Dealing with such a unique population requires Karen to take nothing for granted. Her determination to make a difference in the lives of others, along with her infectious sense of humor, are the driving forces that keep Karen moving ahead. The diversity of the people that she touches daily, coupled with her 13 years of experience as a case manager, has convinced Karen that the myths concerning the homeless are just that -- only myths. According to Karen, people who are homeless are far more than just the "stereotypical drifter, drunk or bum; a homeless person may be someone with a job, a runaway kid, a member of your family or even you or me," she explains.
Whenever she was confronted with a problem, one of the most influential people in her life, her Aunt Beaulah, would always extend to Karen these words: "You can either complain about it or you can change; it's your choice." Although the nature of her work leaves plenty of room for complaining, Karen has chosen to live by her aunt's philosophy and to pursue change for homeless people living with HIV. The many grateful people whose lives she has helped turn around are proof that change is possible, even for those who society may think have little chance of succeeding.
How long have you been working with people living with HIV?
I have been working with people living with HIV since 1989.
Can you describe how your work has changed since you first started?
When I started, we had only five cases of HIV in Duval county, medical care was delivered out of a corner of the STD (sexually transmitted diseases) clinic, AZT (zidovudine, Retrovir) was the only thing we had to offer, and case management was just a glimmer in someone's eye. Now, we have a multitude of medical providers, nine case management agencies, a wonderful lead agency and more medications than we can shake a stick at. The clients in northeast Florida receive wonderful care and treatment.
If I were to follow you over the week, what would I see you do at work?
My days start at around 6-6:30 a.m. with the morning coffee clutch. My clients who are living on the streets or in emergency shelters stop by almost every morning for a cup of coffee and a chat. I obtain location information on them. I learn who has a medical appointment and who needs one and get them hot showers and meals. From there, you would also see me assisting clients with applying for Social Security benefits, Medicaid, food stamps, housing assistance and ADAP.
You would also see me discussing their personal issues, dealing with crisis management and assisting them to make good choices and informed decisions concerning not only medical care, but also life issues. My workday is rather unique!
I work with the homeless and marginally housed community, so making appointments is a challenge. It is a challenge not only for my clients, but for service providers as well. I spend a good part of my day hunting down clients and shepherding them into medical, mental health and rehabilitation facilities. Several times a day I directly link clients with emergency care. I coordinate with medical and social service providers to ensure, as much as I can, that my clients are medically compliant. Most of my clients have severe mental health and/or substance abuse issues. My greatest task is to quickly gain their trust. This is crucial to their care and treatment.
On Thursday nights, I coordinate the Title III, STD and HIV testing clinics at the I.M. Sulzbacher center for the homeless. This has proven to be a Godsend for the homeless population. It provides direct medical care and a hot meal. Two or three other evenings during the week I work on the STD outreach van doing the 20-minute Ora-Quick HIV testing.
What's the best thing about your job?
Helping people go from homeless to more permanent housing situations, watching their health improve and helping them reunite with their family. Also, when a homeless person tells me "thank you," I know that it's from the heart.
What's the worst thing about your job?
The way the general population sees the HIV-positive homeless community.
What have been your greatest successes in your work? Greatest failures?
I guess my idea of success is different from other people's. Success is when a client comes back ... when they keep a medical or social service appointment without my prompting them. When they BOUNCE into my office grinning from ear to ear to tell me about their new job or new home or when they slap their lab results on my desk and say, "Look, non-detectable!"
My greatest failure would be not being able to reach a client.
What is the biggest challenge you face as a case manager/social worker?
The complacency. HIV has been around for 20 years and when you say to kids today, "Be careful, HIV is out there." They are like, "Yeah whatever." They did not see what we saw back in the early days. People have become deaf to it and that is the thing, as a social worker, that blows me away.
For the most part, what do you think is the biggest risk factor for HIV?
We are still living with the stigma of HIV/AIDS, the fear. This will probably be a very unpopular answer, but ... we have come to a place of not talking about HIV/AIDS, not educating our youth ... our children, to the risks involved with unprotected sex and injectable drugs. "Just Say No" doesn't work. Turning a blind eye and deaf ear to it doesn't work. In the early days of HIV we were on the streets educating and talking. There was an educational fund-raiser every weekend. We were active as a community in finding a cure and stopping the spread of HIV. The biggest risk factor is complacency.
What is the most important/memorable/useful thing you have learned from the people you work with?
The most memorable thing I learned from my clients is this direct quote: "I was ready to end my life. I was so broken. I needed a safe place for my family to stop and start over. I was so scared that I kept on walking until I realized I had nowhere to go. No house. No job. Nothing. Homelessness and AIDS has made us ashamed of our bodies, our thoughts and our feelings. AIDS robbed us of certain unalienable rights. AIDS is sitting here with us, in the streets. It haunts every ones thoughts. AIDS' most destructive work was done deep inside our very souls, in those dark unexplored areas. Deep down we came to believe that we were dirty and, even worse, that everyone else was clean and wholesome."
