the former Mayor Pro Tem of the City of Charlotte. We are here to talk about the advocate way of doing business and why you should think twice about welcoming it to Wake County. In Illinois, where Atrium's partner, Advocate Health, operates, We have seen a disturbing pattern of behavior toward the very people who keep their hospital running. When stationary engineers responsible for life safety equipment at Advocates Good Samaritan and south suburban hospitals exercised their legal right to form a union in 2024, the administration didn't respond with respect. Instead, they engaged in a campaign of intimidation and retaliation. The NLRB has already issued a formal legal complaint against Advocate for illegally suppressing union organizing. Is this the kind of employer that we want to welcome into our backyard with open arms? The discrepancy is how the system treats its leadership versus its workforce, and it's staggering. In 2024, CEO Eugene Woods saw his compensation surge to $25.8 million, a nearly 50% increase in a single year. Meanwhile, his own employees are offered healthcare plans that are financially out of reach. The cheapest family plan for an advocate employee costs over $5,300 a year, before a single copay or deductible is met. Worse yet, many of these workers are forced to seek care exclusively at advocate facilities, allowing the company to profit off the illnesses of its own underpaid staff. When you have a CEO making tens of millions while frontline workers struggle to afford the very care they provide, you have a broken system. Advocates low road employment model characterized by substandard wages and high turnover is a direct threat to patient safety and long term reliability. Our workers deserve better and our patients deserve staff who are treated with dignity. We call on this board to stand with labor and reject this acquisition. Thank you.

Thank you. David Smoot. I think Ms. Mitchell will be up next. Ms. Mitchell, then we're going to take a 10-minute break.

Okay, thank you. I'm David Smith from here in Raleigh in Bennett Woods, situated directly between Lyons Park and St. Agnes Hospital, which delivered its last baby to the African-American community in 1961, the year that Wake Med opened. I appreciate the commissioners for your responsible and responsive approach to this important issue. Rather than seeing this simply as a debate for or against the merger, I see it as a challenging opportunity to design an agreement that expands Wake Med's capacity while preserving the local stewardship, accountability, and trust that have made Wake Med such a valued community institution. I want to focus today on three areas where I believe the agreement could be made even stronger. Local authority, clarity in decision making, and accountability for outcomes. First, local authority. The proposed 14-member board would have eight Wake County-appointed members and six appointed by Atrium. Eight is technically a majority, but a very fragile one. Just one vacancy, recusal, abstention could change that majority or eliminate it. So my question is, will the commissioners consider seeking either a stronger 10 of 14, Wake County majority, or a super majority requirement for decisions that could substantially affect the quality or availability of services to our community? Second, clarity in decision making. One of the most important questions that's remained with me is who decides? I would encourage the commissioners to require a straightforward governance matrix that identifies who has final authority over major categories of decisions, serves provision, capital investment, budgets, executive leadership, charity care, strategic planning, and other changes that would have a big impact on Wake Med's mission or structure. So the second question I pose is would you require a clear governance matrix clarifying who makes decisions? Representation on the board is important, but representation is not necessarily the same as authority. Third is accountability for outcomes.

Sorry to cut you off, but your time is up. Okay, thank you. Thank you. Miss Mitchell?

Good afternoon. My name is Lucy Mitchell, and I serve as Chief Development Officer for Nourish Up in Charlotte. For more than two decades, I have worked with organizations focused on addressing poverty, food insecurity, and basic needs in our community. One thing I have learned during that time is that health and nutrition are deeply connected. At Nourish Up and through our partnership with Atrium Health, we understand that food is medicine. When families are worried about where their next meal is coming from, it becomes so much harder to focus on managing chronic conditions, recovering from illness, or maintaining overall health and well-being. Through NourishUp's partnership with Atrium Health, I have seen firsthand our shared missions become practical support for community. From our food pharmacies, in Atrium Health clinics that connect patients with nutritious food to our Meals on Wheels program that delivers meals to patients to continue recovering in their own homes after hospitalization. In 2025, Atrium Health referred over 30,000 neighbors for food access. That work reflects a broader commitment to helping people access the resources they need to be well. The challenges facing our communities are often complex, and no single organization can solve them alone. Meaningful progress happens when healthcare providers, nonprofits, faith communities, and community leaders work together toward a common goal. Based on my experience, I believe this kind of partnership will continue to create positive outcomes for the people and families we serve. Thank you for your time.

Thank you. And then we will go ahead and we'll be adjourned for a 10-minute break. I'm back from break. The first five that I'll be calling is Terrence Dewberry, Patricia Walker, Wanella Eddy, Julia Peter. And also Adeline Martin. So Ms. Dewberry should be up first. Terrence Dewberry?

Yes. Okay, I'm sorry. Good afternoon, Commissioners. Terrence Dewberry, President of Triangle Labor Council, proud member of the Wake County. birth center, 1963. I enjoyed being birthed there and has been remembered as one of those things that my mom has cherished for years and years based on the 1963 era. But over 60 years, weight med has served As a matter of fact, I guess that makes me three years out there, out there open. But they've served our county independent non-profit net hospital and built our public reputation as being one of the places where you can go to regardless of economic status. As a labor person and seeing a former bus driver, I've seen people being helped that probably wouldn't get helped in a different atmosphere. There's a thing that I like to state when I look at situations. I've negotiated over 25 contracts as being a union representative. And my daughter taught me something years and years ago. She says, Daddy, what's the WIFU? I said, what's in it for me? And looking at this deal, and I don't have all the details, but I'm trying to figure out what's in it for me. Is there high cost? better working condition or worse working conditions. We're giving away something that our tax dollars pay for. And at the end of the day, we're not in a financial situation where we have to do this deal. So what's the with them? What we have asked and we sent a letter to you all, haven't had a response. I know you all have been busy. But at the end of the day, if someone on this board said, sooner or later we have to do it.

OK, sir. I'm sorry to cut you off. But your time is up. Please do not do this deal. Thanks, sir. Thank you. OK, Patricia Walker.

Good afternoon. I'm Pat Walker, and come this November, I will have lived in Raleigh for 50 years. And during all that time, Wake Med has been an important part of the community. And like many, many others, I'm very concerned about the lack of transparency regarding this deal. So far, no one has been able to tell us how this is going to make healthcare better for the citizens of Wake County. And I would suggest that unless and until they do tell you and tell all of the community that we do not approve this deal. And here's another suggestion. Put this on the ballot in November. Let the people of Wake County make the decision, up or down, yes or no, because Wake County is our hospital. It belongs to us. Forward together, not one step back.

Thank you. Manella Eddy.

Good afternoon, my name is Fridella Edie and I serve as the chief nursing officer for Caroline's Rehabilitation. I've been a registered nurse for 26 years and I've spent the last 16 years serving patients and teammates at Atrium Health. Caroline's Rehabilitation includes four rehabilitation hospitals across Charlotte. And every day, I have the privilege of working alongside extraordinary nurses, therapists, physicians, and caregivers who help patients regain independence and improve their quality of life. One of the accomplishments I am most proud of recent excuse me, our recent achievement of magnet designation in June 2026. Magnet designation is considered the gold standard for nursing excellence. It reflects outstanding patient care, strong professional practice, investment in nursing leadership, and commitment to continuous improvement. What is especially meaningful is that this recognition was the result of a five-year journey. It was not achieved overnight. it reflects years of dedication teamwork and investment in our caregivers and patients throughout my career at atrium health i've seen a seen a consistent commitment to supporting nurses through professional development continuing education leadership opportunities and resources that help caregivers grow and succeed when organizations invest in their nurses patients benefit As a nurse leader, my focus has always been on creating the safest and highest quality environment possible for patients and caregivers alike. This commitment is one of the reasons I am proud to share my experience with you today. Thank you.

Thank you. Julia Peter. Adeline Martin. And the next five will be Harold Rice, Allison Plano, Dana Moore, Pastor Dr. Dennis William, and Dr. Andrea Fernandez. Please go ahead.

Good afternoon. My name is Adelaide Martin, and I serve as the Vice President of Impact for Ascent Housing in Charlotte. My work is focused on helping create housing opportunities that strengthen individuals families, and communities. Through that work, I've seen firsthand that housing and health are deeply connected. When someone lacks stable housing, it becomes much harder to manage a chronic illness, to recover from a medical condition, to access preventative care, or support just the overall well-being of their family. And so that's why partnerships between health care organizations and community organizations are so important. And over the years in my role, I've seen how Atrium Health recognizes that improving health requires more than just treating an illness. It requires working alongside community partners to address the factors that influence everyday health, including housing, food access, transportation, and economic stability. The challenges facing our communities are complex, and no single organization can solve them alone. Meaningful progress really happens when health care providers, nonprofits, businesses, and community leaders come together around the shared commitment to improve people's lives. And based on our experience, I believe that organizations like Atrium Health understand the connection between housing and health are better positioned to create lasting positive change for the communities they serve. Thank you.

Thank you. Okay, Harold Rice.

Good evening, my name is Harold Rice, President and CEO of the Ada Jenkins Center in Davidson, North Carolina. I serve as the President of the Ada Jenkins Center in Davidson, and for many years our organization has provided educational opportunities, health services, and support programs that help families build brighter futures throughout northern Mecklenburg County. Strong partnerships are essential to that work. has consistently demonstrated a commitment to our community and to our organization like ours that are working to improve lives every day. What I appreciate most is simple. When Atrium Health makes a commitment, they honor it. I have seen the commitment through years of partnerships and community investment. That consistency creates trust and trust matters when communities are evaluating important decisions like this one. Based on my experience, I believe Wake County would benefit from the same commitment and partnership that we have. Thank you. Thank you.

Allison, pronounce it Palana.

Paladino.

Paladino, okay. Yes. Thank you.

Hi, my name is Allison Palladino, and I serve as President and CEO of the Cabarrus Regional Chamber of Commerce. Healthy communities and strong economies go hand in hand. Businesses want to invest in communities where people have access to quality healthcare, and families want to live in places where they know those services are available. From an economic development perspective, healthcare organizations play a critical role in workforce recruitment, workforce retention, and community growth. Atrium Health has been an important contributor to that success throughout our region. I see this firsthand. When we tackle complex community issues like workforce transportation, Atrium brings key leaders to the table. When it comes to local workforce development, they're involved at every level, from supporting regional education summits and career days for high school students, to participating in Leadership Cabarrus and honoring our educators and first responders. The Atrium team rolls up their sleeves and takes an active part. Their commitment to local partnerships strengthens our small businesses, and their investments have helped support both community health and economic vitality. I believe Wake County has an opportunity to benefit from those same strengths and partnerships. Thank you.

Thank you. Danny Moore.

