San Diego County’s health and human services director headed for new job at UCSD

After 26 years working for the county, 15 of them directing its health and human services agency, Nick Macchione announced Wednesday that he will take a new position at UC San Diego Health.

According to an internal announcement sent to university health system employees, the new position, chief health officer of community health, will oversee the complex network of “external relationships” with other organizations.

The university health system often works with the county health department, other health systems and government agencies that often collaborate on everything from border health care to serving those on Medi-Cal or without health insurance.

Patty Maysent, chief executive officer of UC San Diego Health, said that years working directly with Macchione made it clear to her that he was the best fit for the role.

“I’ve worked with Nick a lot over the years, and we were very close partners through COVID,” Maysent said. “We did a tremendous amount of work together around testing, around the vaccination super station downtown, around monoclonal antibody treatment and wastewater (analysis).

“All of that work came together because, at the end of the day, I could call Nick, and he would talk to me and we would figure out how to get something done.”

In nearly three decades of work with the county, Macchione, 55, has had occasion to meet and get to know pretty much everyone in the local health care and social services world, experience that Maysent said is needed as UCSD embarks on a $2.5 billion redevelopment of its Hillcrest medical campus, a location where Macchione’s two children were born.

Other collaborations around behavioral health and outreach to migrants are also underway or in the works.

Born in Italy and immigrating to New Jersey with his family as a young child, Macchione found himself drawn toward public health administration during the AIDS epidemic, becoming the youngest director of a fractious local planning council as it struggled to prevent infections and care for those who were dying of the disease.

Success back East led the county to recruit him to San Diego in 1997 to run the region’s Office of AIDS Coordination.

Appointed director of the county’s health and human services agency in 2008, Macchione oversees a staff of nearly 8,000 and a $3 billion annual budget, which includes aging and independence, behavioral health, child welfare, public health, self sufficiency and housing and community development services.

By comparison, the number of direct reports at UCSD is likely to be much smaller.

Saying he always considered himself an “activist trapped in a government suit,” Macchione said Wednesday that he was intrigued by working for the region’s only public organization that operates a full-service hospital that takes care of the region’s most needy residents. Advocating for these people, he said, is the main reason why he decided to leave the county.

“I have only really ever seen myself working for a public organization, and UCSD is allowing me to keep doing that in a new way,” Macchione said.

UCSD, which operates what used to be the county’s hospital in Hillcrest, is a key piece of the region’s health care safety net, the executive said.

“I looking forward to bringing my experience and skills in building upon UCSD Health’s numerous community health impacts for our entire community,” Macchione said.

After earning master’s degrees in health care management and leadership from Columbia and New York universities, Macchione received national recognition for his work, including the Harry S. Hertz Leadership Award from the Baldridge Foundation, an influential health care quality arbiter, in 2018 and a Public Official of the Year award in 2016 by Governing Magazine.

More recently, San Diego County has seen the lowest per-capita COVID-19 death rate among Southern California counties.

Former county Supervisor Ron Roberts, who was on the board for much of Macchione’s time at the county, said Wednesday that he always found the executive to be genuine when trying to bridge the interests of groups that may have competing interests.

“He tried to treat people fairly and work with virtually every group that needed health and human services help,” Roberts said. “If you’re not genuine, you know, people will see through that sooner or later and it was always clear that Nick, he really wanted the outcomes to be right irrespective of who was involved.”

In a memo to his county colleagues sent Wednesday, Macchione announced the change as a retirement, which will occur on June 27, though a county official said he does not intend to take retirement benefits “at this time.”