Part 1: The Real Cost of 99.999% Uptime Requirements
This is Part 1 of a 5-part series on how states can deploy cutting-edge crisis care coordination technologies that deliver maximum value, avoid burdensome costs, and encourage innovation while expanding their pool of exceptional vendors
State and local governments are making unprecedented investments in crisis care response software procurement, driven by the urgent need to strengthen mental health response systems and support communities in crisis. From 988 Suicide & Crisis Lifeline infrastructure to comprehensive behavioral health management systems, these investments represent genuine commitment to public health and safety—and they’re absolutely necessary.
However, state crisis software costs can increase implementation costs by 200-400% through well-intentioned but misguided RFP requirements that add complexity without improving outcomes for people in crisis. Understanding these hidden cost drivers is essential for procurement officials seeking maximum value and vendors trying to deliver effective solutions within reasonable budgets.
Today’s blog highlights one requirement beginning to appear in some state RFPs: the “99.999% Uptime” mandate.
The Five-Nines Appeal: Learning from 911’s Example
The adoption of 99.999% uptime requirements in some states for crisis care systems reflects natural and understandable thinking. Procurement officials look to 911 systems as the gold standard for crisis response technology—and for good reason. Both systems serve as critical lifelines during emergencies, and both require reliable, always-available service.
Understanding the Rationale: The drive toward five-nines availability for crisis care systems reflects genuine commitment to excellence. Five-nines availability represents the engineering goal cited in standards for Next Generation 911 (NG911) core services, creating a natural benchmark for other emergency response systems. When someone calls 988 in crisis, system availability isn’t just a convenience—it’s potentially a matter of life and death. High availability requirements also demonstrate to stakeholders that states are taking crisis care implementation seriously and aren’t cutting corners on critical infrastructure.
The Reality Gap: What 911 and 988 Actually Achieve
Before fully embracing the 911 model for crisis care systems, it’s important to understand what five-nines availability actually means in practice for emergency services.
911’s Hidden Reality: While five-nines represents the engineering goal for NG911 systems, there’s actually no national dataset that reports average or modal annual Public Safety Answering Point (PSAP) downtime by state. The five-nines standard represents a procurement target, not a published performance scorecard demonstrating consistent achievement.
Recent FCC enforcement actions around multistate 911 call failures—including Verizon in 2022 and AT&T in 2023—underscore that even well-funded 911 systems don’t achieve perfect availability every year. These documented events are incompatible with universal five-nines realized uptime. Perhaps most tellingly, FCC rules require rapid notification and reporting of 911 outages, but they don’t set a numeric uptime Service Level Agreement for PSAPs or carriers nationwide.
988’s Current Standards: Unlike the five-nines requirements being imposed in some state RFPs, actual 988 system requirements are more pragmatic. According to recent review of state 988 implementations, most states either require 99.9% average uptime in their crisis center contracts or simply note the need for 24/7 continuous operation and compliance with national standards, without specifying a numeric uptime percentage. The Veterans Administration which oversees the 988 Veterans Crisis Line “strives for all systems to achieve ‘three-nines’ of uptime.”[i] Generally, the federal approach focuses on reliability principles rather than specific uptime percentages. The FCC requires outage reporting and rapid response for 988 disruptions, while SAMHSA emphasizes 24/7 availability and operational standards, but neither mandates five-nines availability for the service.
The Funding Reality Gap
One critical factor distinguishing 911 from crisis care systems is funding scale. According to a 2022 FCC report to Congress, states collected 911/E911 fees totaling $3.85 billion in calendar year 2022 alone. In contrast, federal and state funding supporting 988 crisis line services is a fraction of this amount (likely substantively less than $1 billion total, beginning with $177m annual grant to states from SAMHSA alongside state and local 988 crisis hotline funding).
This funding disparity has real implications. Requirements that may be achievable within a well-funded 911 ecosystem could create insurmountable barriers in more resource-constrained crisis care environments.
Understanding the Technical Reality: Five-nines uptime means your system can only be down for 5 minutes per year—including planned maintenance. The infrastructure to achieve this can triple your implementation costs while providing minimal benefit for crisis response.
Most behavioral health and crisis response systems operate effectively with 99.9% availability (three-nines), allowing roughly 8.77 hours of planned and unplanned downtime annually. This readily supports routine maintenance windows, system updates, hardware refreshes, and disaster recovery testing.