Good afternoon, commissioners. My name is Dani Moore. I'm a Raleigh resident, and I'm speaking today as someone with a personal connection to Wake Med and to the importance of affordable, accessible, locally accountable health care. I grew up poor in Tarboro in Edgecombe County. In 2000, my mother was diagnosed with cancer while uninsured, even though she was working full time as a nurse. This personal experience informs my interest in healthcare affordability. I know what it means when a serious illness becomes a financial crisis for a family. And I also know what Wake Med means to my family today as an adult living in Raleigh. My teenage son has been involved in two separate life-threatening accidents. The first time, he was a pedestrian hit by an SUV in a crosswalk. The second time, he had a serious bicycle accident resulting in a traumatic brain injury. Both times, emergency responders took him to Wake Med. Thankfully, he has made a full recovery, but as a parent, I will never forget those moments or what it meant that Wake Med was there when our family desperately needed it. That's why I'm deeply concerned about Atrium taking over Wake Med. Wake Med isn't simply a Wake County hospital. Thousands of patients come from surrounding counties, including eastern North Carolina counties like my hometown, in Edgecombe County. It's a regional provider of emergency, trauma, surgical, and specialized care. I'm worried about Wake Med losing its important safety net role, including serving Medicaid patients and providing substantial charity care. So we need to look beyond the promise of new investment and ask two main harder questions given your role and responsibility to North Carolinians. Number one, what will happen to uninsured and underinsured patients?

Okay, thank you, ma'am. Sorry to cut you off. Please oppose. Thank you. Pastor Dennis Williams.

Greetings, I'm Dr. Dennis Williams, pastor of Faith Memorial Missionary Baptist Church, former interim superintendent of schools for Charlotte Mecklenburg Schools many, many years ago, and the executive director for the African American Faith Alliance for Educational Advancement. I'm here today to talk to you about my role with Village Heartbeat. village heartbeat was built on a simple belief communities are healthier when trusted local leaders faith communities and health care organizations work together for years our work with atrium health has demonstrated what that kind of partnership can make possible Together we have supported community health education, wellness initiatives, chronic disease awareness, and conversations that have helped to reduce stigma around mental health. During the height of the COVID-19 pandemic, that partnership became even more important. Village Heartbeat and Atrium Health worked together to mobilize churches and community partners to expand access to testing, vaccinations, trusted information, and healthcare resources. At a time when fear and misinformation were widespread, those efforts helped to connect thousands of people with the care, guidance, and support they needed. Atrium Health also advocated for grant support that strengthened Village Heartbeat's ability to serve the community and continue addressing health disparities. What I've learned from those experiences is this. The strongest healthcare partnerships are not transactional. They're built on trust, listening, investment, and a shared commitment to the people we serve. That is why I support the proposed partnership between Wake Med and Atrium Health. I believe it creates an opportunity to expand resources, strengthen community engagement, improve healthcare outcomes for families across Wake County. Thank you for your time.

Thank you. Next would be Dr. Andrea Fernandez, but also let me call the next five, which is Kaylin Bideen, Reverend Dr. Frank Thomas, Amy Smith, David Johnson-Millerton, and Wayne Whelan. Okay, please proceed, ma'am.

Thank you. Good afternoon. I'm Dr. Andrea Fernandez, and I serve as the chief medical officer for Atrium Health's Wake Forest Baptist area. I have the best job in the world because in addition to my leadership role, I get to deliver babies every day. uh... as a physician the quality of care that i deliver and safety is the uh... most important to me so in two thousand twenty when wake forest baptist joined atrium health many people had questions about what that future would look like including me over the last five years i've had the ability to witness that shared future firsthand we decrease mortality in our patients by sixteen percent We've decreased serious safety events by 57%. We've improved care for all, doing things like improving our ability to avoid C-sections in black females. Across our facilities, we've improved safety. All of the eligible facilities in our area now get an A or B safety grade in leapfrog. I'm pretty proud of that, as you can tell. Sorry. In fact, we've improved innovation to care, we have improved access for all, and we've really doubled down on community partnerships that help our patients break through the barriers to care that they may have had. Most importantly to me, we've kept our true north at heart, which is our desire to enhance the life and health of the patients that we serve. So my support for this opportunity comes from experience, not in theory. I have witnessed firsthand what happens when two organizations come together with a shared commitment to patients, safety, and community health. Because of that, I have confidence in the opportunity that exists for Wake County. Thank you for your time today. I appreciate it.

Thank you. Okay. Dean?

Khalil Fahimuddin.

Yes. Good afternoon. Commissioners, thank you for having the foresight to convene this hearing to allow your constituents to be heard. We've heard a lot here today, yeah? We've heard a lot on both sides. I had a prepared speech, but what I want to talk to you about is this. I've heard information about some of the benefits of Atrium and some of the opportunities that Atrium has demonstrated in communities. What we know from the history, I was here during the time that St. Agnes was a hospital here. It was the only, during segregated Jim Crow South, it was the only facility that we had. It was our only lifeline. So we're looking at the mandate, the access mandate, the universal access mandate as a part of the 1955 referendum. We're asking that, we're not asking you guys not to do business with Atrium. but we're asking you to be transparent to make sure that the deal works good for all of the citizens and that you don't take your hands off of it if you take your hands off of it You know, there's nothing you can do no matter, you know, what your intentions are afterwards. And so we're just asking that you, you know, you go forward and, you know, if I don't see why we need the deal. If you ask me personally, if I was voting, I'd vote no, because we don't need it. But there's been a lot of, you know, back and forth about, you know, pros and cons. And I'm just asking you all to be the trusted servants that the brother spoke about earlier. Be the trusted servants and do the best job for all of your constituents. Because my mother's 83. She needs her... She just had a 20, she's been with the cardiologist for 20 years, and that cardiologist was removed because of a decision that was made. And now we're still trying to find a path forward. So these kind of things are important and critical to your citizens' vote. I would vote no.

Thank you. Thank you.

Reverend Dr. Frank Thomas.

My name is Reverend Frank Thomas, a pastor of Mount Zion Baptist Church in High Point, and I also have the honor of serving as chairman of the board for High Point Medical Center, who had this same experience several years ago. I speak not only as a health care board chair, but also as a pastor and community leader. Each of us, each of those roles has taught me the same lesson. Health care is about people. It's about the mother sitting beside the bed of a sick child. It's about the senior citizen wondering whether the care they need will be available close to home. It's about the nurse finishing a 12-hour shift and coming back tomorrow because somebody will need her. It's about physicians, technicians, caregivers, and support staff who have dedicated their lives to caring for others. And it's about communities that depend on strong hospitals, not only when they are sick, but as employers, partners, and anchors of community well-being. From my experience in healthcare governance, I've learned that the question is not whether healthcare will change. We all can see healthcare changing. The question is whether we have the vision and courage to change with it. We have the opportunity not merely to preserve what we have, but to build what our community needs. It's not simply becoming bigger, but becoming better. Not simply combining organizations, but expanding possibilities. Not simply prepare for the next year, but prepare for the next generation. As a pastor, I've stood with families in hospital rooms. As a community leader, I have seen the difference between what strong hospitals make. And as a health care board chair, I understand that leadership sometimes requires making tough decisions today, which greatest benefits will not be seen until tomorrow. I urge you to support stronger hospitals, stronger health care, stronger communities, and a stronger future for the people we are privileged to serve.

All right, thank you, sir. Okay, Amy Smith, then David John Millerton, Wayne Wilhelm.

Good afternoon, commissioners. Thank you for having me today. I'm so happy to be here with you and encourage you to vote in the affirmative for this merger between Wake Med and Atrium Health. My name is Amy Smith. As you all know, I'm the executive director of the Women's Center of Wake County. work closely with some of our community's most vulnerable neighbors, specifically single women experiencing homelessness. We currently offer the community's only recuperative respite program, and Wake Med has been an incredible partner in bringing that to fruition. Without Wake Med, it is not an overstatement to say that program would not exist today. We work with women while they're experiencing sometimes life-changing sickness, but we work with them to also make sure that they've got a safe discharge plan in place that ensures they are moving towards and working towards permanent housing after their stay in respite. As many of you know, we will be expanding our respite program in 2027, this time to include men in the program. And again, Wake Med has shown up to make sure that that's a possibility. Again, without Wake Med, it would not be possible. innovation like this and health care saves money for entire community for even more importantly increases the health outcome for our most vulnerable residents. I'm here today in support of this merger based on the track record and trust that we've built with Wake Med over the past three years of our program and the track record that Atrium has and brings to this proposed partnership. I'm confident that this merger would mean better health outcomes for our community as a whole, but more specifically for the most vulnerable individuals in our community that are experiencing homelessness. We've seen multiple times over, whether it's Bridge to Home, which was referenced earlier, whether it's Wake at Home referenced earlier, partnerships are at the heart of some of the most successful endeavors that we bring to Wake County and that Wake County is nationally recognized for and regularly receives awards for. So please vote yes on this. I appreciate your time.

Thank you. David Milton. The next five would be Libby Pearson, William Ratcliff, Kendrick Hood, Craig Gerben, MD, and Nancy Potharo. Go ahead, please.

Good afternoon, Commissioners. My name is David Middleton, and I serve as Executive Director and CEO of the Community Care Clinic, serving patients in Forsyth, Stokes, and Davie counties. Each year, our clinic provides care and support to about 2,000 uninsured patients who might otherwise have nowhere to turn for health care services. That work would not be possible without the hundreds of volunteer health care providers who generously give their time and expertise each week. Many of those volunteers come from Atrium Health and the Wake Forest School of Medicine, demonstrating a shared commitment to ensuring that everyone in our community has access to quality care. Our organization serves individuals and families who often face significant barriers to accessing healthcare. Many are hardworking people who simply need help navigating the healthcare system and connecting them to the care and resources they need. What I've learned over and over and over again is that strong community partnerships make an extraordinary difference. Earlier in my career, I led the integration of two large senior living organizations. Particularly through that experience, I found that successful partnerships ultimately depend on more than financial and operational considerations. They depend on culture, community investment, shared values, and perhaps most importantly, trust. Having previously lived in both Mecklenburg and Wake Counties, and now the Triad area, I can attest that you are blessed to have those qualities in both Atrium Health and Wake Med. I've seen firsthand Atrium Health's commitment to working alongside organizations like ours to expand access to care and improve health outcomes. Those partnerships don't just connect people with health care. They strengthen families, improve quality of life, and build healthier communities. Based on my experience, I firmly believe Wake County will benefit from that same commitment to partnership.

Hate to cut you off, sir. Your time has run out.

Thank you. That was it.

Thank you. Wayne? Wilhelm?

Good afternoon, commissioners. My name is Wayne Wilhelm. I currently serve as the first vice president of the Raleigh Apex NAACP and the state faith tri-chair for the North Carolina Poor People's Campaign. This merger is not just a merger between two law firms or two technology companies. This decision is about a hospital that has been built by this community. This decision is about who gets care, what that care costs, and who makes those decisions for decades to come. Wake Med belongs to the people who built it, worked in it, paid for it, and depend on it. But this process has not treated the community like a true stakeholder. Atrium and Wake Med negotiated for years without any meaningful community input. I do appreciate that the commissioners removed it from the consent agenda and created more time for public review. That was a great decision, but this problem is still not solved. The community, patients, and employees are asked to trust summaries, slogans, and promises. We keep hearing about $2 billion in investments and thousands of jobs. But the question is not what Atrium says in public. The question is, what is binding in the agreement? What services are guaranteed? What staffing levels are guaranteed? What price protections are guaranteed? What happens if Atrium fails to follow through on all of these promises? A promise is not accountable unless the public can read it. understand it, and enforce it. A takeover under this structure, Atrium would become the sole member of Wake Med and stand to gain real control over the operations and major decisions. Commissioners, you are the public safeguard. You have the authority to say no. Please do not surrender this authority based on a trust us. Please, we ask you to block this merger by refusing to amend these articles of incorporation and vote no. And thank you for your time.

