In a crisis system, routing is not merely the movement of a contact; it is the first decision about which people, knowledge and local resources will surround the person seeking help.
To software, a queue can look interchangeable.
To a person in crisis, it is not.
The center that receives a 988 contact may know the caller’s community, local mobile-crisis coverage, nearby stabilization options, established relationships with public safety and the practical limitations of services after hours. Another center may have more immediate capacity but less local context. A statewide system has to respect both realities.
That is why smart routing is not simply a technical feature. It is a public-safety decision expressed through software.
Ohio’s network includes nineteen 988 Lifeline providers—the most of any state. RingMD is developing Ohio’s State Centralized 988 Platform to bring voice, text, chat, documentation, referrals, reporting and interoperability into a coordinated statewide environment.
Within that work, RingMD’s smart-routing logic is designed to prioritize established Public Safety Answering Point relationships and geographic considerations while expanding available response capacity when needed.
We are building the system to make a better first connection while preserving the local knowledge needed for the next one.
Location Is Necessary but Not Sufficient
The national 988 system has been improving how wireless calls reach a crisis center near the caller’s physical location rather than one associated with the phone’s area code. The Federal Communications Commission’s 988 georouting rules are intended to improve access to local intervention services without providing the receiving center with a caller’s precise location.
That is an important advance. Someone who moved from Cleveland to Columbus years ago should not be routed according to an old area code when local help is needed now.
But identifying a useful geographic area does not complete the decision.
The system may still need to consider which center normally serves that area, whether it is able to accept the contact, which local relationships support escalation and whether another center can answer more quickly without losing continuity. It must also treat voice, text and chat as connected parts of the service rather than three unrelated channels.
Geography tells the system where the need is arising. Smart routing determines how geography, capacity and local operating knowledge should influence the response.
Local Knowledge Is Operational Infrastructure
Ohio’s nineteen centers are not identical endpoints.
They have histories, service areas, staffing models, partnerships and familiarity with local resources. Some relationships are formal. Others have been built through years of repeated coordination among crisis counselors, 911 professionals, mobile teams, hospitals and behavioral-health organizations.
That knowledge cannot be captured entirely in a directory.
A counselor may know which mobile team covers a particular community overnight. A center may have an established procedure with a local PSAP. A referral that looks correct in a database may have eligibility, transportation or availability constraints that local staff understand from experience.
Centralization is most valuable when it improves statewide visibility and resilience while preserving the local knowledge that makes crisis response work.
We are making that knowledge part of the routing model. Existing PSAP relationships and geographic patterns are core inputs to the platform now being designed.
The goal is one statewide view with local knowledge preserved.
Capacity Changes the Answer
The closest or historically assigned center is not always the center that can answer soon enough.
Crisis-contact volume changes by hour, event and region. Staff availability changes. A local incident can create sudden demand. A center may be managing multiple complex contacts while another has capacity.
RingMD’s model is designed to honor the preferred local path and bring in statewide capacity when demand requires it.
That balance must remain visible, configurable and testable as conditions change.
We begin with the preferred local path, respond to current conditions and expand capacity through defined rules. That makes overflow intentional and carries enough context forward for the receiving specialist to understand where the person is and which local resources may be relevant.
Queue length is only one input. Because contacts differ in urgency, modality and support needs, we are building the platform to apply agency-approved rules, record the basis for each routing decision and give authorized operators visibility into patterns over time.
Properly designed, statewide capacity strengthens local care by ensuring that one overloaded point does not become a barrier to the wider network.
The Route Continues After Answer
Routing does not end when a specialist says hello.
The person may need emotional support and safety planning. They may need a referral, a warm transfer, mobile response, emergency assistance or follow-up. In some circumstances, 988 and 911 must coordinate without confusing their different missions.
SAMHSA’s national behavioral-health crisis-care guidance frames crisis care as a continuum rather than a single line or facility. The National 911 Program similarly emphasizes that Next Generation 911 is intended to improve the flow of voice and digital information and the transfer of calls based on location.
