RHMR Reimbursement Submittal Program Overview

 
RHMR REIMBURSEMENT
SUBMITTAL PROGRAM
 
 
PURPOSE
 
Expedite Reimbursement Process
Funds to agencies
Standardization
Knowledge of required documentation
Accountability
Contractual guidelines
 
FORMS
 
Website
Caloes.ca.gov—Divisions—Response Operations—Fire & Rescue—Hazardous Materials—
RHMR—RHMR Reimbursement Program
Reimbursement Forms and Guidance
Table of Contents
RHMR-01
 
Checklist
RHMR-02
 
Workbook
RHMR-03
 
Workbook Guidance
 
 
FORMS
 
Table of Contents
RHMR-04
 
Pre-Approval Form (Training)
RHMR-05
 
Pre-Approval Form (Training) Guidance
RHMR-06
 
Pre-Approval Form (Excess Lodging)
RHMR-07
 
Pre-Approval Form (Excess Lodging) Guidance
RHMR-08
 
Pre-Approval Form (Backfill, Out of Rank)
RHMR-09
 
Pre-Approval Form (Backfill, Out of Rank) Guidance
 
FORMS
 
Table of Contents
Supporting Documents
RHMR Travel Tri-fold
RHMR Reimbursement Submittal PPT
 
Equipment Forms and Guidance
Under Development
 
REIMBURSEMENT SUBMITTAL PACKAGE
 
RHMR-01 Reimbursement Checklist
 
Separate workbook for each submittal
Only applicable workbook tabs
 
RHMR-01 REIMBURSEMENT CHECKLIST
(BACKFILL / OT)
 
Agency Invoice
Invoice number
Agreement/Contract number
Date
Point of Contact and contact information
Total reimbursement
Location where reimbursement is mailed
Description of service provided
 
RHMR-01 REIMBURSEMENT CHECKLIST
 
RHMR Reimbursement Workbook
Separate workbook for each submittal
Only applicable workbook tabs
Itemized list of payroll costs (Backfill and OT)
 
 
RHMR-01 REIMBURSEMENT CHECKLIST
 
Completed Pre-Approval Request Form
RHMR-06: Pre-Approval Request Form (Excess Lodging)
Lodging costs above listing in Travel Tri-fold guidance
RHMR-08: Pre-Approval Request Form (Backfill, Out of Rank)
Replacement employee from higher rank
 
 
RHMR-01 REIMBURSEMENT CHECKLIST
 
Receipts
All lodging
All Rental vehicles
All airfare
All self-parking (Greater than $10.00)
All toll roads / bridges
 
 
RHMR-01 REIMBURSEMENT CHECKLIST
 
Receipts
Mileage requires Google map or MapQuest documentation
Mileage is for personal vehicles only
Proof of comprehensive and liability insurance required
 
Receipts are not required for:
Per diem meals
Incidentals
Parking under $10.00
Gas station receipts
 
 
RHMR-02 REIMBURSEMENT WORKBOOK
RHMR-03 REIMBURSEMENT WORKBOOK GUIDANCE
 
Required with every Reimbursement Submittal Package
 
The Reimbursement Workbook Guidance sheet defines how to complete the
Reimbursement Workbook.
 
 
 
 
 
RHMR-02 REIMBURSEMENT WORKBOOK
RHMR-03 REIMBURSEMENT WORKBOOK GUIDANCE
 
The Reimbursement Workbook consists of four tabs
 
Summary Page tab
Backfill / OT Reimbursement tab
Course Training Reimbursement tab
Blood Work / Treadmill Reimbursement tab
 
 
 
 
 
SUMMARY TAB
 
Open the Reimbursement Submittal Guidance document
Complete the entries per the guidance document
“Contract Budget” column self-populates and updates the allocation balance
Do not make entries in this column
Enter the Reimbursement Type (corresponds with following tabs)
If entries are made under multiple tabs, list all applicable tabs
 
 
BACKFILL / OT TAB
 
Open the Reimbursement Submittal Guidance document
Complete the entries per the guidance document
All training courses require Pre-Approval or shall be sponsored by Cal OES
Pre-Approval Shall be obtained prior to first day of course
Completed Pre-Approval Request form shall be included with Reimbursement Submittal
Package
Each student shall be listed on a separate row
 
