PROFILE: Welcome home, world traveler

Monika Fischer-Massie, executive director of Welcome Health, Northwest Arkansas' first free health clinic, was born in a town named Garmisch-Partenkirchen. Good luck pronouncing that, though it rolls easily off of Fischer-Massie's tongue, accompanied by her soft German accent. The small town -- population approximately 27,000 -- is located in Bavaria, Germany, in the Alps on the Austrian border. Google it, and you'll find photo after photo of a town green and lush in the summer and sparkling with glittering snow in the winter, with streets lined with buildings so charming they look as though they're straight out of a Disney scene shop.

Fischer-Massie's childhood here was as idyllic as you might imagine it would be after perusing these photos.

"If you can, imagine a Bavarian town in the mountains, with cows and trees and woods," she says by way of a description. Garmisch-Partenkirchen was a tourist town, a prime destination for skiers in the winter, but also busy in the summer. "We skied, ice skated, swam or hiked in the mountains.

"My mother always entertained. She loved people. She was certainly an extrovert. When I was little and [also as] a teenager, I was always embarrassed about my mother, because she would never find a stranger. There are benches around town for people to sit on when they go for walks, and she would always sit down on a bench where someone else was sitting so she could start a conversation. Certainly, I have discovered that I have become my mother. I'm just like she is -- I love people. If I go for a walk, I prefer to sit down with somebody and start a conversation than to sit by myself."

After graduating from high school, Fischer-Massie spent two years as a ski instructor in the winter, traveling in the summer.

"I worked for six days a week, and, on the seventh day, I would go skiing," she says with a smile. "I guess I wasn't sure what I wanted to do for the rest of my life."

It's not very surprising that, after those two years, Fischer-Massie decided she wanted to pursue a career in the hospitality industry: Her mother ran a bed and breakfast while her father was a chef, so it seemed like a natural fit. But first, Fischer-Massie set off to have an adventure, enrolling at the University of Alaska and attending college there for six months.

Fischer-Massie was -- and is -- always up for adventure.

"I never have any fear of going anywhere," she says. "If I go abroad, I'm not fearful. I'm fearless, because I know I can deal with whatever came up. I guess it's part of my family -- my grandfather came here around the turn of the century to Silver City, Idaho, and worked in a brewery with a friend from Germany. I guess I inherited that sense of adventure."

Even for this intrepid traveler, though, Alaska was a bit tough.

"It was very cold," she says with a smile. "It was very dark. I was there in the winter months, so it got light around 10:00 in the morning and then it got dark around 2:00 or 2:30. Pitch dark. I was riding public transportation, and it was always a very cold wait for the bus to take me to school and home again. It was a great experience, because it was in a place that I had never been. So I learned a lot about the culture there, and I learned what it was like to go to school in the United States."

At the end of the six-month period, she headed back to Garmisch-Partenkirchen, where she served in an apprenticeship program in the hospitality industry.

"It was exciting," she says. "It was challenging. It was lots of action. We were always busy, there was no down time, and I certainly had the energy for that. I was always meeting new people and working in an environment where I was meeting people from all over the world. I worked with Italians, Norwegians, a person from Spain ... it was an international working experience in this small town of 27,000, and that was very interesting to me."

Ambitious and energetic, Fischer-Massie knew she wanted to pursue additional training in the field but soon realized that would be impossible to do in Garmisch-Partenkirchen. Germany, she says, offered no bachelor's degrees in hotel and restaurant management -- so she headed to the Conrad Hilton College of Hotel and Restaurant Management in Houston.

For Fischer-Massie, heading back to the United States was a dream come true.

"I've always wanted to be in America," says Fischer-Massie, who became an official American citizen this year. "That was always my dream. When I came here, it was like I belonged here. It didn't feel like a stranger in a strange country."

Change of heart

Fischer-Massie would meet her first husband in Texas, where the two then had a child. After she received her bachelor's degree in 1986, the family moved to Mississippi, where Fischer-Massie pursued her MBA and her husband sought a law degree. They then moved to Fayetteville so he could pursue his master's in law. Once in Fayetteville, Fischer-Massie started a Ph.D. program in health science -- because as much as she loved the hospitality industry, she had reluctantly realized that it was incompatible with having a family.

"There was a shift," she says. "I knew that I could not stay in hotel and restaurant management. I had a family now, and it's a 24/7 job, especially during the holidays. That's what I experienced with my father, and I couldn't do that with my child. I started out just taking master's-level classes in public administration, and some of the electives were heath science. I thought, 'Wow, this is great. This is what I want to do.' It was very interesting to me."

