Metro Pulse/Insights/Ken Badal

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by Joe Sullivan

When Ken Badal took the helm of the Helen Ross McNabb Center in 1973, it had about 60 employees and a budget of $1 million. Its primary role was to help the droves of mentally ill who were being released from institutions as new medications permitted them to live, however fragilely, in the community.

Providing outpatient treatment to mentally ill adults remains an important part of McNabb's mission. But during the 30 years Badal has served as president, the scope and scale of McNabb's services have grown enormously. An array of programs for disturbed children of all ages, alcohol and drug rehabilitation programs, and vocational assistance have all been added, along with new facilities to support them. McNabb's reach extends into the schools, the jails and homeless shelters. Its annual budget has grown to $21 million, and its staff of nearly 400 includes 11 psychiatrists, 76 master's level clinicians and 35 nurses.

As Badal nears retirement on June 30, all of the above stands as testament to his leadership in making McNabb one of if not the foremost community mental health center in the state. What makes his accomplishments all the more impressive is the fact they have come amid repeated threats to the governmental funding on which McNabb depends for most of its sustenance.

"Ken has been a great manager under difficult circumstances," says Sam Beall, who served as chairman of McNabb's board during the 1990's. "He helped the center survive through the ebbs and flows of public funding," adds Dr. Clif Tennison, a psychiatrist who has been McNabb's chief clinical officer for the past 20 years and somewhat of an alter ego to Badal, the chief administrator.

Perhaps the biggest single challenge to McNabb's treatment regimens, if not its very existence, was the advent of TennCare in the mid 1990's. Until then, Medicaid had paid for the treatment of most of the 5,000 adults and 2,000 children under its care on a fee-per-service basis. But TennCare imposed a per capita basis for reimbursement that required McNabb to continue treating all its patients but cut its payments almost in half.

As painful as it was to do, Badal had to cut McNabb's staff accordingly. Hard-nosed administrator that he is, he did so in a way that averted a loss even in this worst of years.

Some services inevitably suffered, but McNabb developed new approaches to minimize the impact of the cuts. "To try to serve more people with fewer staff, we established multidisciplinary teams of doctors, nurses and social workers," Tennison recalls. And the team approach was extended to a program known as PACT that concentrated a staff of 12 on meeting the needs of the 100 most severely ill. "Ken was instrumental in helping us get a specialized TennCare grant for PACT, and the savings to the state have been remarkable by way of keeping them out of the hospital," says Tennison.

Another McNabb program that seemed destined for extinction at the time was its therapeutic nursery that serves pre-schoolers who've suffered from abuse or neglect. Badal is credited with getting funding from United Way that enabled the program to survive.

The TennCare experience led him to seek diversification so that McNabb would never again be so dependent on a single source of revenue. The biggest single step in that direction was a move into alcohol and drug rehabilitation, accomplished via a 1997 merger with the Detoxification Rehabilitation Institute (DRI). Since more than half of the mentally ill also have substance abuse problems, it was a natural extension of McNabb's sphere. DRI's programs had an excellent reputation in the community, but its facilities were obsolete.

Badal spent countless hours with the prospective donor of a site for a new facility in Blount County convincing him of the need. The new Gateway Center on that pastoral site offers a three-to-five month residential rehab program for teenagers. A separate new facility called Center Pointe on Ball Camp Pike offers a 28-day residential rehab program for adults.

The DRI merger was only one of many extensions of services and funding sources that Badal initiated. "His tenacity in seeking a diversity of funding sources has made a huge difference and serves as a great example of accessing all resources and delivering a variety of services based on need," says Elisabeth Rukeyser, until recently the state's commissioner of mental health and retardation.

Badal has benefited greatly from the efforts of dedicated board members who have spearheaded McNabb's fund-raising campaigns, along with its vice president for development, Andy Black. In addition to the Gateway Center and Center Point, these campaigns have raised the money to build McNabb's Children and Youth Center on Arthur Street and a just underway, $5 million facility off Central Avenue to which adult and administrative services will be relocated from the annex to UT Hospital that housed all of McNabb's operations when Badal came aboard.

"Ken was a model in professional administration of a not-for-profit," says Black. "Unlike a lot of others, we never had to huddle in fear because he saw to it that we were strong financially and strong strategically."

Badal's successor is Patti Hall, who was executive director of DRI prior to the merger and has since served as McNabb's vice president for community relations. She will have big shoes to fill.