 
BACKFILL / OT TAB
 
Only students that satisfactorily complete the training are eligible for reimbursement
Enter OT and Backfill totals separately
OT and Backfill reimbursement requests shall have supporting payroll records
The OT and Backfill Cost columns auto-populates the total entries.
Complete Backfill, Out of Rank Pre-Approval Request form for replacement personnel from
higher rank prior to beginning of assignment
 
 
BACKFILL / OT TAB
 
Enter total lodging reimbursement request
Include closed out lodging receipts with Reimbursement Submittal Package
Include Pre-Approval Request Form for lodging in excess of GSA 2020 per diem rates
(
https://www.gsa.gov/travel/plan-book/per-diem-rates/per-diem-rates-
lookup/?action=perdiems_report&state=CA&fiscal_year=2020&zip=&city=
)
The Lodging column auto-populates the total entries at the bottom of the column.
 
 
BACKFILL / OT TAB
 
Enter Airfare, Car Rental reimbursement totals
The Airfare, Car Rental and Meal columns auto-populates the total entries at the bottom of the
columns.
Include receipts with Reimbursement Submittal Package
Enter Mileage total
Personal vehicles at $0.65 per mile rate
Enter meal per diem total
GSA 2023 per diem rates (
https://www.gsa.gov/travel/plan-book/per-diem-rates/per-diem-rates-
lookup/?action=perdiems_report&state=CA&fiscal_year=2020&zip=&city=
)
Do not claim meals that are included with lodging or conference
 
BACKFILL / OT TAB
 
Enter self-parking fees
Receipt required for fees in excess of $10.00
Valet parking in non-reimbursable
Road and Bridge toll fees require a receipt
Enter incidental costs up to $5.00 per 24 hour period
After first day
The Self-parking, Tolls and Incidental columns auto-populates the total entries at the
bottom of the columns.
 
 
COURSE TRAINING TAB
 
Open the Reimbursement Submittal Guidance document
 
Complete the entries per the guidance document
 
All training courses require Pre-Approval or shall be sponsored by Cal OES
Pre-Approval Shall be obtained prior to first day of course
Completed Pre-Approval Request form shall be included with Reimbursement Submittal
Package
 
 
COURSE TRAINING TAB
 
Enter the Contractor / Company / Instructor Name
 
Enter the contracted fee total or instructor total fees (hourly wages)
 
Enter the additional fees (tuition, certifications, equipment/supplies, facility rental)
 
All Fee columns auto-populate the total entries at the bottom of the column
 
 
BLOOD WORK / TREADMILL TAB
 
Open the Reimbursement Submittal Guidance document
 
Complete the entries per the guidance document
 
Reimbursement for a maximum of 25 hazmat personnel
 
 
BLOOD WORK / TREADMILL TAB
 
Each hazmat member shall be listed on a separate row
Receipt required for each reimbursement submittal
 
Enter the date of service
 
Enter the name of the provider of treadmill test
 
Enter the cost of the treadmill test
 
 
BLOOD WORK / TREADMILL TAB
 
Enter the name of the provider of blood work test
Heavy metals
 
Enter the cost of the blood work testing
 
All Fee columns auto-populate the total entries at the bottom of the column
 
 
 
PRE-APPROVAL REQUEST FORMS
 
The Regional Hazardous Materials Response (RHMR) Pre-Approval Forms are designed to
provide flexibility for assignee agencies to allow personnel to attend training, exercises and
conferences within the guidelines identified by contractual agreement.
 
The Pre-Approval Form provides for accountability of expenditures and adherence to
contractual agreements for the California Governor’s Office of Emergency Services (Cal
OES) Fire and Rescue.
 
RHMR TRAINING PRE-APPROVAL FORM
 
Open the RHMR Training Pre-Approval Request Guidance document
 
Complete the entries per the guidance document
 
The document is designed to have fillable entries and can be saved and / or printed
 
 
 
RHMR TRAINING PRE-APPROVAL FORM
 
Enter the Contract Agency
This is the agency that is listed as one of the 12 Assignee Agencies listed on the contracts
(Example: Marysville would list Yuba City in the section)
 
Enter the type of event for Pre-Approval request (Training, Exercise, or Conference)
 
Enter the location of the event (name of city)
 
 
RHMR TRAINING PRE-APPROVAL FORM
 
The Anticipated Costs column auto-populates the total row at the bottom of the form
 
An agency may request multiple events on a single Pre-Approval Request form
Cal OES will check the approval or not approved box next to each request and notify the
requestor
 
