The Centers for Families and Children was among those caught off guard when Ohio pushed through Medicaid expansion.
James Penman, the Centers chief program officer, says the level of growth was unexpected.
"We were sure that there were people out there that needed service but I had no idea that the numbers would be this dramatic," Penman says. "So, we've been hiring as fast as we can"
They've increased staff by 18 percent so far this year. The non-profit agency provides medicine, counseling and healthcare coordination for about 7,000 residents in Northeast Ohio who suffer from behavioral health problems. They say they can already see improvements in their clients' health, including stable blood pressure and cholesterol.
This week Governor John Kasich's top adviser on health transformation, Greg Moody, paid the Centers a visit to see for himself.
Moody says he's been hearing these sort of success stories a lot lately.
"We're starting to learn from people who are right here in the community providing these services that when you knit these services together well, you have a real strong likelihood of being able to avoid costs by meeting the upfront needs of individuals."
The testimonials on the successes of Medicaid services may give Kasich some leverage when he asks state legislators to fund the expansion in his next budget. Something they wouldn't do first time around.