How do you maintain a positive outlook and avoid burning out?
I laugh a lot. I tease and cut-up with my clients. As you know, attitude is everything.
If you weren't doing what you are doing now, what would you be doing?
I would probably be working with child abuse issues.
What do you think are the biggest problems people living with HIV face today?
Budget cuts affecting service provision.
Do you see a lot of women now? What are their lives like?
Yeah, I see a lot of women and single mothers who are struggling with balancing their families with their health issues. The mothers that I see are homeless. Their health takes a back seat to their children, to finding a home and to securing food. By the time I see them, their health has deteriorated to a point where they have to be hospitalized.
Do you work with any particular population of people? If so, can you detail. What are the specific challenges these people face.
The first and most important thing to realize about the HIV-positive homeless population is to realize that the tired old stereotypes concerning them are just not true. You'll discover that the homeless are more than the stereotypical drifter, drunk or bum. A homeless person may be someone with a job, a runaway kid, a member of your family or even you or me. Many people with HIV/AIDS have lost their homes because of discrimination, illness and hospitalizations caused by HIV-related illnesses. Most will also find their health insurance and incomes drained by the increasing costs of medications and health care. Millions are among the hidden homeless -- people who are one crisis away from losing their homes. Some are 48 hours away from eviction or about to leave a hospital with nowhere to go. The homeless HIV/AIDS community has not moved forward. Seemingly, it has kept going backward in terms of real human living conditions; only the scenery changes. This view hasn't changed in over 20 years. Tragically, many individuals with HIV/AIDS die before they are able to receive housing assistance. Efforts to ensure HIV/AIDS emergency housing assistance often encounter chronic funding shortfalls and bureaucratic indifference. All people infected with HIV/AIDS need safe, affordable housing and supportive, appropriate health care. Emergency housing funds should be available for persons with HIV-related illnesses who are in danger of losing their homes and housing assistance should be available for those already on the streets.
Who would you dedicate this award to if you could?
Daddy Mack 1940-1999
Billy Praiter 1939-2001
Those were the men who taught me courage. Each one of them, as they got closer to not being with us anymore, faced it straight on with no regrets. They died with more dignity than any man or woman who I have ever seen.
Where did you grow up?
I spent my formative years in New Zealand.
What did you want to be when you were a kid?
What kind of work did your parents do?
My father is retired from military service. My mother retired from civil service. Both are now enjoying watching their grandchildren and great grandchildren explore the world. Their favorite phrase is quickly becoming, "I told you so."
When did you decide you wanted to be a social worker?
I thought I could make a difference and I guess, in some small way, I have.
What other jobs have you had?
What made you decide to do this kind of work?
I had a dear friend who died of AIDS in the early years of the disease. I admired his courage, especially in the face of the fear that surrounded him.
Who were the most influential people in your life, both professionally and personally? Please explain why you have given this answer.
Dick Neimann. He and a small handful of people fought for more service and better care here in northeast Florida in the early 1980s. Mother Theresa, who dedicated her life to service. And my great Aunt Beaulah who always said, "You can either complain about it, or you can change it ... it's your choice."
What do you do in your spare time?
Play with my grandsons, garden, and fuss at my dogs.
Do you have a partner?
I have three wonderful adult children; a daughter, 25, and two sons, 23 and 21. I also have the three most beautiful, clever and smart grandsons in the entire world.
Three spoiled rotten little Corgi's.
Where do you live? What kind of community is it?
I live in a tiny cottage in one of the historic districts here of Jacksonville. What I like is that I know all of my neighbors. Every Sunday afternoon the smell of fresh cut grass and barbeque fills the air. There are invitations called over backyard fences to stop on over for a burger and a glass of iced tea. On nice evenings we sit out on our front porches and gossip.
If you had any place to live besides where you live now, where would you live?
Nowhere. Jacksonville is home.
What's the best vacation you ever had?
Vacation?! What's that???
What's the biggest adventure you ever had?
I spent 2002 traveling every other weekend as a representative of the Ms. World Leather Organization, gaining exposure for HIV and homeless issues. During that year we raised over 100,000 dollars nationwide.
What's currently on your bedside table for reading?
A collection of short stories by Jack Rinella.
What book would you say has had the most impact on you?
The Red Tent. It's a wonderful book about the strength of women.
What kind of music do you like to listen to? Who are the artists you listen to the most?
Jazz oldies like: Linda Hopkins, Sonny Rollins, Miles Davis, Gerry Mulligan and, on occasion, the Irish Rovers.
Anything else you think it would be important that people reading this interview know about you?
Nothing really. I'm just a little 'ole lady all hopped up on estrogen.