Thank you. Libby Pearsall.

Hi, I'm Libby Pearsall. I serve as the Chief Nursing Officer at Adrian Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. And first, let me commend you for your due diligence that you are all taking on this immense responsibility that you have. Like Dr. Fernandez, I have been at this same facility since 1998, serving alongside very dedicated caregivers who felt very committed to our mission to serving Forsyth and surrounding counties. And in 2020, we all had, as she said, a lot of questions and really weren't sure what the future looked like, but based on some of the conversation today, I think it's just important that I share our experience, and that is that in the time since we have become part of Adrian, we have been able to expand rapidly the number of patients that we've been able to see and have not had any substantive changes to our staffing models, which I know some parts of North Carolina with other mergers had not experienced that, but I can share that at Adrian Wake Forest Baptist that is true for us. I will also say that being a part of Advocate has given us access to really services for our teammates that we did not anticipate. Expanding education support for nurses, and honestly, EVS workers, everyone to kind of rise up in the ranks and live out the full potential. We've also seen access to innovative technologies. We're working with Epic to pilot ambient listening, which allows nurses to document really just by speaking to their patients. It picks up what they're saying, allows that to go into the record, and my teammates are telling me that they're getting an hour back in their day to spend with patients related to that technology. So we've seen a lot of positive gain, and I just wanted to share our experience. Thank you so much.

Thank you. William Ratcliffe.

I'm Reverend Ratcliffe. Chair Miles and members of the Wake County Board of Commissioners, everybody has an opinion, especially social media and Monday morning quarterbacks, but this is no game. This is health care, and lives will be affected by your decision. I respect this board. You didn't get in those seats playing musical chairs. You have been tried, tested, and trusted. Consider three things, history, experience, and credibility. History. In 1896, St. Agnes Hospital cared for African Americans who had nowhere else to go. In 1961, it closed as Memorial Hospital of Wake County. Today's Wake Med is open to everybody. Somebody prepared for the future. Experience. Wake Med has served this county for 65 years. Atrium brings decades of experience and a proposed $2 billion investment. You don't untangle a knot by staring at it. You bring experienced hands together. Credibility. Wake Med has earned it. Atrium has earned it. The board has earned it. I understand the concerns, but growth requires wise decisions. Alexander Pope said, be not the first by whom the new are tried, nor yet the last to lay the old aside. The ruins of St. Agnes still stand, but Wake Mill is still a living institution. so perfectly, so protect affordability and accountability and give Wake Med the opportunity merely not to survive, but to thrive. And when history looks back on this boy, may it simply say they got it right.

Thank you. Kindred Hood. And while Ms. Hood is coming, the next five, I think it's Margaret Eskusten, Deborah Smothers, David Daggett, Valerie Barlow, and Demarcus Williams. Please go ahead.

Good evening. My name is Kedrick Hood and I serve as the Director of Nursing for Adult Critical Care at Atrium Health Wake Forest Baptist. My connection to healthcare and service in Wake County began way before I became a nurse. I was born and raised right here in this community. I remember early mornings riding down New Bern Avenue to drop my aunt off at Wake Med to work in the pathology lab. I remember long nights when my mom would come home after working at Dorothea Dix as a nurse manager. And there has been several times where my father, a mortician, worked with the community here in Wake County and Johnson County to provide comfort. Growing up, healthcare and service were simply a part of my life. Today, I come wanting the best for my home community. As a nurse who has been through this experience of combining organizations, I know that this is the right choice. I have experienced firsthand what can happen when an organization brings their people, knowledge, and resources together. I have been able to connect with colleagues across the system, learn how other teams are solving similar issues, and bring those ideas back to strengthen our team. I've also seen that growth through the expansion of our critical care tower and service line. We have been able to build a new tower that services our cardiac ICU and our trauma ICU. This commitment and investment represents the growing, it represents the commitment of Atrium Health to the growing needs of our community. What is this partnership and what it means to me? It is not simply about organizations coming together. It is about people coming together, sharing knowledge, expanding opportunities for caregivers, and ultimately providing best care for our patients and communities. Having experienced this values firsthand, I'm excited about what opportunities can come for my hometown. Thank you.

Thank you. Okay, Craig Kerberon, MD.

I'm Dr. Grevin, Dr. Craig Grevin, and I serve as interim president and CEO of Atrium Health Wake Forest Baptist. I've served as a physician and professor in the Department of Ophthalmology at Wake Forest School of Medicine for the last 37 years. I'm speaking today because Wake Forest Baptist has already experienced many of the same questions and considerations Wake County is evaluating today. When Wake Forest Baptist joined Atrium Health in 2020, people understandably wanted to know what it would mean for patients, caregivers, and our communities. Five years later, we have real results to evaluate. What I have seen is our organization and our communities are stronger because of that combination. We have expanded clinical programs, strengthened behavioral health, increased access, accelerated investments that would have been impossible to achieve independently. We've continued investing in our communities and increased investments in charity care, partnerships, rural health, programs that improve health well beyond the walls of our hospital. As a physician and healthcare leader, what matters most to me is whether patients benefit. Based on what I've seen over the last five years, the answer is a resounding yes. My support is based on experience, not speculation. At the time of our strategic alignment with Atrium Health, the pandemic was on the rise and the world and healthcare were in very uncertain states. Wake Forest leaders met with Advocate Health CEO, Gene Woods, telling him that we understood if we needed to put a hold on moving forward due to the pandemic. Mr. Woods told our team and I quote, I made a promise and we intend to keep it. He moved forward with honoring all of the investments that had been promised. Now we have opened a new care tower, An outpatient surgical center, soon an eye institute, and everything promised on time. Major investments in uncertain times. I've seen firsthand what amazing things can happen when organizations come together around a shared commitment to patients, communities, and the future of healthcare. Thank you.

Thank you. Nancy Patero.

Good afternoon. My name is Nancy Prothero and I'm a certified nurse midwife and a psychiatric mental health nurse practitioner and I practice at Atrium Health Wake Forest Baptist. For my entire career, I've had the privilege of caring for women and their families during some of the most important and vulnerable moments in their lives, from pregnancy and childbirth to mental health care and recovery from substance use disorder. The work has taught me that health is about much more than physical well-being alone. Health is emotional, it's spiritual, it encompasses the whole person. The challenges that women face are especially significant in underserved communities where access to coordinate high-quality care can make the difference between thriving and just surviving. What I appreciate most about Atrium Health is a commitment to caring for the whole person. Through women health services, behavioral health programs, community partnerships, and efforts to address barriers to care, Atrium recognizes that people are more than a diagnosis. They're individuals with unique stories, needs, and circumstances. The most important thing that I've learned for working with Atrium is they supported me to develop and implement a perinatal mental health service and a perinatal substance use disorder clinic. I am allowed to see patients and have better access to care. We do telehealth services and we do in-person services. This clinic has helped increase access for vulnerable populations. And it's decreased stigma because people are receiving their care in their OB-GYN office. I believe bringing together Wake Med's strong local foundation with atrium health resources, expertise, and network creates an opportunity to expand access to care, strengthen mental health and substance use disorder treatment services, and enhance support for women and families throughout Wake County.

Okay, thank you, ma'am. And next one, is it Marguerite?

Margo.

Margo, okay.

My name is Margo Escoteen. I'm autistic, have ADHD, and have called Wake County home since I was three. You learn how truly patient-centered a hospital is by how it treats those who don't communicate in the way staff expect. When an autistic person is in crisis, we may shut down. Overwhelmed by lights, noise, touch, pain, fear, or even past trauma, we may not answer quickly. That does not mean we're being difficult. It means we need care that is trained, patient, respectful. That's when patient rights matter most. Patient rights can't just be words on a website or a poster on the wall. They have to be real in the ER or exam room when someone is scared or unable to perfectly advocate for themselves. I know what it feels like when that doesn't happen. I recently sought help at an ER in a Raleigh hospital. They made it clear I had no agency over my own body. Though I was fully competent, my rights to make decisions about my health were ignored. My rights only mattered if I could behave exactly the way staff expected me to behave in a crisis. Wake Med is different. I've been treated with care and have had providers who make the accommodations I need to feel safe. County commissioners are some of the most powerful people in this state, even more so today. You're intelligent people, you know Atrium's track record. If an abuser has a proven history of harm, you don't expect them to stop hurting its target. You know what will happen if this multi-billion dollar company, who'll only be answerable to itself, will do, raise costs. This is a matter of life and death. Should you approve Atrium to take over Wake Med, you'll price healthcare as a luxury cost many North Carolinians cannot afford. You'll be complicit in bleeding lifelong North Carolinians such as myself dry and recklessly endanger the lives not of just Wake County voters, but also all of North Carolina. Thank you.

Thank you. Next, Deborah Smothers.

Good afternoon, commissioners, and I want to say thank you for allowing all voices to be heard today. My name is Debbie Smothers. I'm a family nurse practitioner in my 31st year with Atrium Health. 23 of those years were with High Point Medical Center that Dr. Thomas spoke about earlier. Currently, I serve as the director of work and campus care solutions. Throughout my career, I have seen firsthand that delivering exceptional care begins with investing in the people who provide it. Healthcare organizations are strongest when they support the growth and development of their caregivers and teammates. One of the things I value the most about Atrium Health is its commitment to professional development. Whether through continuing education, tuition reimbursement, leadership development programs, or opportunities for career advancement, teammates are encouraged and supported in growing throughout their careers. My current leadership role is a direct result of the investment Atrium Health made in my career through meaningful professional development opportunities, many of those which came after High Point became part of Atrium. The investments matter. Professional development is a standing agenda item during our monthly team rounding, reinforcing that our teammates are valued, supported, and encouraged to grow. When healthcare professionals have the resources and support they need to grow and learn, patients benefit as well. Care teams and communities are stronger and the quality of care improves. My experience has been that Atrium Health understands that connection and remains committed to supporting both the people who provide care and the patients who receive it. Thank you so very much.

Thank you. Okay, David Daggett, and then Valerie Barlow, and Demarcus William, then I think it's Dr. Chahara, and then Mickey Brim. Taylor Walker, Michael Anthony, please.

