About the Director



Director and Deputy Chief Administrative Officer
Health and Human Services Agency
County of San Diego, California 

As Director of the County of San Diego’s Health and Human Services Agency, Nick Macchione manages one of the largest health and human services networks in the nation, supporting the public health, safety, and well-being of the over 3.2 million residents of San Diego County.  With an annual budget responsibility of $2 billion, Mr. Macchione oversees a workforce of 6,000 employees, hundreds of volunteers and 1,000 contractors that collectively provide direct services to over one million clients annually.  With a focus on innovation and service integration, he directs the delivery of health and social service safety net programs, including public health services; behavioral health services; Medicaid managed care and other safety net health insurance programs; nutrition assistance for the indigent; child and adult protective services; and early childhood development programs.  Mr. Macchione implements policy direction of an elected Board of Supervisors and oversees the operations of the County’s Psychiatric Hospital; Edgemoor Skilled Nursing Facility (2014 winner of a Silver Achievement in Quality Award by the American Health Care Association and the National Center for Assisted Living); Polinsky Children’s Center, a 24-hour facility for the temporary emergency shelter of children; and San Pasqual Academy, a first-of-its kind residential campus for foster youth.

Under Mr. Macchione’s leadership, in 2010 the Health and Human Services Agency and the rest of County government embarked on a bold and ambitious ten-year, county-wide wellness initiative known as Live Well San Diego. This groundbreaking initiative is being implemented throughout the region to build better health, encourage safer living, and promote economic vitality for all San Diego County residents.

He is a Fellow of the American College of Healthcare Executives, having previously served a three-year term as the elected Regent for San Diego and Imperial Counties.  He is a Public Health Leadership Scholar Alumnus with the federal Centers for Disease Control and Prevention and a Creating Healthier Communities Fellow Alumnus of the American Hospital Association’s Health Forum. He is a Commissioner of the First Five Commission of San Diego and serves on numerous regional and national boards, including serving as vice chair of the National Association of Counties’ Healthy Counties Initiative Advisory Board and steering committee for Harvard University’s Human Services Summit.

Mr. Macchione holds dual masters’ degrees from Columbia University and New York University where he specialized in health services management and health policy. For the past 17 years, he has been an instructor and faculty member at San Diego State University’s Graduate School of Public Health.  In 2007, he was appointed as the School’s John Hanlon Executive Scholar for the division of health management and policy.



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