More than 2 million people in Michigan live with disabilities: mental illnesses, intellectual disabilities, or physical disabilities. For these individuals and their families, it is challenging to find living situations that maximize independence while providing needed care. 

Northern Lakes Community Mental Health Authority (NLCMHA) offers adult foster care (AFC) homes that provide such living situations across Crawford, Grand Traverse, Leelanau, Missaukee, Roscommon, and Wexford counties. These AFC homes serve adults of all ages and are funded through Supplemental Security Income (SSI), Medicare, and Medicaid. 

NLCMHA residential services administrator Dave Simpson relates that these AFC homes have been helping people since the early 90s, when Michigan closed its state mental hospitals.
Dave Simpson.
“Think of hundreds, maybe even in the thousands, of people who were served in the state hospitals being moved into community-based settings from an institutional setting,” Simpson says. “These homes were part of that movement to bring them back closer to their homes, communities, and family members.” 

Constructed  to meet the needs of the many different types of disabilities, each home employs a supervisor and 10 residential care aids for four to six residents who either have their own room or share one with a roommate. Limiting homes to these numbers of residents provides more direct and higher quality care compared to AFC homes housing larger numbers of residents.. Rooms are furnished with input from the residents and their families or guardians so they feel like home. 

“I had a guy for years who was a minion’s guy. Then he decided he wasn’t a minion’s guy anymore,” Simpson says, recalling decorating the room in that theme and then redecorating when tastes changed. “He was interested in tropical fish. We even found a station on the TV that had 24/7 tropical fish videos, and it just brought him so much joy.” 

A Northern Lakes CMHA group home.
Homes accommodate individual needs

In 2014, NLCMHA designed one of its homes in Roscommon specifically for individuals living with autism.  

“When you’ve got a person who is on the autism spectrum mixed into a home with people who have more general intellectual, mental, or physical disabilities or mental illness, it doesn’t go well,” Simpson says. “Generally serving people with autism is more successful when they have their own room and are in a home with staff who are trained in how to work with people who live on the autism spectrum.”   

Keeping in mind that some residents don’t do well with change, decorating for the holidays means paying close attention to colors, textures, and the overall aesthetic. 

“Flooring textures is really important because of ambulation issues,” Simpson says, noting that carpeting is usually best. “With the advent of carpets coming in squares, we can replace the squares as we need to due to stains or soils.” 

Licensed dietitians create seasonal menus for the AFC homes based on age-appropriate caloric intake scales for BMI, or body mass index. Meals are modified individually for each resident to accommodate medical issues, chewing and swallowing abilities, and food allergies. 

“We are able to sustain people on G-tubes [gastrostomy tubes] who receive their food and medications through the tube,”  Simpson says. “We even have portable blenders so when residents are out in the community, we can prepare their G-tube meals on outings.”
Northern Lakes Community Mental Health Authority Houghton Lake location.
NLCMHA prescribes each resident an individual plan of service (IPOS) and provides therapy, transportation, and personal care for residents who need assistance in dressing, bathing, toileting, grooming, eating, taking medication, and mobility.

“Ninety percent of the people that I provide care for are not able to arrange public transportation on their own,” Simpson says. “Every home has a handicap-accessible van to take residents to appointments or out recreationally.” 

Residents are evaluated regularly to make sure the homes are providing needed care. If residents require more care than the home staff can provide, they are transitioned to a nursing home. 

Simpson takes great pride in providing this community-based care. AFC homes are vital to keeping people living with disabilities close to their families as well as safe and comfortable. 

“I’ve got people who are still traumatized by their time in the institutional setting because it was not individualized,” Simpson says. “These homes give residents the dignity and respect they deserve to have a successful future.” 

It can be difficult for AFC home staff to navigate individualized care.  Simpson’s key to success has been to work with residents rather than against them. 

“Too often in this business, providers try to score square pegs into round holes,” he says. “By meeting residents at the same level with gentleness and understanding, they can live happier lives.” 

Simpson shares that families and guardians have rarely moved their loved ones out of NLCMHA AFC homes due to dissatisfaction with the level of care. When families have moved a resident, it has typically been to bring them closer to their loved ones. Families and guardians feel  a sense of relief knowing their loved ones are in a caring atmosphere. 

Simpson concludes, “Our home is their home.” 

Genevieve Fox is an award-winning journalist from Detroit. Since graduating with a bachelor's degree in journalism from Michigan State University, she has built a solid background in environmental reporting and previous experience in radio broadcasting and photography at Great Lakes Echo and WKAR. When not working, she loves spending time outdoors and reading a good book. More by Genevieve Fox. 

Photos courtesy Northern Lakes Community Mental Health Authority (NLCMHA).
NLCMHA offices photo by John Russell.

The MI Mental Health series highlights the opportunities that Michigan's children, teens, and adults of all ages have to find the mental health help they need, when and where they need it. It is made possible with funding from the Community Mental Health Association of Michigan, Center for Health and Research Transformation, Mental Health Foundation of West Michigan, Northern Lakes CMH Authority, OnPoint, Sanilac County CMH, St. Clair County CMH, Summit Pointe, and Washtenaw County CMH.