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Healthcare Instructions A  Work Release Self Surrender

Definition: An order of confinement for Work Release allows the Self Surrender individual to go to work.  The individual remains in jail when not at work.

Basic Information

1.  To notify Correctional Health Services (CHS) about healthcare issues, call the Self Surrender line at
(602) 876-6884.  Healthcare Information can also be faxed to the CHS Fax Line at (602) 455-6147.

2.  Bring the following items when you self surrender:

•   Prescription medications (see below).

•   Sentence of 15 days or more requires a Healthcare Provider’s Certification Form.  If you do not bring
      in the completed form or  your physician states that you do not meet medical fitness criteria, you may
      be housed in an indoor facility and not eligible for Work Release.

•   Completed “Medical Receiving Screening Questionnaire” available at www.mcso.org (Jail information
tab, select Self Surrender)

3.  Upon arrival at the jail, your “Medical Receiving Screening Questionnaire” is reviewed (or completed if you did
not bring a copy with you).

4.  If you have current medical problems that indicate the possible need for emergency evaluation, intervention,
and/or hospitalization, you may not be accepted for booking.

5.  Housing is outdoors on dirt/rock surfaces using military, dorm-style tents for shelter.

6.  Healthcare criteria that may prevent you from being housed at tents are: frail health, unstable acute or chronic

condition, pregnancy, complex wound care, non-weight bearing to lower legs, use of wheelchair, walker or cane, alcohol or drug withdrawal.

7.  For reasons of safety and jail security, additional conditions that will disqualify for housing in tents include:
casted arms or legs, prosthetics, special medical equipment.

8.  For complete information on the self surrender process and requirements, contact the Maricopa County Sheriff’s
Office at the MCSO website www.mcso.org or the MCSO Jail Information line at (602) 876-0322.

9.  The Lower Buckeye Jail (LBJ) is located at 3250 W. Lower Buckeye Road, Phoenix, AZ.

10. Self Surrender parking is located in a separate, fenced off parking area at the far east end of the building. There
is a “Self Surrender Parking Only” sign at the entrance.

Preparing for Confinement

1.  If you are currently on medications for an acute or chronic condition or are being treated by a healthcare provider, you should request a self surrender date from the court for a Thursday, Friday or Saturday, excluding holidays, from 9:00 AM-6:30 PM.  A nurse is assigned to LBJ Intake during these hours to facilitate the screening process and insure continuity of care.

2.  Call the CHS Self Surrender line (see above) for any acute or time limited serious medical condition. Examples of this may include, but are not limited to: chemotherapy, acute infection, specialized wound care, pending surgical procedure or physical therapy.

3.  Prescription medications must be in their original containers and in an amount that will last for the number of sentenced days.

Healthcare

1.  Your own medications must be taken as prescribed.  Lockers are provided, along with refrigerators for Insulin.

2.  You are responsible for going to your healthcare provider for routine and urgent concerns.  This must be done during the hours you are not in the custody of the jail.

3.  Emergency healthcare services are available.

4.  If you are not placed on Work Release, your healthcare and medications will be provided by CHS unless you are housed at Con-Tents.

Healthcare Instructions B Work Furlough Self Surrender

Definition:

An order of confinement by Superior Court that allows participation in the Work Furlough Program.  Individuals will not participate in the Work Furlough Program until approved by Adult Probation and the Maricopa County Sheriff’s Office.

Basic Information

1.  To notify Correctional Health Services (CHS) about healthcare issues, call the Self Surrender line at
(602) 876-6884.  Healthcare Information can also be faxed to the CHS Fax Line at (602) 455-6147.

2.  Bring the following items when you self surrender:

•   Prescription medications (see below).

•   Sentence of 15 days or more requires a Healthcare Provider’s Certification Form.   If you do not
      bring in the completed form or  your physician states that you do not meet medical fitness
      criteria, you may be housed in an indoor facility and not eligible for Work Furlough.

•   Completed Medical Receiving Screening Questionnaire available at www.mcso.org (Jail
information tab, select Self Surrender)

3.  Upon arrival at the jail, your Medical Receiving Screening questionnaire is reviewed (or completed if you
did not bring a copy with you).

4.  If you have current medical problems that indicate the possible need for emergency evaluation,
intervention, and/or hospitalization, you may not be accepted for booking.