Good evening and thank you for your patience with all of us today. I'm David Daggett. I'm an attorney in Winston-Salem. I am here today only as a grateful patient. I have never worked for Atrium Wake Forest. I've never been paid for them. I don't have any interest. I'm just a patient. I think I'm the first patient to speak. I first started treating at Wake Forest when I was a brand new law student in Wake Forest in 1982. Since then, I've had my primary care, all my specialty care, been married, my wife's care, my three kids' care, my parents have moved, they're elderly, they're 89 and 94, their care, and we have always been treated professionally, intelligently, and I've been impressed all these years about how the education, the research, the innovation all ends up in the patient care. Through those years, I've become friends with Harold the Orderly, the nurses, the ladies at the reception desk, people throughout the hospital and throughout the organization, and we have always felt a compassionate connection health-first attitude through the people that we've interacted with. Most recently, it's become more personal for me because I've been in excellent health my entire life. 18 months ago, I got diagnosed with prostate cancer. I was thrown into a whole new clinic, surgical oncology, doctors I didn't know, staff I didn't know. I now know the janitor, the receptionist, the secretary, everybody in the place, and I'm being treated by who I believe is the best urological oncologist on earth, and I've been very pleased. I don't have time to tell the whole story, but I could make you laugh, I could make you cry, and at the end, you would cheer for Atrium Wake Forest Health and their treatment. I think you'll cheer too. Thank you. Thank you.

Bower Barlow.

Good afternoon, my name is Valerie Barlow. I'm the Senior Vice President and Administrator of Wake Med North Hospital. I appreciate your time today and I would like to express my support of the strategic combination of Wake Med and Atrium Health. I've had the privilege of calling Wake Med home for the past 26 years. and I am one of the few leaders at Wake Med that have worked at all three hospitals. I've worked at Wake Med Cary, Wake Med Raleigh for 11 years, and Wake Med North for the past six years. That experience has given me a unique opportunity to learn the important role Wake Med plays across all of our communities. More importantly, I have seen firsthand the compassion, dedication, and excellence our team brings to patients and our families every single day. My perspective is not only shaped as a hospital leader, but my background is also as a pharmacist. Earlier in my career, I oversaw pharmacy for the Wake Med system, where I witnessed countless examples of our commitment to ensuring patients receive the medications they need, regardless of their ability to pay. I oversaw programs that provided medications at little to no cost, and teams that worked tirelessly to remove barriers to care. These experiences shaped my belief in Wake Med's mission and reinforced why our commitment to this community is so special. I believe the partnership with Atrium Health will strengthen our community to continue that mission. As our community continues to grow, This strategic combination will help Wake Med expand access to care, invest in innovation, and continue meeting the healthcare needs of future generations while being locally led and focused on the people of Wake County. I'd also like to share that Wake Med is deeply personal to me. My husband and I have lived in Wake County for the past 30 years. He graduated from Cary High School and he has owned a business in Cary for the last 31 years. All three of my children were born at Wake Med Carry. Today, my daughter has chosen to begin her healthcare career as an anesthesia assistant at Raleigh Campus as part of our trauma program. And I'm extremely proud I attended her graduation down in Nova Southeastern of Florida over the weekend. So when I think about the future, I think about the patients that we serve, the families who depend on us, and the next generation, including my daughter, who's carrying this mission forward. Please vote yes. We appreciate your support. Thank you.

Thank you. Demarcus Williams.

Good evening, Chairman Miles, my friends on the Wake County Commissioners. My name is Demarcus Williams. I'm a Durham resident, but patient of Wake Med for the last 12 years. And of those 12 years, 11 years have been spent standing with St. Augustine's University. And I'm proud today to continue standing with them in this capacity, which is the Miracle in Oakwood in the home of St. Agnes Hospital. I have a statement to read on behalf of the Board Chair, Sophie Gibson, and Interim President, Dr. Virginis Peoples. St. Augustine's University values its developing relationship with Wake Med and recognizes the important role Wake Med plays in this community. We are encouraged by the potential for an expanded healthcare ecosystem to create new opportunities in healthcare education, workforce development, clinical pathways, community health, and investment in Southeast Raleigh. As SAU looks towards its future, we welcome opportunities to deepen our work with Wake Med and Atrium Health in ways that benefit our future students, our historic institution, and the broader Raleigh community. Thank you.

Thank you. Dr. Chadri?

Good evening, Chairman Mayall and the county commissioners. My name is Vijay Chaudhary. I'm a board certified hematologist and a medical oncologist, and I serve as chief of oncology at Wake Med. I'm here tonight in support of the proposed combination between Wake Med and Atrium Health. Four years ago, in July of 2022, Wake Med launched a bold vision to build a comprehensive cancer program for the people of Wake County. Since then, we have cared for more than 15,000 unique patients and over 130,000 cancer care encounters. Those numbers, they represent mothers, fathers, grandparents, friends, and neighbors who entrusted us with their care through some of the most difficult moments in their lives. As our program grew, one need became increasingly clear. Our patients deserve access to the full continuum of case or care close to home, including radiation oncology, advanced subspecialty services, clinical trials, and leading edge treatments. When Wake Med received approval to develop radiation oncology services, we actively sought partnerships with academic and community health systems across the state. We asked who would be willing to invest in Wake County and help us build something greater for our patients. Only one organization stepped forward with a comprehensive proposal, Atrium Health. The big question is why? From my perspective, the answer is simple. Atrium Health shared our belief that access to high quality cancer care should not depend on patient's zip code, insurance status, or financial circumstances. And I have devoted my career to improving equities and disparities in cancer care. And that mission really defines what Wake Med has done for 65 years, care for all. The combination is not about changing who Wake Med is, it's about strengthening our ability to fulfill the mission that has always defined us. The question before us is not whether Wake Med has been successful, it has. Okay, sir. The question is whether we can do more for Wake County. Thank you for your support.

Thank you. Mickey Brigham, and then Louis Archibald, Gwendolyn Oglesby, Miss Smith, and Mark Graham will be the next five. Please go ahead.

Good evening. I'm a community organizer with the Party for Socialism and Liberation here in Raleigh. I'll be reading the statement of my comrade Maria, who could not be here today. I'm at Wake Med right now being treated for a kidney infection that I put off getting care for for days because I knew it would cost me at least $600 to just walk through the doors. I hoped and prayed that my antibiotic would kick in to make this go away, but I couldn't ignore the pain and crushing exhaustion anymore after not sleeping for nearly three days straight. I am speaking as a chronically ill person that is a frequent flyer at Wake Med for my immunosuppression and my chronic illnesses. I don't dread going to the ER because Wake Med has consistently offered very good care. I dread the costs, even though I have one of the better health plans in the state and a decent job. I face nowhere near the difficulties that others do, like folks experiencing life-threatening emergencies and monthly or more frequent visits. As a public health professional, I know that these are often the same people without insurance coverage or with public coverage that doesn't reimburse at competitive rates. Communities in Southeast Raleigh face a much higher incidence of health issues due to systemic racism through environmental toxins, income inequality, and a lack of affordable housing. It is for these folks that Wake Med Raleigh serves as a place of hope to actually receive high-quality care, and it is for them that I speak out today in such anger. The facts are clear, and no one can twist them in any way that make them pretty or wholesome. Care under Atrium will not be better. It will be more expensive and of lower quality. People will die. The people of Southeast Raleigh will not have a say in their care any longer. Nothing is stopping Atrium from going back to suing people for their medical debt and putting cancer patients' homes on liens. I ask you, Board of Commissioners, what are each of our lives worth to you? I urge you to stand with your community and vote no.

Thank you. Taylor Walker. Then Michael Anthony and Louis Archibald.

Hi, good afternoon, good evening commissioners. My name is Dr. Taylor Walker. I'm a board certified family medicine physician. I see patients in the hospital and in clinic in a community health system that I value very much. Patients and workers at Wake Med and the people of Raleigh have been asked over and over again to trust the executives at Wake Med and at Atrium. As a family medicine doctor, I know that trust has to be earned, not bought or dictated from on high. So why should Wake Med's workers trust Atrium Advocates executives when Atrium's CEO, as you've heard, was paid $25.8 million in 2024 after receiving a 50% raise from the year prior while providing his own workers with subpar health insurance? Why should patients trust a system that, according to the state treasurer investigation, sued more patients over medical debt than any other hospital in the entire state, accounting for a total of 42% of those lawsuits in the entire state of North Carolina? Maybe that's why Gene Woods himself told a reporter that people don't trust large institutions because there have been promises that have not been kept. If one of those promises was to prioritize patient care over profits, I can understand why. I went to medical school just over the mountains from here in Eastern Tennessee at Johnson City's Quilling College of Medicine. In 2018, the state approved the nation's largest state-sanctioned hospital monopoly when two systems merged to become Ballad Health. That merger included promises of controlled prices, quality control, maintained charity care. Is this sounding familiar? Two months later, Ballad laid off 150 employees, removed the 50 open positions that had already been posted, and shut down urgent care centers. Today, emergency room wait times have nearly tripled to a median of 11 hours. Tennessee then found Ballad Health fell short of three quarters of its own quality goals. And rather than hold them accountable, the state simply adjusted their quality metrics. They just lowered the bar. And they had to do that because there was a monopoly. When regulators ask for ballots, nursing, staffing members, they mark it as confidential. I'm urging that you vote no. Thank you so much.

Thank you. Michael Anthony.

Good afternoon. My name is Mike Anthony. I'm now retired, but I served on the medical staff as a physician at Wake Med Carey Hospital for 33 years. I was a physician in private practice, and I was not employed by Wake Med. During that time, I served in numerous medical staff leadership roles, including the Obstetrical and Gynecologic Quality Assurance Committee, the Medical Executive Committee, and President of the Medical Staff. Aside from supporting the Wake Med Foundation in their charity fundraising arm, I don't have any financial ties to Wake Med. I do support the proposed partnership between Wake Med and Atrium. I believe that this partnership will support Wake Med's ability to deliver on its mission to improve the health and well-being of the local community for years to come. I believe that this partnership will allow Wake Med to provide a broader access of care for the local community, to provide a greater ability to advance research, innovation, and specialty care, while better allowing Wake Med to service all of its members, all of our citizens, regardless of ability to pay. This partnership will not alter Wake Med's continued commitment to charity care or its commitments to its community-based partners. Under the proposed partnership, Wake Med will maintain the same amount of charity care it provides currently, remain locally led, and of course the board will continue to be appointed by you. I urge the commissioners to vote in favor of amending Wake Med's transfer agreement and Articles of Incorporation to allow for this partnership. Thank you very much.

Thank you. Louis Archibald. Gwendolyn Oden Good evening

My name is Dr. Gwendolyn Oglesby-Odom. I serve as the Enterprise Vice President of Community Engagement for Advocate Health. I'm based in Chicago. At my core, I'm a nurse, and I'm a daughter of the south side of Chicago. There's been a lot said today about advocate health in Illinois. I'd like to share an alternate perspective. When I joined Advocate Healthcare in 2020 at the height of COVID as the Chief Nursing Officer for Advocate Trinity Hospital on the south side of Chicago, it was deeply personal. I wasn't simply coming to lead a hospital. I was coming home to serve a community that helped shape who I am today. And I arrived at one of the most difficult moments in our community, in our health system, something none of us had ever faced. In 2022, when Advocate Aurora Health and Atrium Health came together to form Advocate Health, our communities were still recovering from the pandemic and facing enormous challenges. What I witnessed was not two organizations competing for attention or protecting the way things had always been done. I saw two organizations sharing ideas, expertise, and best practices with one goal, better serving the communities that were depending on us. Early in his tenure as co-CEO, Gene Woods visited Advocate Trinity. He learned that just a few miles could mean a nearly 30-year life expectancy gap between our north side and south side in Chicago. And rather than turn away from that reality, Gene made it clear we were going to run towards that fire. In 2023, I transitioned into my current enterprise role, and we began listening deeply to residents on the south side of Chicago, not deciding for the community, but working with the community to address this unacceptable life expectancy gap.