 
RHMR EXCESS LODGING PRE-APPROVAL FORM
 
Open the RHMR Excess Lodging Pre-Approval Request Guidance document
 
Complete the entries per the guidance document
 
The document is designed to have fillable entries and can be saved and / or printed
 
 
 
RHMR EXCESS LODGING PRE-APPROVAL FORM
 
Enter the Contract Agency
This is the agency that is listed as one of the 12 Assignee Agencies listed on the contracts
(Example: Marysville would list Yuba City in the section)
 
Enter the Training / Exercise / Conference Name
 
Enter the lodging location name
 
 
 
RHMR EXCESS LODGING PRE-APPROVAL FORM
 
Enter the location of the lodging venue (name of city)
Enter the daily rate
Cal OES requires three additional quotes and may verify that the request is not excessive
Cal OES will verify the GSA rate comparison to the requested lodging site
 
 
 
RHMR EXCESS LODGING PRE-APPROVAL FORM
 
 
The Anticipated Costs column auto-populates the total row at the bottom of the form
 
An agency may request multiple lodging sites on a single Pre-Approval Request form
Cal OES will check the approval or not approved box next to each request and notify the
requestor
 
 
RHMR BACKFILL, OUT OF RANK PRE-APPROVAL
FORM
 
Open the RHMR Backfill, Out of Rank Pre-Approval Request Guidance document
 
Complete the entries per the guidance document
 
The document is designed to have fillable entries and can be saved and / or printed
 
 
 
RHMR BACKFILL, OUT OF RANK PRE-APPROVAL
FORM
 
Enter the Contract Agency
This is the agency that is listed as one of the 12 Assignee Agencies listed on the contracts
(Example: Marysville would list Yuba City in the section)
 
Enter the Training / Exercise / Conference Name
 
Enter the student name and rank
 
 
 
RHMR BACKFILL, OUT OF RANK PRE-APPROVAL
FORM
 
Enter the replacement name and rank
 
 The Anticipated Costs column auto-populates the total row at the bottom of the form
 
Enter the date(s) of replacement
 
 
RHMR BACKFILL, OUT OF RANK PRE-APPROVAL
FORM
 
An agency may request multiple lodging sites on a single Pre-Approval Request form
Cal OES will check the approval or not approved box next to each request and notify the
requestor
 
REIMBURSEMENT SUBMITTAL PACKAGE
 
Reimbursement Workbook Guidance
Further assistance
Shared email
rhmr@caloes.ca.gov
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RHMR Reimbursement Submittal Program aims to expedite the reimbursement process for agencies by providing standardized forms and guidance. The program ensures compliance with contractual guidelines and accountability through the submission of required documentation. Forms include checklists, pre-approval forms, and supporting documents to streamline the reimbursement process efficiently.

  • Reimbursement
  • Program
  • Forms
  • Guidelines
  • Accountability

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  1. RHMR REIMBURSEMENT SUBMITTAL PROGRAM

  2. PURPOSE Expedite Reimbursement Process Funds to agencies Standardization Knowledge of required documentation Accountability Contractual guidelines

  3. FORMS Website Caloes.ca.gov Divisions Response Operations Fire & Rescue Hazardous Materials RHMR RHMR Reimbursement Program Reimbursement Forms and Guidance Table of Contents RHMR-01 Checklist RHMR-02 Workbook RHMR-03 Workbook Guidance

  4. FORMS Table of Contents RHMR-04 Pre-Approval Form (Training) RHMR-05 Pre-Approval Form (Training) Guidance RHMR-06 Pre-Approval Form (Excess Lodging) RHMR-07 Pre-Approval Form (Excess Lodging) Guidance RHMR-08 Pre-Approval Form (Backfill, Out of Rank) RHMR-09 Pre-Approval Form (Backfill, Out of Rank) Guidance

  5. FORMS Table of Contents Supporting Documents RHMR Travel Tri-fold RHMR Reimbursement Submittal PPT Equipment Forms and Guidance Under Development

  6. REIMBURSEMENT SUBMITTAL PACKAGE RHMR-01 Reimbursement Checklist Separate workbook for each submittal Only applicable workbook tabs

  7. RHMR-01 REIMBURSEMENT CHECKLIST (BACKFILL / OT) Agency Invoice Invoice number Agreement/Contract number Date Point of Contact and contact information Total reimbursement Location where reimbursement is mailed Description of service provided

