Timothy Zercher 0:00

Well, good morning, Joy. Thank you so much for joining us. We really appreciate you taking time.

Joy Pendola 0:04

Oh, it's great to be with you, Tim.

Timothy Zercher 0:06

Absolutely, absolutely. You've held leadership roles across clinical and operational sides of behavioral health. What first drew you into the field and what has kept you committed over these, I think, many years now between the different roles?

Joy Pendola 0:20

Yes, I've been in the field over 28 years now. I can't believe that. This wasn't initially a career path that I thought I was taking. I was a peer helper in high school and I always really enjoyed helping my friends out and giving advice and all of that. But going into college, I actually was a molecular biology major. It wasn't until I took a class at University of Connecticut. It was a human development and family relations course. And it was taught by a professor who was a licensed marriage and family therapist. I didn't know anything about that discipline at all at the time, but her description of systems theory and the way family systems actually could treat family systems for behavioral health disorders and seeing that kind of connection where it's not the behavioral health root cause isn't in the person, it's actually the system. It simultaneously blew my mind and completely made sense to me. Like it was something I related to and just was like, this is yes, this totally resonates to me. And I found it so destigmatizing, right? To really identify that people aren't the problem, but the systems that and how we relate to each other absolutely can change the whole course of all of our lives. So I found it both astigmatizing and completely empowering. So from there on, I was like, yes, this is something I want to do. And specifically marriage and family therapy and looking at those systems. And then I became a therapist, a marriage and family therapist. And I think that systems kind of theory and approach got me really interested in all the other things that come with doing clinical work, right? The billing and the compliance and leadership. So I quickly moved into executive and management and supervisory roles because I had an interest in seeing how all these things work together. And I think what keeps me going in this field is seeing the growth and potential of all of the people who are coming into the field and helping them develop their skills and profession, opening up new services and just seeing the advances in our work, how we've gotten better treatments, better medications, better courses and treatment, and still fill in those gaps. There's so many gaps still to behavioral health treatment. So I think all of those things keep me really motivated to keep going in the field. It's never dull. There's always something new. And I just am very optimistic for the future. Absolutely.

Timothy Zercher 3:06

Yeah. So you've led program development and clinical oversight, both at scale. Where do you think organizations tend to struggle the most when trying to balance quality care with operational demands?

Joy Pendola 3:18

I think, and this is no fault to those organizations. I think you could easily get caught up in the actual operations, right? It's how are we going to staff this or the budgets for it, or what curriculum you're going to use, how you're going to train people, all of those things. I think you could easily get caught up in those kind of operational day-to-day things. I highly recommend and always try to keep my teams focused on the quality of care because I think if you take care of that, all the operational stuff kind of goes with that, right? So I always encourage people to keep and analyze good data on what you're doing and use it. So track attendance, track no-shows, track if people go into higher levels of care while they're in treatment with you. Track that stuff, analyze that stuff and see where those are there's opportunity for improvements. Listen to your clients. Client experience is very important too. I just saw that a new adolescent IOP is opening up in my area. And I was like, great, because we don't have enough of those, right? But I saw the schedule of it, and I've opened up many of those in my time as well. And it's two to five. And I was like, oh, schools are going to have a real hard time with that schedule, right? And they're going to be a prime referral source for you. So if they're not happy with that schedule, they're going to be and it kind of erodes into the school time. You're going to have a hard time getting not only schools on board, but probably eventually parents on board too. So it's those kinds of things that you have to consider as part of the quality of care. But again, looking at your data, looking at your outcomes, listening to your clients, I think those are huge benefits and contributing to just continuous quality improvement, which I think is so important.

Timothy Zercher 5:14

Absolutely. Absolutely. No, that makes complete sense. That makes complete sense. And with your background in compliance and supervision, what have you learned about building systems that actually support clinicians while maintaining that accountability, while maintaining that focus on quality?

Joy Pendola 5:30

This is so tough. I and I think it's just something that you're always challenged by, you know, especially in a nonprofit community behavioral health space. I think you always feel you never have enough resources, right? But when it comes to clinicians and supporting them, I think there's two things that I try to do, you know, with all my teams. And that is number one, have clinicians know that we're invested in them not only professionally in their roles, but also their own development. So maintaining good, consistent supervision is always appreciated by clinicians, supporting them in their training goals and advancements. You know, one thing that we have committed to is after a clinician's been with us for a year, we send them to EMDR training if they're interested, and we pay for that for them to get the training certification in that area or any advanced practice. We invest in that, knowing that they may not spend their entire careers with us, but we want well-trained, good clinicians out there for any clients that are being served. So I think that's important. Always finding the efficiencies for clinicians. The demands on clinicians and community health have not gotten easier. They've actually gotten worse in regards to documentation, compliance standards, productivity standards. So I think we really try to focus on supports and efficiencies for them. And then again, supporting them professionally with their own development, knowing good, consistent supervision. I think a lot of times that kind of goes by the wayside. I think it's so important for clinicians to know that their supervision isn't just about their caseload and their productivity and do they get their documentation in? That matters, right? But it also matters that we're taking the time and space to work with them on the challenges of doing their role and finding as many efficiencies as possible for them and supports for them. So I think that's the balance that we care about them not just about being employees, but the work they do and managing that well and them recognizing we're giving them all of those supports and then holding those standards and being very clear about what the expectations are too.

Timothy Zercher 7:54

Absolutely. I think, I mean, if if you support your people well and you make your expectations clear, those two by themselves, much less investing in them or taking care of them or helping them. The general cause of behavioral health right, like anything else is great. But if those two are done, you're gonna have better retention, you're gonna have less turnover, it's gonna be valuable. Like you mentioned, the clinical side impacts the operational side.

Joy Pendola 8:17

It does. It's that whole, you know, if you build it, they will come. But it's it not only if you'll build it, but if you appreciate the experience both on the staff and client side, and you really focus on that, the operational pieces fall into place. And we've had good retention generally with clinicians as well. One of the best things that we did was really build an internship pathway for employment. So a lot of our staff actually stay with us after internship, and that's been just a plus on both sides. And they have very clear understanding of what the expectations are too before they even, you know, engage with us on a full-time basis.

Timothy Zercher 8:58

Absolutely. No, which makes complete sense. Makes complete sense. And last question I wanted to ask you before we wrap up is what have you found is the single hardest part of growing an organization? Because I know you've been part of many growths.

Joy Pendola 9:10

Now I would say absolutely compliance and regulatory expectations. We are just opening up a new residential program. This has been in the works for over a year and it has to be credited, licensed, and certified. So by three different bodies. The zoning took months, the renovations took months, but then the licensing and then the certification took months. The project took three times as long as we anticipated because of those regulatory. So when you're really trying to grow your teams and your organization, I would say the demands of the regulatory and compliance pieces have really it makes it very hard for organizations to start new programming because of those demands. And I think it really does play a huge role, even on staffing. The amount of paperwork and documentation and standards that have to be met are very different in a community health center as opposed to a private practice.

Timothy Zercher 10:14

Yeah, no, that makes complete sense. Makes complete sense. It's an unfortunate reality of the time we live in that uh compliance is just getting more and more intensive and longer and longer to get anything done. But I appreciate the work that you're doing. I think you're doing incredible work for your community and for your team. So thank you so much for taking time to share some of your experience, some of your insights with us.

Joy Pendola 10:33

It's great talking to you, Tim. Thanks so much. Absolutely.