5.  Housing is outdoors on dirt/rock surfaces using military, dorm-style tents for shelter

6.  Healthcare criteria that may prevent you from being housed at tents are: frail health, unstable acute or

chronic condition, pregnancy, complex wound care, non-weight bearing to lower legs, use of wheelchair, walker or cane, alcohol or drug withdrawal.

7.  For reasons of safety and jail security, additional conditions that will disqualify for housing in tents include:
casted arms or legs, prosthetics, special medical equipment.

8.  For complete information on the self surrender process and requirements, contact the Maricopa County

Sheriff’s Office at the MCSO website www.mcso.org or the MCSO Jail Information line at (602) 876-0322.

9.  The Lower Buckeye Jail (LBJ) is located at 3250 W. Lower Buckeye Road, Phoenix, AZ.

10. Self Surrender parking is located in a separate, fenced off parking area at the far east end of the building.
      There is a “Self Surrender Parking Only” sign at the entrance.

Preparing for Confinement

1.  If you are currently on medications for an acute or chronic condition or are being treated by a healthcare
provider, you should request a self surrender date from the court for a Thursday, Friday or Saturday,
excluding holidays, from 9:00 AM-6:30 PM.  A nurse is assigned to LBJ Intake during these hours to
facilitate the screening process and insure continuity of care.

2.  Call the CHS Self Surrender line (see above) for any acute or time limited serious medical condition.
Examples of this may include, but are not limited to: chemotherapy, acute infection, specialized wound
care, pending surgical procedure or physical therapy.

Healthcare

1.  While you are housed in In-Tents, your healthcare and medications will be provided by CHS.

2.  When you are approved for Work Furlough and transferred to Con-Tents:

•   Prescription medications must be in their original containers and in an amount that will last for the
number of sentenced days.  Lockers are provided along with refrigerators for Insulin.

•   You will take your personal medications as prescribed by your physician.

•   You will be responsible for going to your provider for routine and urgent concerns.  This must be done
during the hours that you are not in the custody of the jail.

•    Only emergency healthcare services are available.

Healthcare Instructions C 5 Days or Less Flat (Straight) Time Self Surrender

Definition: An order of confinement that allows the individual to self surrender to serve a sentence.

Basic Information

1.  To notify Correctional Health Services (CHS) about healthcare issues, call the Self Surrender line
at (602) 876-6884.  Healthcare Information can also be faxed to the CHS Fax Line at
(602) 455-6147.

2.  Bring the following items when you self surrender:

•   Prescription medications (see below).

•   Completed Medical Receiving Screening Questionnaire available at www.mcso.org (Jail
information tab, select Self Surrender)

3.  Upon arrival at the jail, your Medical Receiving Screening questionnaire is reviewed (or
completed if you did not bring a copy with you).

4.  If you have current medical problems that indicate the possible need for emergency evaluation,
intervention, and/or hospitalization, you may not be accepted for booking.

5.  Healthcare criteria that may prevent you from being housed at Tents are: frail health, unstable
acute or chronic condition, pregnancy, complex wound care, non-weight bearing to lower legs,
use of wheelchair, walker or cane, alcohol or drug withdrawal.

6.  For reasons of safety and jail security, additional conditions that will disqualify for housing in
Tents include: casted arms or legs, prosthetics, special medical equipment.

7.  For complete information on the self surrender process and requirements, contact the Maricopa
County Sheriff’s Office at the MCSO website www.mcso.org or the MCSO Jail Information line
at (602) 876-0322.

8.  The Lower Buckeye Jail (LBJ) is located at 3250 W. Lower Buckeye Road, Phoenix, AZ.

9.  Self Surrender parking is located in a separate, fenced off parking area at the far east end of the
      building. There is a “Self Surrender Parking Only” sign at the entrance.

10. Housing is outdoors on dirt/rock surfaces using military, dorm-style tents for shelter.

Preparing for Confinement

1.  If you are currently on medications for an acute or chronic condition or are being treated by a
healthcare provider, you should request a self surrender date from the court for a Thursday,
Friday or Saturday, excluding holidays, from 9:00 AM-6:30 PM.  A nurse is assigned to LBJ
Intake during these hours to facilitate the screening process and insure continuity of care.

2.  Call the CHS Self Surrender line (see above) for any acute or time limited serious medical

condition. Examples of this may include, but are not limited to: chemotherapy, acute infection, specialized wound care, pending surgical procedure or physical therapy.

