Become a Support Service Provider

Please click here to access the SSP Application Form. Once completed, you will be contacted by the HISSP Program Team to schedule a virtual meeting to review.

Click here to access the Master Service Agreement (MSA)

The link above will guide you through the necessary information needed in the MSA. Once the required fields are completed and submitted, the MSA will be sent directly to Knowledge Services.

• Please Note: No redline requests will be accepted for this agreement. All MSAs must be submitted electronically through the link above. The MSA document will time out after an extended period of time. Once all content is reviewed, please refresh the document before completing.

At the time of MSA submission, you must attach the following:

• Signed W-9 Form

Click here to download a blank W-9 Form.

Please email the HISSP Program Team with any questions.

Click here to access Exhibit C3 – Support Service Provider Program Code of Ethics

By signing this document, you are agreeing to the SSP Program’s Code of Ethics.

Click here for the Support Service Provider Compliance Form

This form includes the authorization allowing Knowledge Services to conduct the following background/compliance checks:

• eCrim | Hawaii’s Adult Criminal Information (ehawaii.gov)
• Sexual Offender and Other Covered Offender Registration Search

This form also includes Tuberculosis Test Confirmation, Driver’s License verification, and if applicable, certification.

Click here to access the ACH/EFT (Direct Deposit) Disbursement Set-Up Form

In order to receive direct deposit payments through the HISSP MSP Program, please complete one (1) ACH/EFT Disbursement Set-Up Form.

Please attach the following applicable forms of documentation to complete the set-up process:

• For Checking Accounts: Voided check imprinted with company name and Copy of Bank Identification from bank (must show Bank Routing/ABA # and Account Number)
• For Savings Accounts: Voided deposit slip and Copy of Bank Identification from bank (must show Bank Routing/ABA # and Account Number)