Your loved one deserves a home, not just a placement.

Residential habilitation in Boise, Meridian, Nampa, and Caldwell

24-hour residential habilitation for adults with developmental disabilities across the Treasure Valley. Founded by Cass Neilson, a 28-year veteran of Idaho's DD community.

A GemState caregiver and a resident smiling together at home
0
years in Idaho's DD field
4
Treasure Valley cities served
24/7
on-site support and care
Built to Idaho's 2026 residential-habilitation standards
Background-checked, trained support staff
What we do

Support that builds independence, not dependence.

Residential habilitation is around-the-clock support that helps an adult with a developmental disability live in their own home and grow more capable every day. It is a home, with a dedicated team, not a facility.

A GemState support professional and a resident laughing over a board game at home

Daily living skills

Cooking, cleaning, hygiene, and money skills, taught hands-on and at their own pace.

Community life

Work, activities, friendships, and real connection beyond the front door.

Health & medications

Assistance with self-administered medications, appointments, and everyday wellness.

Positive behavioral support

Person-centered, dignity-first strategies built around the individual.

24/7 personal support

Trained staff on-site around the clock for safety and daily help.

Person-centered plans

Goals set with the participant and their team, reviewed and adjusted over time.

Skills we work on, day by day

Every plan is individual, so the mix looks different for every person. These are the practical skills our support is built around:

  • Cooking and meal planning
  • Grocery shopping
  • Budgeting and paying bills
  • Medication assistance
  • Personal care and hygiene
  • Laundry and housekeeping
  • Getting around town
  • Doctor visits and appointments
  • Communication and social skills
  • Home safety
  • Community activities
  • Building daily routines
Why GemState

I have spent my life making houses feel like homes.

GemState was not started by an investor or a management company. It was started by someone who has done the work, in the houses, on the overnights, for almost three decades.

I have been close to the developmental-disability community since I was eighteen. I started as a direct support professional, tried other lines of work over the years, trucking and security among them, and I kept coming back. The DD field is where the work actually meant something. Helping someone have a better day, and a better life, never stopped being worth it.

In every house I worked, I put the participant first, and I cared most about one thing. I wanted wherever they lived to feel like a real home, not a dorm or a communal center. People do not grow in a place that feels institutional. They grow somewhere that feels like theirs.

"I wanted to build the agency I always wished I worked for."

After more than two decades on the front line, I started GemState to bring everything I have learned together with how care should work today. That includes the people who do the work. When a company truly takes care of its staff, staff can give the people they support their full attention. The company, the staff, and the participant all pulling in the same direction is what makes a place steady, warm, and genuinely good to live in. That is where people learn, grow, and reach their own peak of independence.

I also want to make getting started easier. The path in can feel like a maze of paperwork and red tape, and most families are not sure where to begin. We walk you and your loved one through every step, from your very first question to the day services start.

How we think about care

Good care is not one relationship, it is three working together. When each part is healthy, everyone benefits, not just one side of it.

We take care of our staff

Trained, supported, and respected. Caregivers who are running on empty cannot give their best.

So they can focus on care

Staff who feel valued bring their full attention to the people they support.

So participants thrive

Real support in a real home helps each person grow toward their own peak of independence.

Honesty you can verify

GemState is built to Idaho's 2026 residential-habilitation standards (IDAPA 16.03.21) and is certified by the Idaho Department of Health and Welfare as a Residential Habilitation Agency.

We promised to publish our license number right here the day it was issued. Here it is: Certificate No. RHA-6337, issued July 20, 2026. Verify it directly with the Idaho DHW Division of Licensing and Certification at 877-457-2815 or DDARH@dhw.idaho.gov. Not every provider makes that easy. We think you deserve to be able to check.

Application prepared Reviewed by DHW Certified · License #RHA-6337
Do I qualify?

Find out in about a minute.

Idaho's DD Waiver has a few requirements, and not all of them are obvious. Answer five quick questions for a clear, no-pressure read on whether your loved one is likely a fit for residential habilitation.

Question 1 of 5
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What it costs your family

For an enrolled, Medicaid-eligible participant, the residential-habilitation support services cost your family $0, covered by Idaho Medicaid. Families remain responsible for their loved one's own room and board (rent and food), usually paid from their SSI or personal income.

How getting started works

1

Qualify for Medicaid

Your loved one first needs to be financially eligible for Idaho Home and Community-Based Services Medicaid.

2

Apply for DD services

Submit the developmental-disability application and supporting medical records to your regional Health & Welfare office.

3

Complete the assessment

An independent assessor confirms the disability, its impact on daily life, and the level of care needed.