Fischer-Massie crossed off another state on her tour of the southern United States when she left Fayetteville for Louisiana to teach, first at Southeastern Louisiana University in Hammond and then at Northwestern State University in Natchitoches. She liked both appointments and loved Louisiana -- the food, the people, the traditions. But love lured her back to Fayetteville after around three years. Fischer-Massie had divorced prior to moving to Louisiana, and over the course of her time there, a longtime friendship turned romantic.

"I met him [in Fayetteville], and we were friends for probably three years, best friends, and then we were more than friends," she says, smiling. "I was willing to come back here and give it a try."

"She is just a very kind, honest and sincere person that you can't help but like," says her husband, John Reagan.

The two would ultimately marry and have a child together, and Fischer-Massie logged some time as a stay-at-home mother. It was during this time that she accepted a position on the board of Welcome Health, which was, then, called the Northwest Arkansas Free Health Center.

"The mission of the clinic was of interest to me, and I wanted to contribute," she says. Founded in 1986 by activist, volunteer and former justice of the peace Jessie Bryant, the clinic added dental services in 1988. It was the first free clinic of its kind in Northwest Arkansas and was immediately in demand, promptly outgrowing first its home in a church basement and, later, a space in the basement of the old city jail.

Fischer-Massie accepted the position of executive director of the organization in 2002.

"We had a great feeling about that," says Dr. Kenton Ross, who was a board member at the time. He also served as a volunteer and, later, as the organization's dental director. "She hit the ground running. She immediately decided to get things in order, so we could tell the world about how much work we were doing and how important it was. She provided a sophisticated fundraising approach and began building what the clinic is today. It's all been upward movement from that point forward. I'm amazed at how much we do, and that's happened under her leadership for the last 17 years."

"I knew that she was good willed, she was competent, she had a PhD in the health field," says Reagan, who was also a board member then (he stepped down when his wife became executive director). "I knew she was a great researcher, and I knew she was tenacious. I did not know that the clinic would become what it has become under her, though."

Fischer-Massie assumed the position of executive director years before the Affordable Care Act, legislation that she says helped ease the rate of the uninsured in Northwest Arkansas.

"It was a lot worse then, because many, many individuals didn't have health insurance and didn't even have access to health insurance," she says. "Unless you paid for it yourself or got it through your workplace, there was no access to health care. If you were a single mother, low income, you may have been eligible for Medicaid. Buying a policy on their own was not something that low income people could afford. After they paid for their rent, their food, their clothing, their gasoline, their car payment and for their children, there were no funds left for health care."

Fischer-Massie points out that, prior to no or low-cost clinics like Welcome Health settling in Northwest Arkansas, the uninsured patient's only recourse was visiting the local hospital emergency room for health care. A 2015 Kellogg School of Management at Northwestern University study found that hospital costs increased an average of $900 for each uninsured patient they treated. The study called hospitals "insurers of the last resort."

"And, certainly, if somebody has a chronic illness, the emergency room is not the place to go," says Fischer-Massie.

Poor access to health care also prompts the uninsured and low-income patients to put off their visits to seek treatment. This can increase the spread of communicable diseases, as well as allow a treatable illness to get worse.

"Many people who don't have health insurance and don't have access to care wait, in the hopes that the illness gets better," says Fischer-Massie. "But then it gets worse, and it progresses to a state from which it takes a long time to recover, and it's more expensive."

Fischer-Massie points out that access to health care benefits society as a whole -- much like ripples become waves.

"Some people don't realize that the cost of the uninsured affects everybody, not just the uninsured person. If somebody is sick and goes to work , the productivity will decrease, which affects the employer. If a child is sick and cannot go to the doctor, how can that child concentrate? If the child is sick often and doesn't go to school, that influences grades, and then it influences graduation from high school and influences success in life. It's not just one person access to health care affects, it's many people."

Care and caring

As Welcome Health continued to widen its access to uninsured and low-income patients, it continued to experience growing pains. In 2013, with the help of renowned architect Marlon Blackwell, the organization renovated and moved into a building on the old Washington Regional Medical Center campus on Woolsey Avenue in Fayetteville. The building's award-winning design is sleek and minimalist, with an abundance of sunlight shining through the wide windows. Fischer-Massie says the beauty of the building is part of the organization's attempt to show their patients that they are respected and valued. The clinic's name change -- from Northwest Arkansas Free Health Center to Welcome Health -- was a result of a patient survey that revealed that some patients felt the title "Free Health Center" was stigmatizing.

