Worth the Work with Jason Dana Costa
Worth the Work with Jason Dana Costa explores what it really takes to build organizations that matter.
Hosted by healthcare executive, consultant, and mission-driven leader Jason Costa, each episode features honest conversations with CEOs, nonprofit executives, healthcare innovators, and community leaders who are tackling meaningful challenges with curiosity, trust, and operational excellence.
From leadership and organizational strategy to healthcare innovation, culture, financial sustainability, and navigating complex change, Jason uncovers the lessons that don't make it into business books. These are conversations about building organizations that create lasting impact, earning trust when it matters most, and doing work that's truly worth the work.
Whether you're leading a healthcare organization, nonprofit, business, or growing team, you'll walk away with practical insights, fresh perspectives, and the inspiration to lead with purpose.
Worth the Work with Jason Dana Costa
Eric Perry - Executive Director & CEO, Avenir Behavioral Health Center
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What makes a behavioral health organization truly worth the work?
In this episode of Worth the Work, Jason Dana Costa sits down with Eric Perry, Executive Director and CEO of Avenir Behavioral Health Center, to explore what it takes to lead, rebuild, and grow in one of healthcare’s most demanding environments.
Eric shares how an early fascination with medicine and human behavior led him from clinical work as a therapist into executive leadership. He and Jason discuss the realities of behavioral healthcare, including staff retention, continuity of care, building stronger teams, and the importance of listening to the people closest to the patients.
Eric also explains why he believes a resume only gets someone through the door, how he hires for character and culture, and why some of his greatest leadership lessons came from seeing what not to do.
The conversation dives into difficult organizational decisions, including rebuilding teams, changing psychiatric provider groups, and creating a more collaborative approach to patient care. Eric also shares what Avenir’s upcoming 24-bed expansion means for the organization and the community it serves.
At its core, this episode is about building organizations where people trust each other, employees feel supported, and better operations ultimately lead to better patient care.
Hi, everybody, and welcome to Work to Work with Jason Dana Costa. Today's guest is Eric Perry. He's the executive director and CEO of Avenir Behavioral Health, where he leads an organization in Arizona for behavioral health hospitals. And his career has spanned clinical operation and leadership with that Eric here, who is transforming the organization and improving quality care while still staying deeply committed to the people behind the numbers. Eric, welcome to the show.
Eric PerryThank you, Jason. Great to be here.
Jason Dana CostaWe really appreciate you. So here at Worth the Work, I like to connect how you're upbringing your family values sort of translated into your professional career. So I'd love to start by asking, growing up, what shaped the way you think about serving people? And when did you realize that healthcare is really the place you want to make the impact?
Eric PerryOkay. With family, I had a really small nuclear family, just my brother and I, and obviously my parents. But our extended family was really large. And my mom and dad were the only ones that stayed in my little hometown. All of my other aunts and uncles had moved all over the country. But every summer they would all come in and kind of converge back onto hometown. So I'd have the entire extended family. We used to do this big like Christmas in July thing where we'd have people all over the country. And it was a really family-oriented thing. So even though the extended family weren't around often, other than annually, we spoke to them a lot. I visited them periodically. They were always in the summer. So there was always a really strong family component. And most of my family are much givers. They're very helping people. My mom was a hospice nurse. So it's just a lot of it was just instilled in me from childhood from family.
Jason Dana CostaWow. So healthcare was really in your blood. Is that the reason why you sort of started getting it to the healthcare career?
Eric PerryBecause of your mom's influence? She wasn't a nurse when I was younger. When I was a little kid, I was always fascinated with medicine, with health. I remember when my parents used to go out, I stay at an aunt's house, and they had a few of these anatomy books. And you remember the old school books that had like the clear overlay where you like the vital organs and the musculature and things, and you could layer them on top of one another. I was probably, God, six or seven years old. And I just remember being fascinated by this stuff. Way too young to understand what any of it meant. But it was just, I was just drawn to it. So when I started college, I was actually a physical therapy major, not entirely sure where I wanted to go, but that sounded like the right path. But I slowly just kind of moved into more behavioral health. I've always been fascinated in human behavior. I'm a master's level people watcher. I just love going to the airport or traveling and just watching people interact with one another, whether it's someone that they know well or a stranger, a vendor getting coffee or whatever the case may be. So I've just always been fascinated in humans and human behavior.
