988 launched in all fifty states on July 16, 2022, so we at Rave wanted to conduct a briefing. It’s been one hundred days, a popular time to check in on any newly implemented program per legislators. So, what’s the deal? Where are the adoption rates? What are the initial positives and uncovered pitfalls? One of the most important questions: what’s next? Legislators are in the throes of a major election season, preparing bills for the next session and (in many places) an annual budget fight. These are just some of the questions legislators will similarly be looking for in analyzing 988 and its future for funding, policy, and further implementation. Here is our perspective on those questions.
Adoption Rates and Call Taking Capabilities
From initial reports, the usage of 988 has exceeded expectations. Compared to the previous 1-800 number, the previously dominant crisis lifeline number, call rates as compared to last year are up by forty-five percent, according to recent data released by the U.S. Department of Health and Human Services. There was good news for wait times, which also decreased from 2 minutes and 30 seconds to 42 seconds, on average.
While these numbers are incredibly encouraging, several concerns have been made evident with this rapid rise of service needs.
Staffing Needs at Call Centers
Staffing at call centers is not nearly enough for the current or the expected continued rise of call volume. Though the wait times have decreased, for now, it’s still higher than what is the most ideal – no wait time. 911 has been an essential service line for nearly 60 years and has been unable to achieve this feat. Of course, this is not without trying. 911 staffing/retention issues are still pervasive and have even gotten worse over the last couple of years. If this is a reflection, as some see it, then 988 staffing will be just, if not more, difficult as there is more for 988 to prove as it is the newest and largest public-facing service. If call centers are not able to beef up staffing with qualified call takers, then wait times will inevitably increase, negating some of the initial work being done in these call centers.
Funding Going Forward
The adoption data is a great sign for programmatic review. People who need the service are using the service at significant rates, and that’s even better news for investment thrown behind implementing the new crisis line. The federal government invested $432 million in 2021 for call center staffing, backup capabilities, crisis response teams, and building sub-networks for Spanish speakers. Federal regulations also opened Medicaid coverage for operations and administrative costs of 988 centers. Another $150 million was just appropriated through the Bipartisan Safer Communities Act to add to those initial investments. These actions do not have bearing on the multiple bills being considered in Congress right now that would add more funding and open up SSA reimbursements for 988. All this to say, the large investment made into 988 thus far opens it up for strong justifications for future appropriations in budget and/or reconciliation bills.
But this is all at the federal level. It is just as important, if not more important, to look stateside, especially since the bulk of the implementation was placed on states and their respective agencies. In fact, states have taken up the task of 988 in different ways. While some states have added yearly funds for 988 into state budgets or implemented a tax to ensure long-term funding for the line, not all states have completed this process or answered these questions. Most likely, we will not know how those dynamics will look until next year when that flush of federal funding will be out and appropriated, forcing those states to look inward to fill the gaps.
Collaboration with 911 is Mostly Missing
Though staffing and funding concerns seem to be on the forefront of concerns for 988 centers, a more complicated yet imperative topic within the 988 infrastructure is its role within the world of emergency services. As I touched on in a previous post, 911 collaboration will be essential for 988 to reach its full potential. Not only to save some of the heartaches that 911 had to go through when it was implemented, but also because the existence of 988 effectively expands what emergency services mean in the United States. Therefore, 911 and 988 must be a part of the conversation as a united front in many ways, though this has not been happening as much as may be needed.
The most popular talking points we at Rave are hearing from legislators, and relevant stakeholders about their concerns with 988 are: “If a person calls 911 or 988 but actually needs the services of the other line, how do we get people most effectively transferred?” That is a great question. Unfortunately, the current landscape in many states is either (1) instructing an individual to hang up and call the other line, or (2) getting them transferred, but without any of the critical information that person has already provided the dispatcher/counselor. Neither of these responses is what legislators want to hear. When a person is in a dire situation, where the seconds truly count, we have to be able to do better than this. These conversations will be ongoing, but Rave has taken steps to share with legislators and 911/988 agencies that we are here to help.
988 Call Routing Concerns
Last but certainly not least, is the concern surrounding 988’s inability to route an individual who is providing resources to a counselor in their area. Right now, only landline calls can do this. As most people at this point do not own landlines and will be utilizing cell phones to call 988, this is critical to address. The Federal Communications Commission (FCC) took comments in 2021 on the issue, but the next steps in response to those comments are still to be determined. Rave is also engaging with legislators and relevant stakeholders on this issue and how we can be a partner to ensure that 988 gets this capability sooner rather than later.
All this to say, the state of 988 after 100 days is more AND less certain than it was at the launch back in July. We at Rave will continue to engage on the topic. Contact us for questions or more information on Rave’s service capabilities for 911, 988, and community safety overall.