Sorry to cut you off, ma'am. Vote yes. Thank you. Thank you. Okay. Ms. Smith.

Ms. Smith.

Next up, hold on one minute. Next up be Mark Graham, Steve Lawler, Julianne Simmons, Skip Rohrer, and Tim Harris. Okay, please.

Hi. Good afternoon, commissioners. I was going to say, Don, I knew you were going to try my name. My name is Wandisha, and the spelling gets everybody confused. But my name is Wandisha, and I'm actually from Rome, Georgia. I work at Atrium and Atrium Floyd. So I'm coming from outside of North Carolina. and I am actually a frontline nurse as well as the president of nursing staff for Floyd Hospital. I haven't heard much nurse, I don't even think I heard one nurse talk up here, but I want to bring this perspective. One thing I want to share is that all of our hospitals pride ourselves in excellence. Pathway to Excellence, there's several of our hospitals that are Pathway to Excellence. Our hospital was just named Pathway to Excellence with distinction and exemplary in June of this year, as well as Magnet Hospitals. But I wanted to break down Pathway to Excellence for you all because in case you're not familiar with it. There are six principles, shared decision making, where frontline nurses have voices. I wanna give an example. I'm the president of nursing staff and there was a situation where the trauma step down unit nurses actually were complaining about the high acuity patients. So we're talking about ratios here. They were one nurse to five patients and they were saying they didn't have enough time to deliver excellent care. So they actually sat down with frontline nurses and also the leaders at the table that came together for that bi-directional communication and they came up with a plan to have one to four patient ratio. The reason why to deliver excellent patient care to our patients. So I'm gonna disagree with some people that I heard here today and I want to say this. We are very compassionate nurses at Atrium Health. We take part in taking care of our patients. Day in and day out.

Yeah, I hate to cut y'all.

I know.

Thank you. Mark Graham.

As we approach 6 o'clock, I brought a prop. I am Dr. Mark Graham. I am a Wake Med physician in Cary where I've practiced in Wake County for 27 years. I'm one of the few physicians in our Triangle region who has experience at Duke where I trained at UNC where I worked for 14 years, and at Wake Med where I have admitted patients at Wake Med Cary and Raleigh for 27 years. I joined Wake Med in October 2022, bringing my life's work, including 46 employees, a $2 million payroll, and significant cancer expertise along with me to join Dr. Chaudhry, who you heard earlier. I can speak to the trustworthiness and confidence that I have in the Wake Med administration. who have fulfilled all of their practice and financial commitments to my staff, to me personally, and most importantly, to the 4,000 patients that I brought along with me. This is the Wake Med pyramid, not just a prop. It's a real thing. It is our mission statement. Let me first say that the mission of UNC and Duke is threefold. These are teaching, research, and patient care. Our mission at Wake Med is different. Atop this pyramid are all the citizens in red of Wake County. And we are responsible for creating an atmosphere of respect and excellence of medical care for all the citizens of Wake County. Three weeks ago, I went to the open meeting at St. Ambrose in Southeast Raleigh to listen and to learn. Commissioners Stallings and Adamson were there also. Several of my patients and many of my Wake Med colleagues were there. It was a tense environment. A bit like a wedding between the Hatfields and McCoys, with each family sitting on a different side of the sanctuary where deep down we all knew we would need to come together and get along. Several points were raised, and you've heard them here today, regarding the culture of Atrium and whether it would fundamentally change the nature of Wake Med.

Sir, I'm going to have to cut you off.

Thank you, I support the proposal.

Thank you. Steve Lawler.

Good evening, I'm Steve Lawler, I'm a Wake County resident and I live in Raleigh. So first I want to say thank you for your service and thank you for the due diligence you're giving this important issue. I spent over 40 years in healthcare, mostly in North Carolina, leading hospitals and health systems, starting in Greenville, ending in Raleigh with the State Hospital Association, And I've had the privilege of seeing every organization, especially these two that you're talking about. So I think it's important to consider that Wake Med and Atrium previously was Carolina's medical center, have the same roots, they have the same history. They were the first hospitals in their cities to take care of everyone. Those values and those things that they bring to work every day are what I see both in the state as well as nationally as being the key ingredients for a successful future. There are lots of organizations that look at balance sheets and say if we are together, one plus one equals four. That's not the case here. This is a partnership and an aspiration that's based on like values and like goals. Healthcare has changed significantly over the past 20 years. And what we're seeing is unprecedented pressure based on policy and payment that are forcing hospitals to make tough decisions. Some of those decisions are looking for a new partner. Some decisions are closing services and cutting jobs. And for smaller hospitals, some of those decisions are closing their doors completely that is not what this is about this is about a compounding opportunity based on share values to increase and enhance the quality of care not only in this community but also through the state and i've listened to the concerns of people today and have read the reports earlier those are valid concerns and must be addressed but i believe that this relationship as a compounding a good effect for the people in this county. And I think the decisions you make are much like the decisions you made 50 years ago with education and privatization of Wake Med. I would strongly urge you to say yes.

Thank you. Julianne Simmons, and then it'd be Skip Roy, Tim Harris, and then the next five would be Chris Hare, Octavia Rainey, Manuel Bynum, Fernando Little, and Michelle Schweitzer. Please.

Hello, Commissioners. As part of the Raleigh community and an organizer with the Party for Socialism and Liberation, I oppose the Atrium Health takeover of Wake Med. Atrium has shown consistently across the state that they care only about profits and not the people in their care. From reducing the number of beds available in a hospital, reducing the number of nurses and staff on shift, or increasing the price of care up to 40% while the quality of care goes down, and a CEO that made $25.8 million last year, Atrium has shown that they do not care about their patients and they are only hiding what I can assume is a shady deal from the public. My family and many others rely on the Wake Med hospital system for our health needs and have consistently received quality care from their doctors and nurses. The community that is actually served by Wake Med does not support this takeover and we see it for what it really is. A way for Atrium to expand, make more money, and continue putting profits over the people they are supposed to be serving. And we just saw them fail their patients in Charlotte with a 2.1 million settlement because they disclosed private patient information to third parties such as Google and Meta. Something we can all agree is an egregious blunder that calls our trustworthiness into question. And it seems like most of those speaking behalf on atrium here today are not from Wake County. None of them are Wake Med patients and I'm sure that many of them stand to gain something from this takeover. I would like to remind you that those are not the people who voted for you and they are not the people who will vote again in November. I thank you for your time and I urge you to vote no.

Thank you. Skip Roy.

Well, commissioners, thank you for your service to Wake County. My name is Skip Roy. I'm a physical therapist and was privileged to come to the Memorial Hospital of Wake County in 1969. I was there for almost 52 years and continue my involvement with Wake Med as the vice chair of the volunteer board at Wake Med. I came to Wake Med at a time when it was not popular in our community to be an ethnic minority, especially to be black. It was not popular to be poor. It was not popular to be doing stupid stuff that brought you to us for care. I cared for a young man with a shoulder injury who the night before acquired his injury in a shootout with the Raleigh Police Department after he had shot and killed Raleigh Police Officer Paul Hale. Stupid stuff. And yet in spite of who you were or how you got to us, we provided outstanding, innovative, clinically excellent, compassionate care. That culture, in my view, has persisted to this day. I am privileged to hang out with colleagues across the state in the acute rehab services world and to a person in the area, the Triad area and the Charlotte area where partnership with Atrium has existed. They have said that partnership has facilitated their ability to continue to provide that innovative, clinically excellent and compassionate care. And so with that, my experience at Wake Med with Atrium and what colleagues tell me, I would urge and encourage you to support that collaboration. Thank you very much.

Thank you. Dr. Tim Harris.

Good afternoon, I'm Tim Harris from Raleigh. I work at Wake Med. Have you ever missed a step and fallen? You land wrong, broken wrist, broken ankle, broken knee. One moment you're fine, the next you're in an emergency department. You're scared, you're in pain, and you're being told you need surgery. I'm an orthopedic trauma surgeon and I've taken care of patients like that at Wake Med for 23 years. I chose to work at Wake Med because I wanted to take care of everybody who comes through the door. There are six fellowship trained orthopedic trauma surgeons in Wake County and we all work at Wake Med. break a bone badly enough, and we're gonna be taking care of you. And it's not just us. Surgeons from other hospitals send us their complex fractures, but when we're out of network, we can't see those patients. Here's what happens. A patient comes to our emergency room with a bad fracture. We reduce it, we splint it, and we tell them, the swelling's gotta go down, I'll see you in a week. And then we find out they're not in Wake Med's network. And I can't see them, so they start over. Another surgeon, another hospital, another city, Durham, Chapel Hill. This happens repeatedly this year, more and more. I understand the concerns about this partnership. They're legitimate. And I appreciate you asking hard questions. but there's a cost to standing still, and my patients are already paying it. So I'm asking you to support this partnership. So when I see a frightened patient in the ER, and I look them in the eye, and I tell them, I'll see you next week, I can keep that promise. Thank you.

Thank you. Chris Hare.

Octavia Rainey. Am I next?

Yeah. Go ahead. You there at the mic. You there. Go ahead.

Go head on?

Yeah.

Okay. Good evening. My name is Octavia Rainey, and I live in Southeast Raleigh. I am very excited about the partnership between WaitMed and Atrium. You just don't know how excited I am. This will bring Two, you heard a lot of talk about Southeast Raleigh, but this will bring the opportunity to further, further build upon what Wake Med is doing. But when they bring Atrium to the table, they can do all kinds of outreach, all kinds of service, all kinds of healthcare. And what I'm really excited about is now there's the possibility that they're bringing St. Augustine's University to the table. So for the first time, we have some hope and we're looking at St. Agnes, but we're looking at the other opportunities that Atrium can bring to St. Augustine's University. This is a good thing for the city of Raleigh. This is a good thing. I'm just excited. I really, really am. And just the thought of it just makes me smile. So I hope that this board supports the partnership between Wake Med and HROM.

Thank you. Chris Herr.

Good afternoon, or maybe good evening. My name is Chris Hare. I'm the CEO of PRTI, a North Carolina industrial technology company. I'm also, however, a nine-year partner in innovation with the Wake Med leadership team. My family and I have lived in Wake County for over 20 years and have always appreciated the work and the dedication of the Wake Med team for my family, my team, and for me. On the inside of WakeMed, what I've also witnessed is firsthand how WakeMed cares. This is not just the clinical team, it is the whole administration, it is the whole leadership team. They have one heart, and that's exemplified by their thought process leading into the pyramid, the prop that you saw a few moments ago. I've seen them work hard to innovate and increase investment in the services across a broad range of areas. This needs to be able to continue. I'm here to express my support that I believe in the combination with Atrium. Through their work in the communities they serve and folks that you've heard this afternoon who live in those communities, I think you've heard that they are of similar character and similar approach to the Wake Med family that we all know. I believe this will be a successful pairing for Wake County and beyond. My opinion of this alignment with Wake Med and Atrium is that this allows the not-for-profit organization to stay a not-for-profit and to have the values that we are all used to in this community. This allows Wake Med to invest in infrastructure, both new and existing. This is crucial to the growth and to the health of the community. We would really appreciate your support in this. Thank you very much for listening.