Jason Dana CostaYeah, I've shared that with you. Behavioral health is a place where we share some work together. I was the C F O and CO of a community behavioral health here in Rhode Island. You're in Arizona, I'm here in Rhode Island. And I know it's one of the toughest fields to lead in. So another great question I'd love to learn more about is what stretched your you the most? Sort of what taught you the most about being resilient in this very, very difficult field?
Eric PerryTo drill that down into a single answer is really difficult. I started my career as a clinician. I was a therapist for years, primarily family therapy. And despite how difficult sometimes the population is, it's often the bureaucratic stuff. It's the staff things, it's the all of those limitations. And for the most part, and I can't say across the board, but for the most part, I always loved the clients and the population that I worked with. But the frustrating thing with agencies or policy and procedure or whatever the case may be, that was always the hardest part for me. And then as I morphed into leadership, one of the things that was always difficult because it directly affects quality of care is staff turnover. And in behavioral health, turnover is it's expected. I'm blessed at the hospital that I'm at. Our turnover rate is like 5%, which in behavioral health is outstanding. At a level one hospital, it's unheard of. Yeah. That is something that I don't deal with as much where I'm at right now. Interesting.
Jason Dana CostaUm I'm curious because I can't remember off the top of my head, is Arizona a C C B H C state? Yes. It is. I thought so. I wasn't 100% sure. Rhode Island was a C C B H C state too. I'm kind of curious how did that go for Arizona, particularly from a hospital perspective, because I've been doing the sort of in the community CMHC work. For those listening in, that's Community Health Center, and CCPHC is a certified community behavioral health center. I'm very interested, Eric. How's your perspective from the hospital as CCBHC has event implemented in your state?
Eric PerryUh it's really difficult to say because I've worked at only two hospitals, both here. Everything prior to that was always in the outpatient scope. Ah, I see.
Jason Dana CostaHow long has Arizona been a C C B H C state? Do you know? That I do not know.
Eric PerryIn Rhode Island here, we've been doing it about three years. Jason, now you've got me questioning if we actually are. Oh, okay. So yeah, I want to say yes, but now for whatever reason I'm questioning that. So you might want to hold off on adding this to the That's quite alright.
Jason Dana CostaThat's quite alright. Well, still, I am very curious from your perspective, because I know there's been a lot of work with our CMHCs. We have one standing hospital here in Little Rhode Island. That is the place to work with. Perhaps there's two in Arizona gives you reference to. But I'm curious about your relationship potentially with the community mental health centers, even if they aren't CCBHCs. How's that collaboration and sort of work within the community versus an inpatient setting working from your perspective?
Eric PerryArizona, well, Phoenix, rather, is a huge city. If you factor in the metro, it's absolutely massive. One of the things I learned really early on here is despite the size of the metro area, behavioral health is incredibly tight-knit. Everyone knows everyone. It's really fascinating to me how really intertwined everyone is. So with that being said, I try to the best of my ability to maintain some degree of open working relationships with all of the other hospital leaders, outpatient leadership. I want to be able to pick up the phone and call someone and say, hey, I got a patient that we can't take. Do you have availability? Or hey, I've got some questions regarding Coliseum Procedure. Can I bounce something off of you? So just having that open collaborative, I think at the end of the day makes all of the facilities run better.
Jason Dana CostaYeah, I agree. The biggest challenge I've seen, at least in our community here in Rhode Island often, is the transition of care as people are exiting the level one hospitals and coming back into the community and sort of that strong handoff. So the emergency getting somebody in fairly well identified. It's when they've got well, and you guys have done your great job in the hospital and getting people back into the community in a strong, sustained way. There's great successes, but there's also been some misses, to be honest with you.
