$100 million for hospital: Charlie Lucas leads the biggest bet yet on a children’s hospital
The site of North Carolina’s future children’s hospital is still mostly trees.
It’s 220 acres of woods in southern Apex, near where U.S. 1 meets N.C. 540, with so little built on it that maps show it only as GPS coordinates.
That’s where the Duke Endowment announced that it would give $100 million to North Carolina Children’s, the freestanding pediatric health system that Duke Health and UNC Health are building together.
The grant is the largest charitable commitment the project has received so far.
Charlie Lucas, who chairs the Endowment’s board, brought more family history to the announcement than anyone else there. He is the grandson of Mary Duke Biddle Trent Semans, the great-great-grandson of Benjamin N. Duke, and a direct descendant of Washington Duke.
After the Civil War, Washington Duke walked 130 miles home and found dried tobacco in his barn. That tobacco started the family fortune, and James Buchanan Duke later turned part of it into the Duke Endowment.
Lucas has served as a trustee since 2004 and as chair since 2022.
He has said the family’s history of giving is humbling, that “our ancestors set the bar very high,” and that “we take donor intent very seriously.”
“Opportunities like this do not come along very often,” Lucas said at the site.
“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.”
Lucas fits a partnership between two rival universities unusually well.
As a high school senior, he had already been admitted to Duke and was waiting to interview for a Duke scholarship when UNC offered him its Morehead-Cain scholarship.
He called his grandmother to ask what to do.
She told him he had to accept it because Chapel Hill would teach him things about North Carolina that Duke could not.
He went to UNC and later earned his law degree at Duke, which he jokingly called a way to “redeem myself a bit in my family’s eyes.”
Now, as head of a foundation with deep ties to Duke, he is putting $100 million behind a hospital that Duke and UNC will build and run together. On basketball nights, that partnership would be unthinkable.
The gift also brings the Endowment back to some of its oldest work.
When James B. Duke set up the foundation in 1924, building hospitals was a central goal. He believed hospitals brought medical care to rural communities and helped their local economies.
Over time, the Endowment moved away from paying for buildings and toward funding health programs across both states. Lucas has described its role as an “accelerating partner” rather than a builder.
That’s what makes this commitment unusual. In the Endowment’s second century, its trustees decided that one project was worth one of the largest grants in its history.
Supporters of the project say the need is clear. North Carolina is the largest state without an independent children’s hospital.
The state has 11 children’s hospitals, but they all operate inside larger systems that mostly treat adults.
“Eighty-five to ninety percent of what the health care system does is geared toward adults,” said Dr. Wesley Burks, chair of the North Carolina Children’s Board.
He previously led UNC Health, served as dean of the UNC School of Medicine, and headed its pediatrics department.
“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.”
As a result, many families leave the state when a child needs specialized care. According to Burks, last year about 5,000 children on Medicaid had to go elsewhere for treatment, and that number doesn’t include children with other coverage.
Some families travel to Washington, D.C. or Atlanta for cancer treatment or care for rare genetic conditions. North Carolina also sends more children out of state by air ambulance than any other state served by the two pediatric flight services.
The Apex site was chosen because it is within a three-hour drive for three out of four North Carolina families.
The goal is to bring that care closer to home for the state’s 2.3 million children.
The plans are large.
They include a hospital with about 500 acute-care beds and a separate 70-bed behavioral health hospital for children. That second building matters at a time when young people’s mental health needs often outstrip the beds available.
The campus will also have an outpatient surgery center and space for research, medical education, and training. Faculty from both Duke and UNC Chapel Hill will train future pediatricians and specialists there.
Next door, Wake Tech Community College plans a campus focused on children with complex chronic illnesses and behavioral health needs. The project sits within Veridea, a roughly 1,100-acre mixed-use development.
The Endowment’s grant builds on $424.5 million from the North Carolina General Assembly, made up of earlier federal pandemic relief money and new money in this year’s state budget.
Duke Health and UNC Health are each expected to contribute about $500 million. The full campus is projected to cost about $3 billion, so a great deal of fundraising remains.
The project’s leaders hope to raise $1 billion from private donors, and earlier this year Coca-Cola Consolidated pledged $25 million.
Thomas A. Owens, a 32-year Duke veteran who leads North Carolina Children’s and is Duke Health’s chief clinical executive, said the project is on track to finish the year with “north of” $175 million in private support.
“We think the Duke Endowment grant will really accelerate it,” he said.
Groundbreaking is planned for next year, and construction is expected to take about six years, with the hospital opening in the early 2030s.
Most of the children who will be treated there are not born yet.
Their parents may never have to choose between their child’s care and staying close to home or watch a medical flight take their child out of state.
Lucas has said his grandmother gave him his love for Duke, and she also pushed him toward Chapel Hill.
Mary Semans was the first woman to chair the Duke Endowment and led it for 19 years.
Lucas described her as someone who gave whoever was in front of her her full attention, as though they were the only person in the room.
“By supporting the collaboration of institutions that have deep ties to the Endowment,” Lucas said, “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.”