  8. RHMR-01 REIMBURSEMENT CHECKLIST RHMR Reimbursement Workbook Separate workbook for each submittal Only applicable workbook tabs Itemized list of payroll costs (Backfill and OT)

  9. RHMR-01 REIMBURSEMENT CHECKLIST Completed Pre-Approval Request Form RHMR-06: Pre-Approval Request Form (Excess Lodging) Lodging costs above listing in Travel Tri-fold guidance RHMR-08: Pre-Approval Request Form (Backfill, Out of Rank) Replacement employee from higher rank

  10. RHMR-01 REIMBURSEMENT CHECKLIST Receipts All lodging All Rental vehicles All airfare All self-parking (Greater than $10.00) All toll roads / bridges

  11. RHMR-01 REIMBURSEMENT CHECKLIST Receipts Mileage requires Google map or MapQuest documentation Mileage is for personal vehicles only Proof of comprehensive and liability insurance required Receipts are not required for: Per diem meals Incidentals Parking under $10.00 Gas station receipts

  12. RHMR-02 REIMBURSEMENT WORKBOOK RHMR-03 REIMBURSEMENT WORKBOOK GUIDANCE Required with every Reimbursement Submittal Package The Reimbursement Workbook Guidance sheet defines how to complete the Reimbursement Workbook.

  13. RHMR-02 REIMBURSEMENT WORKBOOK RHMR-03 REIMBURSEMENT WORKBOOK GUIDANCE The Reimbursement Workbook consists of four tabs Summary Page tab Backfill / OT Reimbursement tab Course Training Reimbursement tab Blood Work / Treadmill Reimbursement tab

  14. SUMMARY TAB Open the Reimbursement Submittal Guidance document Complete the entries per the guidance document Contract Budget column self-populates and updates the allocation balance Do not make entries in this column Enter the Reimbursement Type (corresponds with following tabs) If entries are made under multiple tabs, list all applicable tabs

  15. BACKFILL / OT TAB Open the Reimbursement Submittal Guidance document Complete the entries per the guidance document All training courses require Pre-Approval or shall be sponsored by Cal OES Pre-Approval Shall be obtained prior to first day of course Completed Pre-Approval Request form shall be included with Reimbursement Submittal Package Each student shall be listed on a separate row

  16. BACKFILL / OT TAB Only students that satisfactorily complete the training are eligible for reimbursement Enter OT and Backfill totals separately OT and Backfill reimbursement requests shall have supporting payroll records The OT and Backfill Cost columns auto-populates the total entries. Complete Backfill, Out of Rank Pre-Approval Request form for replacement personnel from higher rank prior to beginning of assignment

  17. BACKFILL / OT TAB Enter total lodging reimbursement request Include closed out lodging receipts with Reimbursement Submittal Package Include Pre-Approval Request Form for lodging in excess of GSA 2020 per diem rates (https://www.gsa.gov/travel/plan-book/per-diem-rates/per-diem-rates- lookup/?action=perdiems_report&state=CA&fiscal_year=2020&zip=&city=) The Lodging column auto-populates the total entries at the bottom of the column.

  18. BACKFILL / OT TAB Enter Airfare, Car Rental reimbursement totals The Airfare, Car Rental and Meal columns auto-populates the total entries at the bottom of the columns. Include receipts with Reimbursement Submittal Package Enter Mileage total Personal vehicles at $0.65 per mile rate Enter meal per diem total GSA 2023 per diem rates (https://www.gsa.gov/travel/plan-book/per-diem-rates/per-diem-rates- lookup/?action=perdiems_report&state=CA&fiscal_year=2020&zip=&city=) Do not claim meals that are included with lodging or conference

  19. BACKFILL / OT TAB Enter self-parking fees Receipt required for fees in excess of $10.00 Valet parking in non-reimbursable Road and Bridge toll fees require a receipt Enter incidental costs up to $5.00 per 24 hour period After first day The Self-parking, Tolls and Incidental columns auto-populates the total entries at the bottom of the columns.

