Nick Macchione, MS, MPH, FACHE
Director and Deputy Chief Administrative Officer
Health and Human Services Agency
County of San Diego, California
Nick Macchione has served since 2008 as Director of the County of San Diego Health & Human
Services Agency (HHSA). He has over 30 years of clinical and executive experience leading and
managing large, complex service health and human service delivery systems in various settings
in the New York metropolitan area and County of San Diego.
In 1997 he moved from his position as Executive Director of a health planning organization in
New Jersey to San Diego County government. After serving 10 years as a Deputy Director for
HHSA was named Agency Director. Today, he leads an agency that annually supports 1.3
million of the County’s 3.3 million people with health, housing, and human services through a
workforce of over 8,000 employees, 350 contracted organizations, 168 citizen advisory boards, and a $3.0 billion annual budget. Nick was the architect of, and launched in 2010, “Live Well San Diego.” Today, Live Well San Diego is a nationally recognized large-scale, population health strategy focused on improving life expectancy and social well-being throughout the county so that all San Diegans have the full opportunity to be healthy, safe, and thriving.
Under Macchione’s leadership, in 2017 HHSA received the California Awards for Performance Excellence (CAPE) Eureka Award for Performance Excellence–Silver Level. That same year, HHSA’s Edgemoor Skilled Nursing Facility earned the 2017 Gold Excellence in Quality Award by the American Health Care Association and the National Center for Assisted Living.
In response to the COVID-19 pandemic in May 2020, Macchione stepped away from day-to-day Agency operations to build from the ground up a public-private partnership and multi-sector collaborative effort charged with protecting the public’s health against COVID-19, with an emphasis on health equity and disproportionately impacted communities. As director of the county's COVID-19 T3 Strategy of Test, Trace, and Treat, his efforts included in October 2020 leading the rollout of equity-based, region-wide public COVID-19 vaccinations. The T3 strategy was a critical component of the region’s achieving and maintaining one of the highest testing and highest vaccination rates in the state and nation. As of summer 2022, more than 79% of eligible San Diegans have been fully vaccinated.
Macchione holds dual master’s degrees from Columbia University and New York University and a professional certification from Harvard University specializing in executive leadership, management, and health policy. He is board-certified in healthcare management and holds two national fellowships in community health and public health leadership. Included among his numerous awards and recognitions is the Malcolm Baldrige Foundation’s 2018, Harry Hertz Leadership Award Recipient. As the John Hanlon Executive Scholar, Nick teaches and mentors graduate students specializing in health services management and policy at the San Diego State University’s Graduate School of Public Health