Eric PerryWell, the step down piece is one of the hardest things to deal with because if you're in outpatient care, you're typically there for an extended period of time. So there's an establishment. My hospital, and we're one of about 15 across the valley that is just a level one facility, we're discharging five, six patients a day. And now if you factor in some of the more pre-screening agencies or the acute observation centers, they're sometimes discharging 20 or 30 patients. So if you factor in all of those hospitals, that they all need step-down services, not just their PCP and their site, but often specialized services based on their social determinants of health. So the availability of a lot of step-down services, be it a residential, outpatient, intensive outpatient, partial, sometimes it's really hard to get someone in as quickly as you want to or need to, with the proximity that works for them, with the level of care and to get everything to work together. The biggest piece in that, because it's one of those, you really need to strike where the iron's hot. Because when a patient leaves, if you don't literally give them your here's your appointments, and you got something like set up for tomorrow, hypothetically, if it's two weeks out, the likelihood of them showing up drops significantly, which just reinforces the probability that they're going to be back at a level one at some point in the future because that safety net from a step-down perspective just isn't there.
Jason Dana CostaI agree. It's a challenging work.
Eric PerryYeah, yeah, it is.
Jason Dana CostaYou know, you've clearly been in this career for a long time. So looking back, what was a mentor for you that challenged you to become a different kind of leader? And sort of what was the conversation that you had with them that sticks with you today?
Eric PerryEvery leader I've had has brought something to the table. Honestly, probably the one that impacted me the most was the one that I thought was the worst leader. Ha ha, really? Yeah, because it really just taught me what not to do. And she was incredibly knowledgeable, and she was a clinical background, and her and I personally got along very well. But she always took this approach from I'm older than you at the time, I was not licensed, I was just bachelor level. And she always took this almost condescending, and I know the answers and you don't kind of thing. And at the time, I was an inpatient family therapist, and I'm with my partner going out, meeting these families, and meeting for having conversations with them firsthand. We would staff them on a clinical level with her, and she would often override one or both of us and say, Yeah, that's not right. And while she may have been right, and I don't question her clinical acumen, while she may have been right, not accepting what the frontline person has to say was just, it was always demoralizing to me. And it was one of those things like, if or when I become someone on a top-tier leadership position, I'm never gonna do that. And I've always, probably because of her, I've always taken the stance that the individuals that are working with the people are the experts, regardless of what the initials after their name are.
Jason Dana CostaYeah, I can't agree with you more. It's funny, one of the questions I was hoping to ask you, because behavioral health hospitals are often, at least from an accountant's perspective, I am an accountant by training, I'm not a clinician like you are. But having worked in behavioral health, it's always sometimes comes down to more beds and bums and seats, for lack of a better phrase. But that's not really true, and it really comes down to the employees and the patient or client. I don't know if you refer to them as clients in your behavioral health system, that trust you're building. So what has in your journey taught you about earning trust of employees, investors, and even the community to do this kind of work?
Eric PerryI think it was Richard Branson that that made a comment that was really famous and it still is to this day, stating that everyone says you need to take care of your client, and that's the most important thing. And he had said, you know, I very much disagree with that. I think you need to take care of your team. And if you do that, the rest of it kind of falls into place naturally, and then they take care of the client. So I think the first thing for me is just acknowledging the work that my team does. I try to visit the floor as often as I can. I try to make my rounds between all of the disciplines in the facility, but I also recognize that there's a separation there. I'm not doing the degree of work that they are doing. And on any given day with a level one facility, our patient turnover rate, length of stay is approximately seven days or so. So if I leave work on a Friday afternoon where I come in Monday morning, I got 10, 15 patients sometimes that are brand new. So every day you really don't know what the population brings. So recognizing how difficult that is from a staff standpoint and showing them that you do recognize that and you're there to help. For example, on any given Saturday or Sunday, I'll pop in the hospital to make my rounds. We run, obviously, as a hospital, we're 24-7 facility. So we run two shifts seven to seven. So I try to be at work between 6 and 6:30 in the morning. So I have at least some time to interact with my night shift. If I didn't do that, half of the hospital, I would never meet them. And I just think that's an incredible disservice.
Jason Dana CostaHave you ever come across a team that was really struggling in the or a part of the organization that was really struggling and you kind of need to change your tactic and leadership to get them where you know you want them to be or get them to realize where they needed to be?