Manuel Bynum, then Fernandez Little, then Michelle Schweitzer. Good afternoon.

My name is Manuel Bynum, and I serve as the Enterprise Vice President, Supplier Innovation, and Head of Business Acceleration for Atrium Health in Charlotte. One of my areas of focus is economic impact, and I'm proud to say that we're already investing about $80 million in local companies that are headquartered in Wake County, projecting about $100 million by the end of the year. That's my business connection. I also have a personal connection to this community because I grew up outside of Wake County in the country and still have family today in Knightdale, rural Zeblin, and Wendell, where my stepbrother still runs our family farm. I saw my stepfather wake up every morning to drive to the farm in Wendell to make a living for our family. The values I learned in Wake County helped shape who I am today. Because of those roots, I have witnessed the health disparity gaps in Wake County firsthand. I understand how much people value quality health care, strong community partnerships, and local accountability. The proposed Wake Med Atrium Health combination opportunity is about investing in people, strengthening communities, and helping ensure that future generations have access to outstanding health care close to home, even in rural Wake County. So commissioners, thank you for the opportunity to speak to you about this important matter today. And thank you for slowing the process down and taking the time that you needed for clarity. I did the same thing about five years ago when Atrium Health asked me to join forces. I know that trust has to be earned. So I prayed and I asked God to give me discernment and I bet on Atrium Health and it's been one of the best bets I've ever made in my life. So selfishly, so that I can bring more amazing work that we are deploying across the nation full circle home to Wake County, I'm asking you to trust me and bet on the Wake Med Atrium Health combination. Thank you, and may God bless you.

Thank you. Fernanda Little. Then it'll be Michelle Schweitzer. Then the next five be Kate Zingler, Dr. Carmen Shaw, Lucille Paulson, Aaron Teller, and Captain Martin and Sig Hutchison. Please continue.

Good evening, Commissioners. My name is Fernando Little, and I proudly serve as Senior Vice President and Chief Access and Opportunity Officer for Advocate Health. Throughout my career, I have focused on helping ensure that people have access and access to the care and opportunities they need to achieve their best possible health. Over the past several months, I've spent time meeting with faith leaders, community advocates, and residents across Wake County, and I have truly enjoyed myself. People want to know that they will be heard. They want to know that their healthcare system understands their community values their input, and remains accountable to the people it serves. These conversations have been so personal for me. Throughout my career, I've seen how trust can change the way people experience health care. I've met families who delayed getting care because they felt disconnected. and i've also seen what happens when organizations take the time to listen build relationships and meet people where they are in those moments access becomes more than just the availability of health care It actually becomes someone that understands your need and is committed to helping you achieve your best possible health. Those are expectations that I believe we should embrace. My experience at Atrium Health has been rooted in listening, partnership, and service. These are values that I've seen demonstrated throughout this organization, and they are values that I know will continue to guide this work moving forward. Thank you for your time and your unprecedented commitment to this community.

Thank you. Michelle Swankson.

Hi. Good evening, commissioners. My name is Michelle Switzer. I do live in Raleigh. I'm actually a lifelong Wake County resident. I'm a Wake Med patient and a Wake Med employee. I was born at Wake Med. My parents, who graduated from Garner Senior High School, were just mere teenagers when they entrusted Wake Med with the beginning of my life's journey. More than four decades later, I continue to place that same trust in Wake Med as a patient, a health care provider, a leader and a member of this community. I grew up just down the road from Wake Med. I played sports at Waters Grove, go Wolfpack. I attended Wake County schools and then I chose Wake County to come back to raise my own family and my husband started his own business. Wake Med has been a part of my life for as long as I can remember. As both a patient and a healthcare provider, I have seen firsthand the difference Wake Med makes during some of life's most meaningful and most difficult moments. For the past seven years, I've had the privilege and the pleasure of serving alongside the people who make that difference possible. As a clinician, I care for children who rely on feeding tubes and other supportive care to survive and thrive. I sit with families during some of the most challenging moments of their lives. As a leader, I work to ensure our caregivers have the resources they need to provide exceptional care. at its core health care is not about buildings contracts organizational charts it's about people it's about ensuring that one child children need care for families and families need hope the strong health care system is there to support them My support for this partnership does not come simply from being a Wake Med employee. It comes from wanting future generations to have access to the same high-quality care that my family, my patients, and so many others have received. There are many perspectives on this proposed partnership, and I respect those viewpoints come from a guided desire to see Wake Med and our community succeed. While I understand why some like many, sorry, more information, try to go fast, I also recognize that complex healthcare partnerships require careful evaluation and responsible stewardship.

Okay, ma'am, sorry to cut you off. Your time is up, but thank you. Thanks. Kate Ziegler.

Good evening commissioners. My name is Kate Ziegler and I actually drove here from Asheville, North Carolina to talk about a multi-billion dollar hospital chain that has made many promises. Quote, we're looking forward to investing in North Carolina and helping ensure this hospital's tradition of caring for communities throughout the region continues for many years. This is a tremendous win for the people and communities that we serve and one that may be judged by history as a positive inflection point for the communities we serve, end quote. In the agreements related to this asset purchase agreement, commitments and requirements were made for the hospital to maintain a certain level of service and continue to provide charity care. They promised to center patients, expand care, and increase access to healthcare. Does this sound familiar? Though peculiar, this is actually about, not Atrium, but about Mission Hospital in Western North Carolina when it was bought by the Hospital Corporation of America in 2019. You could say it's apples to oranges, but I would say as two multi-billion dollar hospital chains, I would say this as a cautionary tale. Even with 15 written commitments made by HCA, where I am organizing in Asheville, this is what has happened to the hospital since it was taken over in the last seven years. HCA restricted missions charity care policy to only emergency or strong urgency care and imposed other obstacles to receiving charity care. Cut most non-billable services and missions profits increased to 100 million a year, but most of that increase was from reduced costs rather than increased revenues. Cost savings were due mainly to sharply reducing patient care staff by roughly 40%. HCA closed major primary care clinics, imposed less favorable terms impacting key specialists. Degraded conditions caused patient experience ratings at Mission to plummet from the top range of four to five to the bottom one to two. Serious ER problems plus Mission losing virtually all of its oncologists led North Carolina's Attorney General to sue HCA for breaching the commitments it made when purchasing Mission. That case is still pending in court and now will go to trial. If written promises and provisions can transform a community hospital within seven years from a beloved institution to a broken one, where all of these problems have been created in a hospital where hundreds of patients I have talked to have told me they refused to go in that hospital and now were born there, but now are afraid to die there. Please, I urge you to reject this deal or at the very least, let us see the deal. Thank you.

Thank you. Okay, Dr. Carmen Shaw.

Good evening, Commissioner Miles and the Commissioning Board. My name's Dr. Carmen Shaw, and I serve as the Enterprise Associate Vice President of Nursing Practice and Excellence with Atrium Health. I've been a registered nurse for 24 years, and 22 of those years I've been with Atrium. Separately, I also serve and am honored to serve as an elected member of the North Carolina Board of Nursing. Having been elected, by our nurses across our state to help uphold our mission of protecting the public through the regulation of nursing practice. Throughout my career at Atrium Health and Advocate, I have been passionate and only passionate about fostering nursing excellence and creating a positive practice environment where nurses can thrive while providing the highest quality of care possible for our patients, families, and communities. A significant part of my role as a leader with Advocate is focusing on helping our nurses across North Carolina and Advocate Health achieve and sustain magnet designation, which is widely recognized as a gold standard for nursing practice. Magnet recognition is not achieved quickly or easily. It reflects deep. and sustained commitment to quality professional practice, patient outcomes, leadership development, and creating a positive environment where nurses can provide exceptional care. What I've seen throughout HRM and the growth, the continued growth, is a commitment to investing in our nurses throughout the organization and through continuing education, growth and development, and professional advancement opportunities and resources that support and uphold clinical excellence. Those investments matter because when nurses feel supported, our patients benefit and thrive. As both a advocate health nursing leader and a member of the North Carolina Board of Nursing, I know that strong nursing practice and patient outcomes go hand in hand. That commitment to nursing excellence and patient is one of the reasons why I am here today. Thank you.

Thank you. Lucia Paulson? Paulson? Okay, Erin Taylor. And while, before you get started, the next one up be Dr. Cheryl Walker-McGill, Brandy Hamlin, Newman, Dee Dewitt, John Crumpler will be the next five up, please.

Thank you. Mr. Chairman, commissioners, thank you for the opportunity to speak with you today. I'm Erin Taylor, I'm a clinical nurse specialist at Wake Med. I've also been a patient twice when I had both my baby girls in the last five years. A CNS is a unique type of advanced practice registered nurse who can support the patient, frontline nurse, and health system as a whole. My daily work centers on improving quality of care and patient outcomes, streamlining processes, and promoting financial stewardship. Rather than working on a single nursing unit, my CNS colleagues and I have that 30,000 foot view of our health system. Our team continues to grow because our health system and our community are growing. I support this strategic combination because I have seen firsthand how a community's healthcare continues to evolve. Year after year, more patients seek our services, our care, and our compassion. Our patients, including those that have spoken today, deserve access to the highest quality care, advanced resources, and specialized expertise close to home. By partnering with Atrium Health, we can help strengthen the services available to local families while preserving our commitment to compassionate, community-centered care. This partnership is not about changing who we are. It's about ensuring we have the resources, stability, and clinical support to care for our community for generations to come. It's about investing in the future of healthcare. I have met and talked with other CNSs at Atrium Health, and I believe they support these values as well. As a nurse, the most important question in my mind is will this help us deliver better care for our patients? From my perspective, the answer is absolutely yes. As a former patient with this unique perspective, my answer is also yes. Wake Med is the first health system in the state of North Carolina to achieve the American Nurses Credentialing Center magnet with distinction recognition. This is the international gold standard for high quality nursing care. This reflects our ongoing efforts to constantly improve the care our community members receive inside and outside our walls to affirm our commitment to Wake County and beyond.

I trust our leadership to partner with- I have to cut you off, but your time is now up.

Yeah.

Thank you.

Thank you, vote yes please.

Kathy Martin.

Good afternoon. I'm Kathy Martin. I live in Cary, 20-year Wake County resident. It's been quite the afternoon, eh? Four plus hours and we're still counting. But it's been interesting to hear so many experts on both sides. It's obvious that some people have had good experiences with atrium. So there might be possible to deal with atrium, perhaps, maybe, but at the key, at the core of this whole thing is control. If you do not have control of the future, you cannot guarantee good outcomes with atrium. You cannot walk away from control. If you walk away from control, You abdicate your responsibility to the residents of Wake County. You are giving up your responsibility to represent the people of Wake County. Go ahead and talk to Atrium. Maybe they have a good deal for us, but we haven't heard it. You need to keep this conversation going. You need to keep this public opening. You need to let us know and let us weigh in. Thank you.