3.  Prescription medications must be in their original containers and in an amount that will last for
the number of sentenced days.

Healthcare

1.  Your own medications must be taken as prescribed.  Lockers are provided along with
refrigerators for Insulin.

2.  You are responsible to seek evaluation and medical care for any urgent health concern prior to
surrendering to the jail.

3.  Emergency healthcare services are available.

Healthcare Instructions D - 6 Days or More Flat (Straight) Time Self Surrender

Definition: An order of confinement that allows the individual to self surrender to serve a sentence.

 

Basic Information

1.  To notify Correctional Health Services (CHS) about healthcare issues, call the Self Surrender line
at (602) 876-6884.  Healthcare Information can also be faxed to the CHS Fax Line at
(602) 455-6147.

2.   Bring your medications in their original prescription containers (except refrigerated medications).
This allows the healthcare staff to verify the name, dose, amount, etc. After your medications are
reviewed, they will be placed in your property.  The CHS healthcare provider will prescribe the
medication or a substitute.

3.  Bring a completed Medical Receiving Screening Questionnaire available at www.mcso.org (Jail
information tab, select Self Surrender)

4.  Upon arrival at the jail, your Medical Receiving Screening questionnaire is reviewed (or
completed if you did not bring a copy with you).

5.  If you have current medical problems that indicate the possible need for emergency evaluation,
intervention, and/or hospitalization, you may not be accepted for booking.

6.  For complete information on the self surrender process and requirements, contact the Maricopa
County Sheriff’s Office at the MCSO website www.mcso.org or the MCSO Jail Information line
at (602) 876-0322.

7.  The Lower Buckeye Jail (LBJ) is located at 3250 W. Lower Buckeye Road, Phoenix, AZ.

8.  Self Surrender parking is located in a separate, fenced off parking area at the far east end of the
      building. There is a “Self Surrender Only” sign at the entrance.

Preparing for Confinement

1.  If you are currently on medications for an acute or chronic condition or are being treated by a
healthcare provider, you should request a self surrender date from the court for a Thursday,
Friday or Saturday, excluding holidays, from 9:00 AM-6:30 PM.  A nurse is assigned to LBJ
Intake during these hours to facilitate the screening process and insure continuity of care.

2.  Call the CHS Self Surrender line (see above) for any acute or time limited serious medical

condition. Examples of this may include, but are not limited to: chemotherapy, acute infection, specialized wound care, pending surgical procedure or physical therapy.

Healthcare

1.   CHS will provide your healthcare and medications.

 

Healthcare Instructions E Weekend Self Surrender

Definition: An order of confinement that allows an individual to self surrender to serve a sentence on weekends (Saturday and/or Sunday).

Basic Information

1.   To notify Correctional Health Services (CHS) about healthcare issues, call the Self Surrender line at
(602) 876-6884.  Healthcare Information can also be faxed to the CHS Fax Line at (602) 455-6147.

2.   Bring the following items when you self surrender:

•   Prescription medications (see below).

•   Sentence of 15 days or more requires a Healthcare Provider’s Certification Form.  If you do not bring in the
      completed form or  your physician states that you do not meet medical fitness criteria, you may be housed in
      an indoor facility.

•   Completed Medical Receiving Screening Questionnaire available at www.mcso.org (Jail information tab, select
Self Surrender)

3.   Upon arrival at the jail, your Medical Receiving Screening questionnaire is reviewed (or completed if you did not bring a
copy with you).

4.   If you have current medical problems that indicate the possible need for emergency evaluation, intervention, and/or
hospitalization, you may not be accepted for booking.

5.   Housing is outdoors on dirt/rock surfaces using military, dorm-style tents for shelter

6.   Healthcare criteria that may prevent you from being housed at tents are: frail health, unstable acute or chronic condition,
pregnancy, complex wound care, non-weight bearing to lower legs, use of wheelchair, walker or cane, alcohol or drug
withdrawal.

7.   For reasons of safety and jail security, additional conditions that will disqualify for housing in tents include: casted arms
or legs, prosthetics, special medical equipment.

8.   For complete information on the self surrender process and requirements, contact the Maricopa County Sheriff’s Office at
the MCSO website www.mcso.org or the MCSO Jail Information line at (602) 876-0322.