We are developing Ohio’s platform to work across NG911, Mobile Response and Stabilization Services, and mobile crisis. Our goal is a warm transfer that carries the context and coordination needed to keep care moving.
A strong first route must continue into a coordinated handoff that carries the person’s context forward.
The system has to support the second and third decisions as carefully as the first.
Discovery Came Before Logic
Routing rules should not be invented from an organizational chart.
Since project initiation, we have conducted structured discovery sessions, workshops and continuing engagement with Ohio’s nineteen local 988 centers, local behavioral-health authorities and mobile-crisis partners. Ohio’s 988 Administrator has recognized the approach as highly collaborative and stakeholder-driven.
The work went far deeper than screen preferences.
Discovery had to uncover the operating facts beneath the workflow:
- Which center serves which geography, and under what exceptions?
- Which PSAP relationships already work?
- When should capacity expand beyond the preferred route?
- What information does the receiving specialist need?
- How do voice, text and chat differ operationally?
- What happens when the next service cannot accept the handoff?
- Which decisions need statewide oversight, and which belong locally?
We turn those answers into configuration, workflow and routing logic. For RingMD, discovery is engineering: the platform can only carry decisions that the program and its frontline experts have first made clear.
As RingMD’s COO and a leader of the Ohio project, Varun Arora connects frontline insight with working technology. He keeps state stakeholders, implementation teams and technologists aligned so Ohio’s public-safety and crisis-care expertise is reflected clearly in configuration and testing.
Transparency Matters When Software Chooses the Path
Any system that routes people among public services should be explainable to its operators.
Center leaders need to understand the rules. State leaders need to see whether contacts are flowing as intended. Specialists need enough information to act. Technical teams need auditability when a contact takes an unexpected path.
We make the routing logic governable by giving each authorized user the level of detail needed for their role.
RingMD’s routing model is being designed to support:
- documented, agency-approved priorities;
- role-appropriate visibility into routing decisions;
- monitoring of volume, wait time, overflow and regional patterns;
- alerts when conditions move outside expected ranges;
- controlled change management; and
- testing before revised logic enters production.
Statewide visibility should align resources and improve access while respecting the complexity of each specialist’s crisis work.
Operational transparency gives leaders a way to improve the system without obscuring the human judgment inside it.
Equity Is Hidden Inside the Routing Table
Routing affects who waits, who reaches a locally knowledgeable specialist and which communities receive the benefit of statewide capacity.
A rule that seems neutral can reproduce unequal access. Rural contacts may have fewer nearby resources. A region with chronic staffing pressure may overflow more often. Language, accessibility or modality needs may narrow the number of appropriate destinations. Historical volume may not predict the next surge.
Equity has to be evaluated through actual routing outcomes.
Leaders should be able to ask whether some communities are transferred more often, wait longer or lose local context more frequently. They should examine whether overflow strengthens access or merely moves burden around the network. They should also involve the affected centers when adjusting logic.
Ohio has expanded its 988 network to nineteen Lifeline centers and established clear statewide operating priorities. We are developing the platform to make that network more coordinated and observable while preserving the relationships through which local care happens.
Equitable routing is not the same route for everyone. It is a reliable path to the most appropriate available support.
Building Toward Statewide Operation
Ohio’s centralized 988 platform is advancing through configuration, testing and validation, with statewide production performance to be measured after deployment.
The foundation for statewide operation is already taking shape.
Ohio selected RingMD as its technology partner. We have engaged the state’s nineteen centers and other crisis-system stakeholders, and we are developing an integrated environment for voice, text, chat, documentation, referral, reporting and interoperability. Our smart-routing approach is designed to preserve PSAP relationships and geography while dynamically expanding capacity.
Configuration, testing, user acceptance and operational measurement will carry the platform from design into statewide service.
We are taking that disciplined path because routing logic can affect a person in crisis. Before Ohio relies on it statewide, we are testing it against the real workflows of the centers and professionals who will use it.
A crisis contact needs the right human connection, informed by place, capacity and the local system that can carry care forward. Smart routing is public safety because the route is the first part of the response.