"When people tour the facility, it's always said, 'This is not what I expected from a free health center," says Fischer-Massie. "That makes us very proud.

"At the other facility, some patients would not take care of the facility. They would spill things and leave their empty cups and so forth. Here, it never happens -- we've been here since 2013, and it just never happens. The patients respect this facility. It's LEED certified, and that's what our patients deserve."

"She was bound and determined to do whatever it took to get that LEED certification, and she got it done," says John Moores, former development director at Welcome Health. LEED Certification indicates the building is a "green" building: healthy and energy efficient. "It's not easy to do. There's an extensive list of things to do in terms of recycling all of the materials you're taking out and the use of all of the products coming in. She was on top of that from minute one."

For Fischer-Massie, taking care with those kinds of details and providing a beautiful environment is all part of offering top-notch care to Welcome Health patients.

"Whether they have money or not, they're human beings that need services, and we can offer that for them," says Fischer-Massie. "They're treated with respect, and that's reflected in the comment cards we've gotten."

The comment cards the health center have received from patients, in fact, are quite moving. "When I needed you the most, you healed me, you were there for me," reads one. "I was at a loss due to no dental coverage, and Welcome Health set me up with Dr. Jenna and her team, and they have helped me regain my smile," reads another.

"She's taken that clinic through a major renovation that dramatically improved the facilities we had," notes Ross, pointing out that Blackwell's design was featured in a book titled "Design for Good: A New Era of Architecture for Everyone" that explores innovative architectural designs that help bring restorative surroundings and dignity to the poverty-stricken and disenfranchised. "That book talks about using architecture to do good, helping to set the mood of the patients, especially when they come through the door. They don't feel as though they're going to a second-rate clinic, they feel as though they're going to a world class facility. Because they are."

Uninsured and low-income adults and children can make appointments and be seen for a pretty wide variety of medical and dental issues, and, says Fischer-Massie, if their medical needs go beyond the scope of the clinic, Welcome Health can help facilitate their care.

"We have set up a network of services for referrals," she says. "Some of our referrals see patients either pro bono or they charge a nominal rate or they set up a patient on a payment schedule. Basically, when a patient comes here, they will always be helped. If we cannot help the patient here, we refer them to someone who can. This is never the end of the road for the patient. We have a very generous community -- many of the doctors and dentists may not come here to volunteer, but they see people in their own offices for free."

Fischer-Massie says the health center has around 50 professional volunteers -- doctors, dentists, nurses and dental hygienists -- and around 25 lay volunteers that include medical students.

"What's a pleasure is some of them graduate from medical or dental school and then come back as volunteers," says Fischer-Massie, a note of pride in her voice. "That's a success story -- when you see them as young students, and they come back as professionals. It's a great accomplishment for them and also for us. We're very proud of all of our students and all of our volunteers, I think it's great that they want to give back to their community."

Last year, says Fischer-Massie, the health center saw 2,700 patients and provided 25,000 services. The kind of medical care provided by Welcome Health doesn't come cheap, and if you ask Fischer-Massie what her biggest challenge has been over these nearly 17 years, she answers immediately: funding. It's always a struggle.

"There are still people without insurance, even with the change in health care reform," she says. "And with the change in the individual mandate, it's pretty obvious that more people will be uninsured if they are no longer required to buy insurance -- so we'll have more business."

Fischer-Massie says the majority of their funding comes from foundations.

"Wal Mart has been very good to us, Delta Dental, Blue Cross Blue Shield," she lists. "United Way of Northwest Arkansas. Also, individuals, civic clubs. Washington Regional is a supporter of ours -- they give us monetary donations but also in-kind donations, supplies and services. Quest Diagnostics provide free labs for our uninsured and low-income patients."

"We talked to all of the usual suspects when you think of fundraising in Northwest Arkansas, but we still needed a lot of help from individuals, as well," says Moores. "I know the term 'team effort' is a cliché, but it was. It was probably one of the highlights of my professional career."

"Without the support of the community, we could not operate," notes Fischer-Massie. "We're very grateful for our community, and we need continued funding in order to provide continuous services."

When asked what she thinks would have happened in Northwest Arkansas had Jessie Bryant not been successful in her quest to provide free dental and health care to those who need it, Fischer-Massie pauses for a beat, then answers.

"I've heard people say that they were unable to get an appointment for a tooth extraction, and so they just pulled the tooth themselves," she says with a slight wince. "That's horrible. Nobody should have to do this. Everybody should have access to basic services.

"We're all human beings. Why don't we all get the same services?"

NAN Profiles on 04/08/2018