4

Build the plan

With a plan developer, you set goals and choose services in a person-centered planning meeting.

5

Choose GemState

Select GemState as your certified residential-habilitation provider, and we get to work building a real life at home.

For Case Managers & Plan Developers

A referral partner who actually communicates.

You are matching people with providers who will show up, document well, and treat your client like a person. That is the exact standard GemState is built on, from someone who has spent 28 years on the other side of that referral.

A veteran administrator on-site

Cass has 28 years in Idaho's DD field, most of it hands-on in the homes. You are working with someone who knows the work, not just the paperwork.

Documentation you can rely on

Person-centered plans, progress notes, and incident reporting kept current and clear, so your file stays ready when you need it.

Responsive communication

Straight answers and timely updates. You will not have to chase us down for a return call.

Stable, supported staff

We invest in our caregivers, because consistent staff mean continuity and trust for the people you place.

Transparent licensing

We said we would post our license number the day it was issued, and we did: Certificate No. RHA-6337. Verify us anytime with Idaho DHW.

A smooth referral

Send us the basics and we take it from there, coordinating with you and the family through every step of onboarding.

GemState is DHW-certified (Certificate No. RHA-6337, issued July 20, 2026) and is standing up its first Treasure Valley homes now. We welcome referral conversations with case managers and plan developers today. Serving Boise, Meridian, Nampa, and Caldwell, across Ada and Canyon counties.

Connect with us
Common questions

Answers for families, in plain language.

New to Idaho's DD Waiver? These are the questions families ask us most. If yours is not here, send us a note and we will answer it honestly.

What is residential habilitation?
Residential habilitation is individually tailored, around-the-clock-capable support that helps an adult with a developmental disability live successfully in their own home. It covers daily living skills, community life, health and medication assistance, money management, mobility, and positive behavioral support, all built around the person's own goals. It is a home with a dedicated team, not a facility. For the full picture, including how Idaho's traditional and self-directed options differ, read our guide: What is residential habilitation?
Who qualifies for Idaho's DD Waiver residential habilitation?
Idaho's adult DD Waiver has four requirements, and all of them must be met: a qualifying developmental disability such as intellectual disability, cerebral palsy, epilepsy, or autism, with onset before age 22; substantial limitations in at least three of seven major life areas; a need for an Intermediate Care Facility level of support, confirmed by an independent assessment; and Medicaid financial eligibility. Adults 18 and older qualify, with no maximum age. A diagnosis by itself does not qualify, and the assessment makes the final decision. Our application guide walks through each requirement in detail.
How much does it cost my family?
For an enrolled, Medicaid-eligible participant, the residential-habilitation support services cost your family nothing out of pocket, because they are covered by Idaho Medicaid. Families remain responsible for their loved one's own room and board, meaning rent and food, usually paid from SSI or personal income. The federal waiver does not cover room and board.
Does my loved one have to live in a group home?
No. Residential habilitation is designed around the person's own home, whether that is an apartment, a house, or a certified family home. Our whole approach is to make wherever they live feel like a real home, not a dorm or a communal center.
What areas does GemState serve?
GemState serves the Treasure Valley: Boise, Meridian, Nampa, and Caldwell, across Ada and Canyon counties.
Is GemState licensed?
Yes. GemState is certified by the Idaho Department of Health and Welfare as a Residential Habilitation Agency: Certificate No. RHA-6337, issued July 20, 2026. It is an Initial certificate, the standard first certificate for a new agency. You can verify it directly with the DHW Division of Licensing and Certification at 877-457-2815 or DDARH@dhw.idaho.gov. GemState is built to Idaho's 2026 residential-habilitation standards (IDAPA 16.03.21), and Idaho law does not allow any agency to provide services before it is certified.
How do we get started, and can you help with the paperwork?
Yes. Getting started means qualifying for Medicaid, applying for DD services, completing an independent assessment, and building a person-centered plan with a plan developer before choosing a certified provider. The paperwork can feel like a maze, and we walk you and your loved one through every step, from your first question to the day services start. The quickest way to begin is to send us a note or try our quick eligibility check above. And if your loved one is still in school, our Turning 18 guide shows how to line everything up early.
Does everyone get 24-hour support?
Not automatically. Twenty-four-hour support is the highest support tier, and the level of support a person receives is set by their assessment, based on their individual needs. Some people need around-the-clock help, and others need less. The plan is built to match the person.
Get started

Have a question? Let's talk.

Whether you are a family exploring options, a case manager with a referral, or someone who wants to do this work, send a note and we will get back to you.

The fastest way to reach us is email: cass@gemstatereshab.com. The form below comes straight to the same inbox. A phone line arrives once we are staffed and operating.