By Anne Blythe
Key Takeaways:
- The Duke Endowment announced a $100 million grant for North Carolina Children’s, a planned independent pediatric health system.
- Backers say North Carolina is the largest state without an independent children’s hospital.
- Faculty from Duke and UNC Chapel Hill will teach and train future health care providers on site.
On a heavily wooded tract near the intersection of U.S. 1 and N.C. 540 — a 220-acre spot in southern Apex so void of infrastructure it shows up only as GPS coordinates on a map, the Duke Endowment announced a transformative $100 million grant Tuesday morning.
The investment will help fund North Carolina Children’s, a collaborative effort between UNC Health and Duke Health to create an independent standalone health care system that, if true to their vision, will turn the southwest Wake County property into a destination for pediatric care.
“Opportunities like this do not come along very often,” said Charles Lucas III, chair of the Duke Endowment Board of Trustees. “This is such a unique project. It’s unique in scope, it’s unique in ambition, and it is going to change the face of pediatric care, certainly in North Carolina, but across both Carolinas and the region. We believe this project has the potential to transform children’s health care.”
The Duke Endowment, a philanthropic organization founded 102 years ago, counts children’s health and family well-being among its core priorities. (NC Health News has been a beneficiary of its grants.) The $100 million investment announced Tuesday is the largest philanthropic grant yet for a project expected to open in the early 2030s. Plans are in the works to break ground on the Apex campus next year. The North Carolina General Assembly has kicked in $424.5 million for the project with a combination of American Rescue Act funds allocated in 2023 and appropriations in the state budget adopted in July.
Plans for the Apex campus include a 500-bed acute care children’s hospital, a 70-bed pediatric behavioral health hospital, an ambulatory surgical center and facilities dedicated to research, medical education and training. The projected cost for the entire campus is $3 billion.
Plans call for faculty from Duke and UNC Chapel Hill to train future pediatricians and specialists at NC Children’s.
Narrowing the focus
Although there are 11 children’s hospitals across the state, backers of the new project say NC Children’s will be different because it will be an independent system focused only on children and adolescents.
“Eighty-five to ninety percent of what the health care system does is geared toward adults,” said Wesley Burks, chair of North Carolina Children’s board and a former UNC Health CEO, dean of the UNC School of Medicine and UNC pediatric department head. “Our strategy had to be about that and our decision-making had to be about that, and it was important. The care of kids never got primary purview because it was only 15 percent of the whole. This will be a 100 percent strategy and financial investment in the kids and what’s best for them.”
The site for the new children’s health system is part of a larger development in Apex called Veridea. Tuesday’s speakers explained their choice to put the facility in the middle of one of the most populated areas of the state instead of an area with fewer established health systems nearby, saying the tract is within a three-hour drive for 75 percent of North Carolina families.
The goal is to bring specialized treatment closer to home for the 2.3 million children in North Carolina, according to project advocates.
Too many families now are having to go to health care systems across the country for specialized care for certain genetic diseases and cancers, the speakers said. Last year, according to Burks, 5,000 children in the Medicaid system had to seek out-of-state care, and that doesn’t account for all the other children not on the rosters who also had to leave North Carolina for treatments.
“There are two flight services that will fly a child out of state,” Burks said. “For those services, North Carolina leads as the entity that flies more people out of state to be taken care of than any other. We’re the largest state without an independent children’s hospital.”
Partners already
Thomas A. Owens, lead administrator of NC Children’s and executive vice president and chief clinical executive of Duke Health, echoed many of Burks’ comments.
Neither is worried that investing in an independent children’s health system will diminish the children’s health programs at UNC and Duke. They said they think the opposite will be true.
The two academic centers already have shared fellowships and clinical programs.
“Those programs where we partner today are the strongest programs,” Owens said. “So as we deepen that partnership, leading up to North Carolina Children’s and then fully come together, I’m confident as someone who’s been at Duke 32 years that actually Duke Health and UNC Health will actually be stronger.”
Owens said the plan is to partner with all the children’s facilities across the state.
“We’ve had conversations with WakeMed, Atrium and others,” he said. “We welcome the idea of more partners. Duke and UNC are the most sophisticated academic children’s programs in this state, so our two coming together as the founders makes a lot of sense.”
Billion-dollar goal
Duke Health and UNC Health signed an agreement on Jan. 28, 2025, to commit to the joint project.
In a promotional booklet, they published a brief report about their estimated economic impact, using models from the state Department of Commerce and RTI International :
- 8,400 direct jobs
- 9,800 indirect jobs
- $780 million in annual direct wages
- $26.8 billion in state gross domestic product over 20 years
- $1.1 billion in taxes over 20 years
Even with the Duke Endowment grant, much fundraising lies ahead for the project creators, who are trying to raise $1 billion from private philanthropy.
“We’ve been working with private donors, with industry, corporations and foundations,” Owens said, adding that they’re on track to close the year “with north of” $175 million.
“We’re very excited about the early progress and ongoing discussions,” Owens said. “We think the Duke Endowment grant will really accelerate it.”
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