Director's Office - HHSA

The Health and Human Services Agency Director's Office is responsible for implementing the policy directives of the Board of Supervisors and the County's Chief Administrative Officer, and for managing the day-to-day operations and functions of the Agency.

Mailing Address:
1600 Pacific Highway
San Diego, CA 92101
Room 206, MS-P501

HHSA Organizational Chart

About the Director

Nick Macchione, F.A.C.H.E.

Agency Director and Deputy Chief Administrative Officer

Health and Human Services Agency

County of San Diego

With more than 30 years of 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 (the Agency). Mr. Macchione oversees a workforce of over 6,500 employees and an annual budget greater than $2.5 billion. The Agency and its 350 contracted community-based organizations serve over 1 million people. In his role, Mr. Macchione is at the forefront of transforming how government serves the public to live well. As the architect and strategist of Live Well San Diego, he is championing a large-scale, social movement for prevention, wellness and whole person care. Mr. Macchione oversees one of the largest integrated health, housing, and human services networks in the nation. Under his direction, the Agency has been recognized and awarded for its highly innovative and cost-effective solutions in improving the health, safety and well-being among residents across the San Diego region.

Mr. Macchione manages the day-to-day operations of major service departments which include:

  • Aging & Independence Services,
  • Behavioral Health,
  • Child Welfare Services,
  • Early Childhood Development Services,
  • Housing and Community Development Services,
  • Inpatient Medical Care, which includes 109-licensed bed acute-care Psychiatric Hospital and 192-licensed bed sub-acute care Edgemoor Hospital,
  • Public Guardian & Public Administrator,
  • Public Assistance Services,
  • Public Health Services,
  • the Executive Office (finance, operations, human resources, compliance, strategy, information technology, legislative affairs, media and contracts),
  • the Medicaid Managed Care network for over 900,000 individuals, including major safety net programs to increase access to healthcare for those without health insurance, and
  • the care of populations with special needs (developmentally disabled, severely physically disabled, and/or mentally ill).

Mr. Macchione holds master’s degrees from Columbia University and New York University specializing in leadership, management and policy, and is the Baldridge Foundation’s 2018 Harry S. Hertz Leadership Award Recipient. A leader, professor and a lifelong scholar, he is actively involved in community and professional activities at the national and regional level. Mr. Macchione is a Fellow of the American College of Healthcare Executives, a Public Health Leadership Scholar with the Public Health Institute/federal Centers for Disease Control and Prevention, and a Creating Healthier Communities Fellow of the American Hospital Association. For over 20 years, he has also been an instructor and faculty member at San Diego State University’s School of Public Health and holds the endowed position of the John Hanlon Executive Scholar for the division of health management and policy. In recognition of his professional and academic accomplishments, Mr. Macchione was named the 2016 Public Official of the Year by Governing Magazine.