Eric PerryPerhaps tell us a Tory about that? Yeah. One of the departments at my facility has been a work in progress since I've started. It's gone through some leadership change, and I think the pieces are in place right now. But getting it to kind of function with a degree of autonomy without some level of micromanagement, which I'm very much against. I think the team is starting to come around, but there is that one team that has struggled, and it's one of the more important teams. It's our intake department. And getting everything to work as it should, it's not strictly staff related, it's part of its operations, part of it is state mandates and what we can, can't do, and getting everything to just function well has been a little bit of a challenge. But I think the leadership of the team is in place, and it's just getting everyone to really look at it from a team mentality.
Jason Dana CostaAnd what tactics can you use them to try to get that realization perhaps already occurred because it sounds like you're on your way.
Eric PerryYeah, I've definitely seen improvements. And again, we've made some leadership changes with the department earlier this year, and it's just acknowledging the work that the team is doing. And when you've got a patient coming in, you've got a packet in a referral source that may or may not be accurate. You don't know. And it's not too uncommon to, you know, I've got my sheet of paper and this is who I'm expecting to have walk through the door, but this is not who's walking through the door. So there's always that you don't know who's coming in the door. So there's a safety component, and it's just getting everyone focused because with intake, it's kind of feast or famine in that they're absolutely slamming with packets coming in or intakes, or it's really quiet and crickets. So keeping them motivated, keeping them driven has been a little bit of a work in progress. So we have seen some turnover with that department, and as we're replacing some of those pieces that have left, I think we're seeing a little more cohesion with each step. I've got new employee orientation that starts today, and a good handful of my people, once or twice a month, depending on hires, but a number of the people that are starting today, tomorrow are intake. So I'm very optimistic that we're continuing to get the pieces in place to get that team to be really self-sufficient and autonomous.
Jason Dana CostaWould it be correct for me to assume you you've done some recent hiring around this? It sounds like you have.
Eric PerryIn that department. With leadership, that changed. We needed to bring in an assistant director. Some of the staff had left because of those changes. I just had three individuals that left within a very short period. Actually, if you count everyone within like a two months time frame, I lost about five or six individuals. Wow. That's big for Intake team. Other than one or two core players, the department over the last six months is brand new.
Jason Dana CostaWow. So then if you have these many individuals joining you, there's one question I was curious to ask. When someone joins your team, you're always looking for that one quality that doesn't necessarily show up on their resume, but for you predicts some long-term success for your team. I'm curious, as you've got this new team, was there something you can point to that was one of those kind of things that was like, yep, this is a member that's right for this team?
Eric PerryWell, I think a resume is what gets you in the door for an interview. Yep. And it ends there. And I'm also very cognizant of the fact that not everyone is completely transparent and honest on the resume. That's the truth. I've experienced it. So I think I feel really strongly like I read the resume and I want to know who's coming in, and I make the determination, yeah, let's bring them in. The resume is great. From that point forward, I really don't give a damn about the resume. I also am very much against, I've worked some larger facilities that you need to follow the scripted questions, and you cannot deviate. So if you're interviewing five, 10 people, you need to measure them on the same metric. Very objective. And I'm not a fan of that because it's always the same questions. They're always so expected that anyone that's either planned for an interview or has gone through interviews knows these questions and has a canned answer in their back pocket ready to go. So I don't do that. I'm far more concerned when someone comes in. I want to know who you are as a person. I have your resume, I read your resume, I know what your experience looks like. Who are you? What drives you? I want to know what makes them want to do the work that they do. And probably more important, especially at a facility like mine, where you need to function as part of a team and a team that's part of a much larger team of multiple teams. Yes. I want to know that you could function across lines. Nursing and intake, it's not uncommon to have some some butting of heads. My nursing department does a really good job of wanting to make sure that everyone is safe in the hospital. My intake department, at least previous leadership, their only concern was we need to fill the beds. So there was a constant power struggle between the two. So when I have someone that comes in for an interview, it's all about are you going to fit the culture here or wherever? And what do you bring to the table from a personal standpoint? I will tell you that just after I started, and I've been at the hospital now rather for about three years, when I started, I didn't have a social work director. So one of the first things that I did is like, we need to get this posted. And I am not in a rural area by any means, but surprise Arizona, which is where the hospital is, is enough outside of Phoenix that I'm not getting a lot of Phoenix applicants. So when I posted that job, I literally got a pool of one to choose from. And her resume was great clinically, but she completely lacked leadership experience. She had none. And I've been very vocal with her about this. And I said, if you were fighting against two or three other people, I never would have even called you in for an interview. So she knows this. But I thought, let me bring her in just because I've got nobody else to choose from and I need to fill this position. So let's just see what she has to say. She might surprise me. And she's younger, and again, at the time she had no leadership experience. And she walked in with this attitude of, I mean it's appropriately or sincerely, this attitude of, I know how to do this job and I'm very confident in my ability. And she sat and she not only had great answers, but she clearly owned those answers. And I was really impressed with the lack of congruence between who presented in my office and her resume and how thin it was. So it was pretty easy, even though I don't like to hire from a pool of one ever. I felt much more comfortable. Like, let's give this a shot. And she's been with us over two years now, and she's been an absolute rock star.
