About the Director



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

With 30 years’ experience in the delivery, management and public policy of health and human services, Mr. Nick Macchione serves as San Diego County’s Director of the Health and Human Services Agency.  He directs a professional workforce of 6,200 employees with a $2+ billion annual operating budget, including 166 citizen advisory boards/commissions and 1,000 contracted community service providers. Under Macchione’s leadership, the Agency has earned state and national recognition for its innovative, cost effective solutions in improving the health, safety and well-being for its one million clients. The Agency is one of the largest health and human services networks in the nation, supporting all of its 3.2 million residents residing in San Diego County.  With a passionate focus on practical innovation for improving the quality of life of San Diegans, Mr. Macchione directs the delivery of health and social service safety net programs, including public health services; emergency medical services and disaster response; behavioral health services; Medicaid managed care and other safety net health insurance programs; nutrition assistance for the indigent; child welfare, adult protective services; family and community violence prevention, public housing and community development services, parenting and early childhood development programs, support services for active duty military, veterans and their families, as well as numerous other services.  Mr. Macchione implements policy direction of an elected Board of Supervisors and also oversees the operations of the County’s Psychiatric Hospital; Edgemoor Skilled Nursing Facility; Children’s Emergency Shelter; and a residential high school academy for foster youth.

Throughout his public service career, Mr. Macchione has served as a community-oriented architect, motivating convener, implementer and leader of large scale population-based improvements.  Most notably, under his leadership in 2010 the Health and Human Services Agency and the rest of County government embarked on its most bold and ambitious county-wide “social movement” known as Live Well San Diego. This groundbreaking data-driven strategy is a high level, collective impact for population health and social well-being improvement.  Live Well San Diego is being implemented countywide through hundreds of public-private partnerships in building better health, safer living, and economic vitality for all San Diegans. 

Mr. Macchione is a Fellow of the American College of Healthcare Executives, having previously served a 3-year term as the elected Regent for San Diego and Imperial Counties.  He is a Public Health Leadership Scholar with the federal Centers for Disease Control and Prevention and a Creating Healthier Communities Fellow of the American Hospital Association’s Health Forum.  Mr. Macchione serves on numerous regional and national boards, including serving as vice chair of the Milbank Memorial Funds’ Reforming States Group, National Association of Counties’ health committees, executive steering committee for Harvard University’s Human & Human Services Summit, and Aspen Institute’s TeamWorks project for state health departments.  Mr. Macchione holds dual masters’ degrees from Columbia University and New York University where he specialized in health services management and health policy. Also, he earned a senior healthcare leadership certificate from Harvard University.  For the past 19 years, he has been an instructor and faculty member at San Diego State University’s Graduate School of Public Health and holds the endowed position of the John Hanlon Executive Scholar for the division of health management and policy.  



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