  20. COURSE TRAINING TAB Open the Reimbursement Submittal Guidance document Complete the entries per the guidance document All training courses require Pre-Approval or shall be sponsored by Cal OES Pre-Approval Shall be obtained prior to first day of course Completed Pre-Approval Request form shall be included with Reimbursement Submittal Package

  21. COURSE TRAINING TAB Enter the Contractor / Company / Instructor Name Enter the contracted fee total or instructor total fees (hourly wages) Enter the additional fees (tuition, certifications, equipment/supplies, facility rental) All Fee columns auto-populate the total entries at the bottom of the column

  22. BLOOD WORK / TREADMILL TAB Open the Reimbursement Submittal Guidance document Complete the entries per the guidance document Reimbursement for a maximum of 25 hazmat personnel

  23. BLOOD WORK / TREADMILL TAB Each hazmat member shall be listed on a separate row Receipt required for each reimbursement submittal Enter the date of service Enter the name of the provider of treadmill test Enter the cost of the treadmill test

  24. BLOOD WORK / TREADMILL TAB Enter the name of the provider of blood work test Heavy metals Enter the cost of the blood work testing All Fee columns auto-populate the total entries at the bottom of the column

  25. PRE-APPROVAL REQUEST FORMS The Regional Hazardous Materials Response (RHMR) Pre-Approval Forms are designed to provide flexibility for assignee agencies to allow personnel to attend training, exercises and conferences within the guidelines identified by contractual agreement. The Pre-Approval Form provides for accountability of expenditures and adherence to contractual agreements for the California Governor s Office of Emergency Services (Cal OES) Fire and Rescue.

  26. RHMR TRAINING PRE-APPROVAL FORM Open the RHMR Training Pre-Approval Request Guidance document Complete the entries per the guidance document The document is designed to have fillable entries and can be saved and / or printed

  27. RHMR TRAINING PRE-APPROVAL FORM Enter the Contract Agency This is the agency that is listed as one of the 12 Assignee Agencies listed on the contracts (Example: Marysville would list Yuba City in the section) Enter the type of event for Pre-Approval request (Training, Exercise, or Conference) Enter the location of the event (name of city)

  28. RHMR TRAINING PRE-APPROVAL FORM The Anticipated Costs column auto-populates the total row at the bottom of the form An agency may request multiple events on a single Pre-Approval Request form Cal OES will check the approval or not approved box next to each request and notify the requestor

  29. RHMR EXCESS LODGING PRE-APPROVAL FORM Open the RHMR Excess Lodging Pre-Approval Request Guidance document Complete the entries per the guidance document The document is designed to have fillable entries and can be saved and / or printed

  30. RHMR EXCESS LODGING PRE-APPROVAL FORM Enter the Contract Agency This is the agency that is listed as one of the 12 Assignee Agencies listed on the contracts (Example: Marysville would list Yuba City in the section) Enter the Training / Exercise / Conference Name Enter the lodging location name

  31. RHMR EXCESS LODGING PRE-APPROVAL FORM Enter the location of the lodging venue (name of city) Enter the daily rate Cal OES requires three additional quotes and may verify that the request is not excessive Cal OES will verify the GSA rate comparison to the requested lodging site

  32. RHMR EXCESS LODGING PRE-APPROVAL FORM The Anticipated Costs column auto-populates the total row at the bottom of the form An agency may request multiple lodging sites on a single Pre-Approval Request form Cal OES will check the approval or not approved box next to each request and notify the requestor

  33. RHMR BACKFILL, OUT OF RANK PRE-APPROVAL FORM Open the RHMR Backfill, Out of Rank Pre-Approval Request Guidance document Complete the entries per the guidance document The document is designed to have fillable entries and can be saved and / or printed

  34. RHMR BACKFILL, OUT OF RANK PRE-APPROVAL FORM Enter the Contract Agency This is the agency that is listed as one of the 12 Assignee Agencies listed on the contracts (Example: Marysville would list Yuba City in the section) Enter the Training / Exercise / Conference Name Enter the student name and rank

  35. RHMR BACKFILL, OUT OF RANK PRE-APPROVAL FORM Enter the replacement name and rank The Anticipated Costs column auto-populates the total row at the bottom of the form Enter the date(s) of replacement

  36. RHMR BACKFILL, OUT OF RANK PRE-APPROVAL FORM An agency may request multiple lodging sites on a single Pre-Approval Request form Cal OES will check the approval or not approved box next to each request and notify the requestor

  37. REIMBURSEMENT SUBMITTAL PACKAGE Reimbursement Workbook Guidance Further assistance Shared email rhmr@caloes.ca.gov

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