APEX, N.C. (WPTF) — The planned joint Duke-UNC Children’s hospital in Apex is getting a big boost from a major foundation.
North Carolina Children’s (NC Children’s) is receiving a $100 million grant from The Duke Endowment.
NC Children’s will be the first independent, freestanding children’s health system in the Carolinas. The investment will help advance a new model of pediatric care designed to bring specialized treatment closer to home for North Carolina’s 2.3 million children while establishing a national destination for children with complex medical needs.
The grant is the largest philanthropic commitment to date for NC Children’s and follows a $424.7 million investment from the North Carolina General Assembly, adding major private support to a substantial public commitment. According to a press release, the grant confirms The Duke Endowment as an early partner in an effort that will grow as others join.
The grant carries forward a commitment James B. Duke set down in 1924, when his Indenture of Trust established The Duke Endowment as an independent private foundation, separate from Duke University and Duke University Health System.
“For more than a century, The Duke Endowment has been guided by James B. Duke’s philanthropic priorities of improving lives across the Carolinas through healthcare, higher education, a focus on rural communities and a commitment to the well-being of children and families,” said Charles C. Lucas III, chair of The Duke Endowment.
“Our investment in NC Children’s brings those commitments together in an extraordinary way,” said Mr. Lucas. “By supporting the collaboration of institutions that have deep ties to the Endowment, we have an opportunity to expand pediatric care and expertise, advance research and innovation and make a lasting difference for children and families throughout the Carolinas and the region.”
Established in 2025 by Duke Health and UNC Health, NC Children’s will be an independent health system that cares for children and develops specialized programs for complex conditions, including childhood cancer and rare genetic disorders, that are not available in the Carolinas today. The partnership will create something greater than either institution could achieve independently, united by a shared commitment to North Carolina’s children.
Through clinics, telehealth and partnerships with community hospitals and providers, NC Children’s aims to connect children to specialized expertise while supporting the clinicians who already care for them across the region. This approach will help children access advanced treatment when needed and return to their trusted care teams closer to home.
“By bringing together the extraordinary clinical and research strengths of Duke Health and UNC Health, we have an opportunity to develop deeper pediatric expertise, expand research and build specialized programs at an entirely new scale,” said Dr. Thomas A. Owens, lead administrator of NC Children’s and Executive Vice President and Chief Clinical Executive at Duke Health.
“The Duke Endowment’s investment is a major step toward realizing that vision, creating a children’s health system that strengthens care across North Carolina and helps more families access the expertise their children need closer to home,” said Dr. Owens.
For families navigating complex medical conditions, the need for more accessible pediatric care is deeply personal. Amy Clifton, a mother of three from Chatham County, knows firsthand the challenges of coordinating care across multiple hospitals and states. Her son, Noah, spent his first 63 days in a neonatal intensive care unit and now receives care from specialists at Duke Children’s, UNC Children’s, Cincinnati Children’s Hospital and Nationwide Children’s Hospital in Columbus, Ohio.
“I dream of the chance to travel nearby for Noah’s care instead of 12 hours,” said Clifton, who serves as a patient advisor to NC Children’s during its architecture and design process. “Having a resource like this in North Carolina will simplify and improve things, and offer hope, for so many families across the state.”
NC Children’s is being developed amid a nationwide decline in pediatric inpatient capacity. Between 2008 and 2022, the number of pediatric inpatient units at U.S. hospitals fell nearly 30 percent, compared with a 4.4 percent decline in adult inpatient units, according to research published in JAMA Pediatrics. The loss of pediatric services has raised concerns about access to hospital care, particularly for children in rural communities, where families may have to travel farther to find providers equipped to care for their children. As these options become more limited, the need for a comprehensive pediatric health system capable of treating complex conditions and connecting families to specialized care becomes increasingly urgent. Plans for the NC Children’s campus in Apex include an approximately 500-bed acute-care children’s hospital, a 70-bed pediatric behavioral health hospital, an ambulatory surgery center, and facilities dedicated to research, medical education, and expanding access to specialized care statewide.
Faculty from the Duke University School of Medicine and the UNC School of Medicine will help train future pediatricians and specialists at NC Children’s, while advancing research and developing new treatments for children with complex medical needs.
“Building a new children’s health system from the ground up is an enormous undertaking, and this investment comes at a critical moment in that process,” said Dr. Ian Buchanan, chief operating officer of NC Children’s. “The Duke Endowment’s investment helps lay the groundwork for a comprehensive pediatric health system that can meet the needs of children and families across the Carolinas.”
Groundbreaking on the Apex campus is planned for 2027, and NC Children’s is expected to open in the early 2030s.
“The Duke Endowment’s $100 million grant is a powerful statement of confidence in the vision for NC Children’s and the people working to bring it to life,” said Morgan Abbott, president of the NC Children’s Foundation. “By stepping forward early, The Duke Endowment has set the pace for what comes next. This is the beginning, and there is significant work ahead. We hope this grant encourages others across the Carolinas and beyond to think boldly about the role they can play in creating something that will serve children and families for generations.”