Thank you. Sig Hutchinson.

Good evening, Mr. Chair, commissioners. I'm Sig Hutchinson, and what has struck me most throughout the discussions that we've heard is the collective agreement. Like for example, we all love Wake Med. And we've heard story after story of how Wake Med have saved lives of loved ones and children and babies and moms and dads by providing nationally recognized quality care with compassion for all. The second thing that we all agree on is that we don't want Wake Med to change. because we love Wake Med and this is a tribute to this amazing institution but yet commissioners we know health care is changing and changing rapidly and we also know that size and access to resources and technologies is going to be essential if we're going to continue to expand the level of service and care that we've truly come to appreciate in Wake Med The bottom line is that we need Wake Med to scale to a larger size to have more resources to compete in today's healthcare world and market. We need a partner. And to that end, the Wake Med leadership, the board, the staff, the physicians, and community leaders all agree that Atrium Health is the best partner with the same culture as ours. And they also agree that now is the time that we need to create this partnership for a stronger, more profitable, and valuable Wake Med. We also understand that Wake Med needs to keep the things that we hold dear. That includes our commitment to indigent care, and governance so we can control our own future. But most importantly, once this is done, we need to welcome this partnership with Atrium Health and welcome them to Wake County for a bigger and better Wake Med Health and Hospital for us all. Thank you, Mr. Chair.

Thank you. Cheryl Walker-McGill, doctor.

Good evening. I am Dr. Cheryl Walker-McGill, and thank you very much, commissioners, for the opportunity to have a voice. As a physician, a past president of the North Carolina Medical Board, an engaged community member, and a member of the Raleigh chapter of the Links Incorporated, I have had the opportunity to view healthcare through several different lenses. Perhaps one of the most meaningful firsthand, what can happen when a healthcare system and a community organization come together with shared purpose? Since 2022, we have partnered with Wake Med and our Fight Like a Link program, helping more than 1,200 uninsured women get screening mammograms. We raise awareness, reach deep into communities, and help connect women who might otherwise go without care. For some, the program provides something that many of us easily take for granted, intentional access to high-quality care. It is through this lens, that I am here today, my interest is in what it will mean for the people who live, work, and serve in this community. It is from this perspective that I will focus on two areas. First, affordability and access. Growth and organizational change should ultimately translate into meaningful benefit for patients and communities. How will this relationship make health care more affordable and more accessible than it is today? And will those benefits reach the communities that need them most? The health care workforce, at a time when health care professionals are difficult to retain and recruit, how will the relationship affect our ability to attract and retain tame healthcare professionals? Will it strengthen our ability in the communities that need it most? The measure of any healthcare transformation is whether the people and community we serve have better access to affordable, high quality care, and whether we have the healthcare workforce to provide that care. Thank you.

Thank you. Brandon Newman, and then it'd be Dee DeWitt, John Crumpler, and then the next five would be Jeff DeWorkin, Lisa Cumming, Mary Worthy, Nicole Hill, and Kathy Smith. Please.

I would like to thank the Commission for this opportunity today. My name is Brandy Newman. I serve as Senior Vice President of Community and Strategic Operations at Advocate Health, the enterprise in which Atrium Health is a part. I've been a registered nurse for 25 years, and I've spent 21 of those years at Atrium Health. I speak from the point of view of a nurse who worked at an independent community hospital that combined to become a part of Atrium Health 21 years ago. And I stand here 21 years later to say that that community and me as an individual are both better because of that decision. At the time, many people had questions about what that change would mean, including myself. Looking back, I can honestly say that the combination strengthened our ability to serve patients and communities. This combination would provide the most generous option for charity care in Wake County under Atrium Health's financial assistance policy, which is the most generous in this state. Atrium Health is not a housing developer, yet we have invested in affordable housing to the tune of $51 million in Mecklenburg County. There's the fundamental dichotomy between those who spoke tonight, those who know Atrium Health, and those who don't. The people who know us want this combination to happen because they know our hearts and they know that we keep our promises. Those who spoke against us simply just don't know us. I've been at Atrium Health for 21 years. In my role today, I have the privilege of ensuring that Atrium Health shows up as a strong corporate citizen in each of the communities that we serve. You all have my word. and the word of our organization that we will show up in Wake County. Thank you.

Thank you. Dee DeWitt.

Good evening, Commissioners. My name's Dee DeWitt, and I help to lead the Wake Med Behavioral Health Network. That consists of over 50 community-based organizations in and around Wake County. I spent much of my career in senior leadership roles in nonprofit health care. That experience has taught me a simple lesson. Strong health care is built on strong community partnerships. And I think we've heard that today. In our network, I see that every day. Our behavioral health network works with the community organizations across Wake County and has for over eight years. Together, we connect people to treatment and to support, such as food, housing, and transportation. We also work closely with governmental and community partners, including Wake County Mental Health and the Familiar Faces Collaborative. Over the course of a year, we helped to coordinate and care for services for approximately 14,000 residents. For me, those are 14,000 reasons why I support Wake Med Atrium Strategic Combination. The combination will allow us to expand access, particularly for those underserved residents. It will increase our ability to invest in programs and facilities, in specialty care and in innovation. It can help us to better integrate healthcare with our partners across the county to meet the real life needs that determine many times whether behavioral health patients succeed after they leave the hospital. Equally important, Wake Med will remain committed to charity care and to the community partners that make this work possible. In my opinion, Atrium brings additional resources, expertise, and scale. And yes, scale is important in today's industry. I'm convinced that those strengths will help us to continue to expand our work in Wake County. So I respectfully ask you to support the strategic combination. I believe it strengthens Wake Med's ability to serve the community while preserving its local mission. Thank you.

Thank you. John Crumpler.

Thank you all for your service to Wake County. I'm John Crumpler, a lifelong North Carolinian, 41-year resident of Wake County, and I've spent much of my career investing in and building healthcare companies. For the past six years, our firm has worked closely with Wake Med clinicians and leadership to identify and invest in technologies that improve patient access and care. From that vantage point, I've seen firsthand what an extraordinary institution we have in Wake Med. And it seems everyone in this room agrees. It provides excellent care, and it has an equally strong commitment to caring for everyone, regardless of their ability to pay. I think we all want to preserve both of these, but the challenge is how. Wake Med is strong today thanks to proven leadership and clinical excellence, but the conditions ahead are daunting. Public funding is uncertain, costs are rising, and the demands for technology, specialized care, and capital continue to grow. This is why I believe Wake Med is wise to be choosing its future now. from a position of strength with a partner sharing similar roots, the scale and resources to meet the challenges ahead, and the same fundamental commitment to caring for all. Wake Med has earned this community's trust over six decades by delivering excellent care and never losing sight of the people who depend on it most. The same clinicians and leaders who helped build that record are telling us that the challenges ahead require greater scale and resources. I think we should take that judgment seriously. If we want Wake Med to be as strong for the next generation as it has been for the last, we cannot assume that remaining independent is the safer choice simply because it is the more familiar one. Remaining independent is a strategy too, and it carries significant risk of its own. I respectfully ask you to support this partnership. Thank you very much.

Thank you. Next, Jeff DeWorker.

Good evening, commissioners. My name is Jeff Dworkin. I'm just a regular old, I mean old, 80-year-old resident of Wake County, 25-year heart bypass survivor, 14-year Med at Hearts volunteer at Wake Med. I see... what Wake Med means to cardiac patients and their families every day I volunteer there. One thing I was just gonna mention, this was what I was going to say and there's more scribbles and the reason is I wanted to thank you all for doing this. I've never ever done this before. It is so amazing because I learned by being more involved, which you're probably saying all the time anyway. Anyway, I just wanted to share that because if I came away with anything, it was an appreciation of what this is going to be. The other thing is, I think we all know change is inevitable. It's how it's managed and how it's nurtured to move along because if you go down to US 64 corridor in Apex, it's exploding. Everywhere here is exploding. So I think what you're doing now, if it's managed well, is gonna be an amazing thing for us. I think a lot of these things have been said before, so I don't think I wanna repeat it. But just the opportunity to provide, if it's managed correctly, to provide to our residents more is a good thing. And so I'm saying please vote yes, thank you.

Thank you. Lisa Cummings, then Mary Worthy, then Nicole Hill. And then there'll be Kathy Smith. And then the next five will be Elizabeth Norvo, Thad McDonald, Marie Rouse, and someone by the name of Doug. Please.

Good evening, my name is Mary Worthy and I serve as the Director of Mental Health and Well-Being Clinical Services at Wake Med. I am here today to support the proposed partnership with Wake Med and Atrium Health. I've heard several people today compare this partnership with the acquisition of HCA and Mission Hospital. I believe I bring a unique perspective to this discussion because I previously worked at Mission Health during its acquisition by HCA. I understand why many community members have concerns and why comparisons are being made. However, I also believe there's important differences that should be recognized. HCA entered North Carolina as an outside organization with little existing footprint in our state. In Western North Carolina, many people felt that the local culture and unique healthcare landscape were not fully understood. Atrium Health is fundamentally different. Atrium has been a healthcare leader in North Carolina for 86 years. They are not outsiders. They are North Carolinians serving North Carolinians. HCA was also a for-profit organization. Wake Med and Atrium are both non-profit health systems. That shared mission matters. It means continued focus on investing in facilities, programs, innovation, and access to care for our communities rather than maximizing returns for shareholders. As I mentioned, I'm in mental health. I work with the vulnerable population. As you've heard testament to the care that Wake Med gives, this is seen across the state too. However, it is also seen at Atrium Health. As a mental health leader, I have worked closely with Atrium Health for 16 years. When I needed playbooks or when I needed guidance in launching a new program, I reached out to Atrium Health for guidance and they shared freely with me. I have seen firsthand their experience, their innovation, and the deep commitment to compassionate, high-quality care. Those relationships give me confidence that this partnership can strengthen services for patients while preserving the values that have made Wake Med a trusted community institution.

Ma'am, I hate to cut you off, but your time is now up.

Okay. Thank you for your time and consideration.

Thank you. Mary Worthy. Nicole. Okay. I'm sorry. Nicole Hill. Okay. Then Kathy Smith. There we go.

Good evening. My name is Kathy Smith. I'm a physical therapist, and I serve as the executive director for rehab services for Wake Med. I will be celebrating 32 years of service at Wake Med in October. First, I would like to thank this board for your service and your trust you've placed in Wake Med over the years. Today, I'm asking for your support of the strategic combination between Wake Med and Atrium Health. This partnership will help ensure that we continue providing not only excellent care today, but also advance innovative care for the future. We are proud to be the local hospital, but as a small independent organization, we have limited bargaining power. As a result, we have lost several insurance contracts, including Humana, UnitedHealthcare, and perhaps the most concerning, we will lose participation in the state health plan in 2027. These challenges threaten our ability to invest in people, technology, and facilities. As a leader of rehab services, my team may not provide the life-saving care delivered in the emergency departments, but we help patients regain a reason to live. We help stroke survivors take their first steps. We help patients recovering from catastrophic injuries, amputations, heart attacks, cancer, regain independence, purpose, and hope. We do this exceptionally well. This year, our rehab hospital is ranked number 28 in the nation. The only other North Carolina hospital in the top 50 is Atrium Health, and they're ranked 18th. Yet, despite our success, our technology and facilities are aging. An example is a hyperbaric oxygen chamber, which helps prevent amputation is already 18 and a half years into his 20 year lifespan. A robotic exoskeleton, which helps patients take their first steps in recovery, will reach end of life this year. Replacing these life changing technologies requires capital dollars that must compete with other critical needs across our Raleigh campus.