Jason Dana CostaSo if I'm hearing you this succinct thing you're looking for that's not on the resume, it's that sort of connection to quality and why they're doing this work. What, as our title of our podcast is what makes the work worth it to them. Yeah, fair.
Eric PerryYeah, exactly. Yeah. And she just she had this attitude and she's shown it consistently through her time there. And I try to emulate, not emulate, but I try to I've always been kind of the same way is that first and foremost, I want to support you, and I will always do everything I can to do that. That being said, there are still expectations for any position here. Yeah. So I will support you up to a point, but then it becomes we need to have a different conversation. And she does a really good job of being her expectations, they are very clear-cut, but she also is very much supportive of everyone in the team. And I've always been the same. So that's probably one of the reasons when I interviewed her that I saw a lot of myself in her from a leadership standpoint. Oh, wow.
Jason Dana CostaSounds like she's a great actor.
Eric PerryYeah, she is. She's great to work with. And I'm really blessed that all of the leadership at my hospital, every one of them are great to work with. This is one of only, despite the difficult nature of the job, this is only one of a couple jobs I've had my entire career that on a Monday morning, I'm looking forward to going to work. Oh, wow. That's fantastic, Eric. That's actually true. I've had maybe one, two, one, maybe two other jobs that I'm really looking forward to it. And again, the thing with a level one hospital is what I'm walking into Monday morning, it can be very different from where I left Friday afternoon because of patient turnover. Yeah. So you're always walking into a little bit of a eh, I don't know what I don't know what I'm going to get into. But despite that, I look forward to getting there. How is your weekend? How is everyone doing? What do we got going on today? And it's just the cohesion there is refreshing. That's fantastic. Yeah.
Jason Dana CostaWell, very exciting for you. And for a job. Yeah, it really is. He's been a little bit three years already in. So for it to still feel that fresh is must be very exciting.
Eric PerryYeah. And we just started expanding. When I started, there was some chatter about do we want to expand the hospital? But it was just kind of lunchtime chat. But about a month, a little over a month ago, we broke ground on the lot right next door to us. We're adding an additional 24 beds. So the excitement about literally seeing, I could see it from the window of my office, literally seeing construction of we're almost going to double in size. And the ex and the excitement that brings with it. And just to know that between myself and some of our other leaders, we were part of the planning of this, having those pre-discussions, meeting with architects and contractors. And the way it's unraveled has been an incredible learning experience and just the degree of excitement. And I just can't wait until we have that certificate of occupancy and I could walk the halls of what's going to be our new facility.
Jason Dana CostaOh, that's fantastic. Very exciting. I'm gonna have to watch you guys online to see about your expansion there. So I Every leader has decisions that are hard to make, but that you can't avoid. And I love uh work the work here to ask those kind of questions. A story about uh one difficult decision that ultimately you made the organization stronger because you had the courage to do so. I was curious if you had a story about that that you've done. Maybe not this organization currently, because you have lots of great things happening.
