“I certainly never saw myself in this role,” said Julie Shackley, president and CEO of Androscoggin Home Care and Hospice. “I didn’t aspire to it. The opportunity came along at just the right time.” As leader of the agency which is the largest provider of home healthcare and of hospice services in Maine, Shackley oversees a staff of 425 – about half of whom are professionals including doctors, nurses, social workers; speech, occupational and physical therapists; chaplains – and a budget in the range of $28 million.

Shackley was named interim president of AHCH in March 2005, and promoted into the permanent title in December of that year. A registerd nurse since 1980, Shackley acquired more than 15 years of clinical experience in both hospital and home care environments, gradually adding supervisory responsibilities to her resume, including five years as a nursing supervisor at AHCH. She eventually transitioned into full time management.

“I found I really enjoy the opportunity to think strategically, to participate in community outreach, and to work closely with healthcare partners,” Shackley said. Leading AHCH places Shackley among the foremost healthcare administrators in Maine, but Shackley explained that “there are lots of women nurses who have become CEOs or directors of nonprofit home and hospice care agencies around the country.”

Balancing the differing patient needs among those receiving home-based acute nursing care and those who require palliative or hospice care, and among the different staff who deliver those services, requires a special combination of skills, empathy and compassion, attributes immediately evident when Shackley speaks passionately about the unique mission AHCH serves in its communities. “I love my organization,” she said. “I’m surrounded by really good people.”

In addition to its prominent headquarters building on the corner of Strawberry Ave. and Main St. in Lewiston, AHCH provides service throughout Androscoggin, Oxford and Franklin counties that “spills over,” in Shackley’s words, to portions of northern Cumberland County, Kennebec, Somerset and Sagadahoc. The agency maintains offices in Bridgton, Norway and Wilton, plus unstaffed offices where homecare nurses can find some refuge and access services in Rumford and elsewhere in the vast geography they cover. Perhaps its most distinctive venue is the Hospice House, situated on an idyllic campus on Stetson Ave. in Auburn, the first in-patient hospice facility in Maine.

“We helped create new standards for hospice care in Maine,” Shackley explained. “There had never been anything like this before. We helped educate the state, the city, EMS, the hospitals; we helped the state evolve regulations and licensing requirements.”

The husband of a Hospice House patient said recently, “I really don’t know how any of us could have managed without this incredible facility. It’s a really unique combination of people, place, and philosophy of care. It was a wonderful gift to my wife. There was nothing ‘clinical’ about it, and it was the most life-affirming experience anyone could imagine.”

The agency maintains an average daily patient census that includes between 1,200-1,500 acute care patients, plus another 130-150 in hospice. The next largest homecare agency in Maine serves an average of 1,000 patients daily. AHCH provides acute nursing care for patients of all ages who might have a variety of health challenges, post-surgical conditions, or long-term illnesses. Nurses also provide palliative care such as pain management for chronic conditions, as well as end-of-life hospice care both in-home and in the Hospice House.

“We put a lot of effort into professional staff development,” Shackley says, “and we’re the last in the state to provide true staff development as part of the in-house quality management program.” AHCH is independent and not affiliated with any hospital system. As such, Shackley explained, “we are at the nexus of inter-hospital projects. We’ll be a big part of healthcare reform implementation because we can engage all levels of practitioners and help build relationships between different hospitals and physician practices.”

Shackley said, “We are financially healthy and positioned well to meet the community needs for nonprofit home-based healthcare.” What she doesn’t mention is that the innovative success of the organization is to such a large extent the product of the visionary leadership of a dedicated, knowledgeable, compassionate and versatile woman.

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