9.   The Lower Buckeye Jail (LBJ) is located at 3250 W. Lower Buckeye Road, Phoenix, AZ.

10. Self Surrender parking is located in a separate, fenced off parking area at the far east end of the building. There is a
“Self Surrender Parking Only” sign at the entrance.

Preparing for Confinement

1.   If you are currently on medications for an acute or chronic condition or are being treated by a healthcare provider, you
should request a self surrender date from the court for a Thursday, Friday or Saturday, excluding holidays, from 9:00
AM-6:30 PM.  A nurse is assigned to LBJ Intake during these hours to facilitate the screening process and insure
continuity of care.

2.   Call the CHS Self Surrender line (see above) for any acute or time limited serious medical condition. Examples of this
may include, but are not limited to: chemotherapy, acute infection, pregnancy, specialized wound care, pending surgical
procedure or physical therapy.

3.   Prescription medications must be in their original containers and in an amount that will last for the number of sentenced
days.

Healthcare

1.   Your own medications must be taken as prescribed.  Lockers are provided along with refrigerators for Insulin.

2.   You are responsible for going to your healthcare provider for routine and urgent concerns.  This must be done during the
hours that you are not in the custody of the jail.

3.   If you are housed indoors due to a condition listed in #6 or #7 above, CHS will provide healthcare and medications.

4.   Emergency healthcare services are available.

Healthcare Instructions F - Inpatient Skilled Nursing Care Self Surrender

Definition:  Individual’s healthcare needs require continuous skilled nursing or mental health care, housing, or accommodation in an inpatient unit.

Basic Information

1.  To notify Correctional Health Services (CHS) about healthcare issues, call the Self Surrender line at
(602) 876-6884.  Healthcare Information can also be faxed to the CHS Fax Line at (602) 455-6147.

2.  Bring the following items when you self surrender:

•   Prescription medications.

•   Sentence of 15 days or more requires a Healthcare Provider’s Certification Form.

•   Completed Medical Receiving Screening Questionnaire available at www.mcso.org (Jail information
tab, select Self Surrender)

3.  Upon arrival at the jail, your Medical Receiving Screening questionnaire is reviewed (or completed if you did
not bring a copy with you).

4.  If you have current medical problems that indicate the possible need for emergency evaluation, intervention,
and/or hospitalization, you may not be accepted for booking.

5.  For complete information on the self surrender process and requirements, contact the Maricopa County

Sheriff’s Office at the MCSO website www.mcso.org or the MCSO Jail Information line at (602) 876-0322.

6.  The Lower Buckeye Jail (LBJ) is located at 3250 W. Lower Buckeye Road, Phoenix, AZ.

7.  Self Surrender parking is located in a separate, fenced off parking area at the far east end of the building.
      There is a “Self Surrender Parking Only” sign at the entrance.

8.  Housing is located in the Infirmary or Mental Health Unit for patients who require special accommodations.
These include those who cannot perform their own activities of daily living (showering/hygiene, feeding and
clothing self), have dementia, or who require 24 hour skilled nursing care.  Admission to Inpatient units is
determined/ordered by a CHS provider.

9.  If you are housed in the Infirmary or Mental Health Unit, you will not be eligible for work release or work
furlough. (Refer to “instruction sheet A Work Release” or “instruction sheet B Work Furlough”).

Preparing for Confinement

1.  CHS requires the following items be faxed or mailed by you 7 business days prior to your self-surrender
date:

•   A copy of the court Order of Confinement

•   A print out from your pharmacy or healthcare provider listing each of your current medications,
dosage information, and the reason for the medications (must be current within the last 90 days)

•   A summary from your healthcare provider describing your medical condition and special needs or
equipment.

•   Current healthcare provider’s contact information including name, address, and phone number.

•   Your contact information—name, phone number, address where you can be contacted prior to your
self-surrender date.

2.  You should request a self surrender date from the court for a Thursday, Friday or Saturday, excluding

holidays, from 9:00 am – 6:30 pm.  A nurse is assigned to LBJ Intake during these hours to facilitate the screening process and insure continuity of care.

Send above information to CHS:

1)  By fax:  (602) 455-6147

2)  By Mail to:  CHS Self Surrender Office
Correctional Health Services

Lower Buckeye Jail Infirmary 3250 W. Lower Buckeye Road Phoenix, AZ  85009