What Really Matters: Crisis Coordination, Not Just Uptime: While procurement officials debate uptime percentages, the real crisis response failures happen in coordination gaps. Air traffic control systems don’t just stay online—they orchestrate complex interactions between hundreds of aircraft to prevent disasters. Behavioral health technology RFP requirements should focus on coordination capabilities that prevent the delays we see when systems can’t talk to each other, not theoretical downtime scenarios that may never occur.
The Infrastructure Requirements: Moving from three-nines to five-nines availability typically requires:
- Redundant data centers in multiple geographic regions
- Real-time data replication and failover systems
- Round-the-clock monitoring with rapid response teams
- Complex load balancing infrastructure
- Redundant network connections from multiple providers
- Backup power systems with multiple layers of redundancy
These infrastructure requirements can easily triple the total cost for states managing their limited 988 resources, reducing available funds for technology innovations and additional crisis care services.
Right-Size Availability Requirements
Consider 99.9% Availability: For most crisis care applications, three-nines availability provides excellent service while allowing for cost-effective system maintenance. This translates to less than 9 hours of total downtime per year—more than adequate for systems that can schedule maintenance during off-peak hours.
Consider Phasing in a Redundant Data Center: Rather than requiring immediate multi-site deployment, allow vendors to propose a phased approach that adds a redundant data center in an alternative geographic region as call volumes and funding grow, enabling cost-effective scaling toward higher availability.
Allow for Planned Maintenance: Build realistic expectations for system maintenance into availability calculations, distinguishing planned downtime during low-usage periods from unexpected service interruptions.
RFP Requirements That Drive Innovation and Connection
Creating crisis systems that efficiently connect people to care is important, and this is why a few states choose to focus on the “5 9’s” standard. To this end, forward-thinking crisis management software selection focuses on coordination capabilities rather that enable cross-systems efficiencies to improve outcomes for people in crisis:
- Real-time resource visibility across all crisis teams
- Optimized dispatch like air traffic control
- Integration with existing telephony systems
- Performance dashboards for executive oversight
These functional requirements ensure you get crisis coordination technology that better assures that the people you care about are not getting lost in the system. This is different than purchasing “crisis management software.”
Conclusion: Excellence Without Excess
States pursuing crisis care system modernization deserve credit for their commitment to excellence. However, reflexively adopting 911 availability requirements without considering the funding realities, usage patterns, and vendor ecosystem implications of crisis care systems may achieve the opposite of the intended goal.
By inflating costs by 200-400%, extreme availability requirements can actually undermine the goal of providing excellent crisis care services. The alternative isn’t accepting substandard systems—it’s recognizing that excellent availability (99.9%) can deliver outstanding crisis care services at sustainable costs while maintaining the competitive vendor ecosystem necessary for continued innovation.
Stay tuned for our next blog in this series that will review the impact of excessive Service Level Agreement penalties and Cloud environment restrictions in state RFPs that unnecessarily stifle innovation and drive up costs.
About the Authors
Henry Wengier is an accomplished Chief Technology Officer at Behavioral Health Link with over 25 years of IT leadership experience, specializing in revolutionizing behavioral health crisis management systems across multiple states. His proven track record includes leading technology transformations at Fortune 500 companies, driving millions in cost savings and operational improvements through innovative IT solutions and strategic guidance.
Connect with Henry Wengier on LinkedIn | Email
John Draper, PhD is an international expert in behavioral health crisis services with over 35 years of experience, including leading a mobile crisis team in Brooklyn, establishing and directing NYC’s first crisis hotline service, and founding and serving as Executive Director of the U.S. National Suicide Prevention Lifeline (now 988) for 18 years. He currently serves as President of Research, Development & Government Solutions at Behavioral Health Link, Inc., where he applies research and technology to improve crisis care systems nationwide.
Connect with Dr. John Draper on LinkedIn | Email
What Should You Actually Require in Crisis Software RFPs?
If not five-nines uptime, then what requirements drive better crisis outcomes? Our “Top Eight Considerations to Include in your Behavioral Health Crisis Software RFP” shows what leading states prioritize instead.
Effective crisis care technology procurement requires balancing reliability with market reality. The most successful implementations prioritize functional outcomes and maintain reasonable risk allocation that encourages vendor innovation rather than defensive pricing.
[i] VA Office of Information and Technology – “Operational Excellence – Software Delivery the VA Way