Okay ma'am, your time is now up. Thank you. Next up... Elizabeth Novo, then it'd be Dr. Thad McDonald, and then Marie Rouse, and then Doug.

Thank you for the opportunity to speak with you today. I am a retired school teacher in Wake County and a happy recipient of two titanium rods in both my legs, which I received from Wake Med. I'm here to appeal to you not to agree. As you know, state employees have recently had their amount that they need to pay for health insurance increased. And Brad Briner, who is our North Carolina State Treasurer stated, there is a simple business principle that when suppliers consolidate and competition is reduced, it is the consumers who suffer. This has been proven to be true time and again in the healthcare landscape where prices continue to rise and patients are left with mounting medical debt. And as a member of the North Carolina Retired School Personnel, I represent our membership and would like to say to you, please, we need our healthcare costs to be reduced, not increase. It's been heartening to hear so many people advocate for a takeover by Atrium because of the wonderful things they do, but I didn't hear anybody say that they reduced health care costs. I didn't hear anybody actually mention health care costs once... atrium took over and it's hard for me as a retired teacher to think that a CEO being paid 25.8 million is really concerned about people like teachers were. Teachers were concerned with the people that they taught and connected with. Okay ma'am, thank you.

Thank you. Time is out. Dr. Thad McDonald.

Good afternoon, commissioners. I'm Thad McDonald. I'm the board chair at Wake Med. And on behalf of our board, as this hearing sadly is nearing its end, I simply want to say thank you. Thanks to everyone who participated in our community forums and especially those who've taken the time to be here and speak on our behalf tonight. I also want to thank our friends from Atrium Health. We share something fundamental, something that we're all here today to preserve, a commitment to care for every person regardless of who they are, regardless of where they come from, and especially regardless of their ability to pay. And it might sound surprising, but I sincerely want to thank those who spoke against this proposal. You spoke because you love Wake Med. You love this community, and you care deeply about its future. We may disagree about the answer, but we don't disagree on what we're trying to protect. And finally, I want to thank you folks. I've enjoyed all the time I've been able to spend with you. I appreciate your patience, your diligence, and especially your sincere and thoughtful consideration of what is an extraordinarily important decision for Wake County. For more than two years, we went through the same difficult deliberations, and believe me, this was not easy or a quick decision. If it had been, my gray hair and our meetings would have been elect shorter uh... at the center is one question how do we preserve wake meds mission for the future From that central question, others follow. How do we continue to provide world-class healthcare to our diverse and rapidly growing community? How do we respond to decisions being made in Washington and in Raleigh that affect us? And crucially, how do we maintain local control while competing with much bigger systems in our backyard?

After extensive soul-searching- Dr. McDonald, we have to cut you off. Your time is running out.

I just urge you to vote yes. Thank you.

Thank you. Maria Rouse. Not seeing it. Then the infamous Doug. Doug is not available either. Noah, was this Liquor Bills? And then the last person is Hannah Altice. Hannah?

Please. Hi, commissioners. My name is Noah.

and I'm a Wake County resident and a Wake Med patient. While I've been listening to these comments, I've noticed something. I've noticed that almost none of the people who have spoken today in support of the atrium takeover are patients of Wake Med, and almost all of them have a vested interest in the takeover. I am a patient of Wake Med, and I do not support the proposed takeover. I noticed that the rates Atrium charges the NC Health Plan are five to 30% higher than Wake Med, a fact which Raleigh Mayor Janet Cowell pointed out would necessarily lead to cost increases. Between 2017 and 2022, Atrium sued patients over medical debt 2,482 times, more than any other North Carolina hospital system. And I noticed that the US Department of Justice has sued Atrium over anti-competitive contracting practices. Many have said that Wake Med needs continued investment for the future. But I noticed that UNC Health proposed investing double the amount that Atrium did, but that proposal was rejected for reasons that remain secret from the public. Commissioners, please prioritize the wishes of the people of Wake County and the patients of Wake Med over those with conflicts of interest. Thank you.

Thank you. Hannah.

Good evening, commissioners. My name is Hannah Altus, and I reside in Wake County. And I just want to start by saying I am here to advocate for the children and the people. And I am here to speak on behalf of those who cannot speak up for themselves. And I would like to point out about the red flags that have came about during this proceeding. And I would also like to mention that it would be wise to look into that a little further. And then as well, I would like to bring up the fact that there is a lot more that is happening with this attempt to take over than what meets the eye. And it would just be wise to look into this a lot further. And along with that, I would also like to mention that I would just like to mention that it would be wise to look into this a lot further. And, you know, there is a lot more that is going on with this than what meets the eye. And, you know, that's basically it.

All right. Thank you.

Thank you.

Okay, thank you to everyone who provided comments today. I will now close the public hearing. As noted earlier, no action or vote will be taken by the board on this item today. The purpose of today's public hearing was to receive public comments regarding the potential amendments to Wake Med's article incorporation and the transfer agreement. So again, thank you all. Now let's move on to our appointments. Vice Chair Jackson, does the Board of Commission have any appointments to make to the Citizen Advisory Board or the Commission at this time?

Yes, we do. We have a couple of them to make. Thank you everybody for coming out. Chair, there are several appointments to be made. I therefore move that the Board of Commissioners appoint the following individuals to the respective boards or commissions as set forth below. Board of Adjustment, Wake County, one resignation, Irene Butler, alternative rep. Capital Area Workforce Development, there's one vacancy and one recommendation. The vacancy and recommendation is to fill the community-based organization representing Wake County. The Energy Advisory Commission, one vacancy and one recommendation. Recommendation received by the Advisory Commission for grant Oh, wait, I need to go back. Capital Area Workforce Development, one vacancy and one recommendation. That person is Scott Ferris to fill the vacant community-based organization, Wake County seat. Okay, moving back to Energy Advisory Commission, one vacancy and one recommendation of Grant Layton. Fire Commission, one vacancy, one recommendation to fill the seat. Chris Pierce to fill the vacant citizen consumer rep seat. The Historic Preservation Commission, one resignation of Nathan Gurin, and one recommendation for Mary Peterson to fill that seat. The Industrial Facilities and Pollution Control Financing Authority, one term completion of David Schaefer. We have the Juvenile Crime Prevention Council, one appointment of LaShawn Hewitt, member at large. For Library Commission, we have one reappointment, one term completion, and one recommendation. The reappointment is Wanda Denning, District 2 seat. Term completion, Lisa Mead, member at large, and recommendation for John Saffield to fill that member at large seat. Open Space Parks and Advisory Committee, one reappointment of Emily Milliman as the member at large. And then finally, the Water Partnership, one reappointment of Steven Corsellonell, the private water representative. No. Okay. Thank you for that. Okay, go ahead. Okay.

All right, so Mr.

Chair, I restate my motion that the Board of Commissioners appoint the foregoing individuals to the respective boards and commissions. I'll second that.

Okay, we have a motion and we have a second. The motion has been seconded by Commissioner Evans. The question is on the adoption of the motion to approve the August 17 Board and Commission Appointments as presented by Vice Chair Jackson. All those in favor, please say aye.

Aye.

All those opposed, please say no. Not hearing any, the motion passes. Thank you, Commissioner. Before we move on, Vice Chair Jackson, please let us know what vacancies we will be coming up next month.

Yes, these applications are due August 20th, 2026, with appointments made September 8th. They include the Adult Care Home Community Advisory Board with one possible reappointment, the Cary Board of Adjustments with a possible reappointment, Cary Planning and Zoning Board, one possible reappointment. Juvenile Crime Prevention Council, one possible resignation. And then Water Partnership, a possible reappointment and a possible resignation. And that concludes what is coming up next month.

Thank you, Madam Vice. Other business, Commissioner, would anyone like to share an update from an advisor or regional board that you appointed to? okay not hearing any uh are there any uh reports are from other reports from commission on uh for boards any okay uh commissioner thomas then commissioner waters just really quickly i just want to since we heard from so many people in mecklenburg today um we attended the national association of counties conference in new orleans louisiana and for the third time

in its ninety one year history the president of the association is from north carolina and i just wanted to congratulate president george dunlap on his uh... swearing in to be president of our national association it's great to have somebody from north carolina there uh... i was joined by commissioner jackson commissioner mile and commissioner waters uh... that i will be cheering uh... telecommunications and technology again for a third year with nico and also i will be the vice chair of the large urban county caucus and i look forward to hearing best practices from other large urban counties across the country. Thank you, Mr. Chairman.

Thank you. Commission Waters?

Just wanted to acknowledge all of the community partners and leaders who have invested in our public schools through various events to help them start the school year with the resources and tools that they need and want to wish all who are returning to the traditional calendar in the Wake County public school system, our educators, students, and all who are connected with our schools a successful school year.

Thank you. Any others? Okay, Mr. Attorney, is there a need for a closed session today?

Yes, sir, indeed there is. The closed session motion is being called for the following purposes. One, to consult with an attorney employed or retained by the public body in order to preserve the attorney-client privilege between the attorney and the public body. Two, to discuss matters relating to the location or expansion of industries or other businesses in the area served by the public body. including agreement on a tentative list of economic development incentives that may be offered by the public body in negotiations. And three, to prevent the disclosure of information that is privileged or confidential pursuant to the laws of this state, and particularly NCGS 131E-97.3, or not otherwise considered a public record within the meaning of Chapter 132, all pursuant to NCGS 143-318.11A1.

Mr. Chairman, I'm happy to make the motion for closed session as referenced by Attorney Askew. I'll second.

Okay, we have a motion by Commissioner Thomas and a second by Commissioner Evans. All in favor, please say aye.

Aye.

All those opposed, please say no. Not hearing any. Okay, we are now returning back from closed session, and we have one item to report, and Commissioner Evans, are you going to present that motion?

Yes, I will, Chair. I move that the Wake County Board of Commissioners approve a full and final settlement in the matter of Briggs versus Wake County Sheriff and Deputy DeRoss in the amount of $195,000 in full and final settlement of all claims asserted in that claim and in exchange for a full and general release.

Okay, we have a motion by Commissioner Evans. Is there a second? We have a second by Commissioner Stallings. All in favor, please say aye.

Aye.

All those opposed, please say no. Not hearing any, then the motion carries. Okay, so thank you, everyone. That concludes our agenda for today. The board's next regular meeting is scheduled for Tuesday, September 8th at 5 p.m. Do I have a motion to adjourn? Motion to adjourn. Is there a second? Second. Thank you. The meeting is now adjourned.