Eric PerryBut Avia Breyer, one you were at? No, I would say this one. Because of our smaller size, we don't employ our own psychiatric group or psychiatrists. We have a third party coming, so we contract with them. And when I started, the group that we had for the most part was really good. The nurse practitioners and psychiatrists I had on site were good, but there were limitations and there were some gaps that I felt really needed to be replaced or upgraded, I should say. So we started to have those discussions about do I want to move in a different direction? Which is as a psychiatric facility, I mean, we're very much tied to our psychiatric group. We need them. I mean, all of the departments really, but you know, they're the ones obviously prescribing all the medications. And as a level one facility, we're basically a stabilization unit. And a lot of that comes down to medication. So the recognition was there that a change needed to be made, but is that a boat you really want to rock? And sometimes people are reluctant to make the change because change is difficult. And most of us, at least to some degree, are creature of habit. But I finally made the decision let's bring on a new group. There's a psychiatrist that I had known from a larger hospital out here. He and I began having some early discussions, and we kind of came up with a framework of how that would work. And over the course of a few months, we got them credentialed. I had parted ways with our previous psychiatric group, and we brought the new group in. And obviously, with changes like that, there are some growing pangs, and getting everyone up to speed and on board took a couple months, but in no way, shape, or form do I regret making that change. The group that I have now is outstanding. They really care about the patients. They're directly involved with us on an administrative level. Everything is a cohesive approach. So it was a really scary change to make because you don't know what could potentially happen. But it's one of those things like if it works out well, it's going to be well worth the work. And this is a great example of where once that once the death settled, there's nothing about that transition that I regret.
Jason Dana CostaWow. So was that going from an outsource psych team to another outsource type team? Or two, all right.
Eric PerryAnd what's the most difficult group to convince? Potentially the nurses, I would guess. Yeah, because they're the ones that are essentially working the most closely with them. And there obviously there was the apprehension because the end it was primarily the nurse practitioners that were on site every day, but they were great and the interactions were great. So it was the a lot of the feedback I got was do you really want to go there? Do we really want to rock this boat? And there were just some gaps that I felt needed to be filled, and I just wasn't, I wasn't sure that the group we had in place at the time, and this is nothing against them, it was just with as as thinly spread as they were, I didn't know if they were able to do that. So we ripped the band-aid off, we made the decision to change. And the group that I have now, it's kind of co-medical directors, and I've got typically one of them in the building every day. They're always popping in my office. How's things? What's going on today? What do we need to do? So they work as part of the team. They're open to feedback, both administratively and clinically. They want to hear from the techs and the nurses their feedback on patients because if they feel like a patient needs to stay longer or leave earlier, and the rest of the team disagrees, they're all ears and they want to have that open conversation about what's best for the patient.
Jason Dana CostaWow. So you've done some pretty major changes there. You're in the process of rebuilding your entire take team, which is the evaluation of people coming in initially, and then you've really kind of pivoted your care team, because I agree with you 100%, your site team and medication in stabilization. It's one of the key tools that you do to deploy good health. And you've been there about three years. So although you've been there for a while, there's still pretty broad sense of the terms new. So did you see these changes when you first came in, or is there because of this podcast here, is worth the work? And I truly like to find organizations that leadership sees that are worth rebuilding, and then ask the question why? And I was kind of curious if these are two things you saw when you first got there, or was there somebody else something else while you were doing that interview process to join this organization or when you first got there that went, yep, this is a great place, and I know I can make a significant impact.
Eric PerryOn the surface, the team was functioning really well, but from a medical leadership standpoint, they weren't as involved as I felt they needed to be. We had an interview with our state licensing department came in, which they do with all facilities periodically, and they wanted to be with our medical director at the time because he was so spread thin across other facilities around the valley, he didn't have as much working knowledge of our hospital. And I thought that was a real disservice. And again, I can't stress enough, there's nothing against him. It was just a matter of with all of his hands in so many cookie jars that he just could not give us what I felt we really needed. He typically wasn't there very often. He wasn't seeing patients directly himself. And now by contrast, I've got my two medical directors that are full board certified psychiatrists that are seeing their own patients every single day.
Jason Dana CostaWow, that's fantastic. Having a medical director staying connected to patients and not an administrative job is super important in behavioral health, in my opinion. Uh it really stays connected to the community. Well, Eric, I've really enjoyed having you here as a guest here on Worth the Work. To remind everybody, this is about Eric Perry, who is the director and CEO of Avenir Behavioral Health in Arizona. And thank you so much for joining us.
Eric PerryThank you, Jason. Really appreciate it.
