Treatment - Cert of Completion — USA v. Golden-Larimore et al (Dkt. 306.2)

Summary

Document 306-2 in Case 4:23-cr-00098-BCW in the U.S. District Court for the Western District of Missouri, filed June 26, 2024, is a recovery plan from HCBC - KC (Prospect) for Cameron Henderson in the program United States Pre-Trial Missouri. It records successful completion of the program on 6/25/2024, with Consumer Completed Treatment as the reason for discharge, and is signed by counselor Pamela Bentley, a Certified Criminal Justice Addictions Professional.

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Record facts

Full text

Case 4:23-cr-00098-BCW     Document 306-2     Filed 06/26/24     Page 1 of 4
HCBC - KC (Prospect) - Recovery
Plan

Session Information

Client: Handarenn Cameron (8174381)
Staff: Bentley, Pamela (1035)
Document Date: 6/25/2024
Effective Date: 6/25/2024
Client Program: United States Pre-Trial Missouri (MO-
Western) (USPTMO)
Client DSM Diagnosis as of 11/30/2023
03:15 PM

Client: Henderson, Cameron (8174381)

11/30/2023 03:15 PM
No
Kidner, Wade (26524)

Effective Date/Time:
External Diagnosis:
Diagnosed By:

Comments:
Diagnosis

DSM-5 Severity/Specifier ICD-10 Comments
F12.21 - Provisional F12.21 -
Cannabis Cannabis
Use dependence,
Disorder, in remission
Moderate, In
early
remission

The Diagnoses above display in priority order.

Psychosocial and Contextual Factors
Comments

ICD-10 Code - Description

No records found.

Diagnostic Formulation

mGAF score: 61 11-30-2023

Functional Assessment

Admit Date:
Referral Source:

Program Status
Request:

Dimension 1: Acute
Intoxication and/or
Withdrawal Potential:
Dimension 2:
Biomedical Conditions
and Complications:

Dimension 3:
Emotional, Behavioral,
or Cognitive Conditions
and Complications:
Dimension 4: Readiness
to Change:

Dimension 5:
Substance Use and
Relapse Potential:
Dimension 6: Recovery/
Living Environment:

Henderson, Cameron (8174381)
Case 4:23-cr-0O0098-BCW Document 306-2

11/30/2023
Fed, St, Ctny Probation

Discharge

None (Early Intervention)

None (Early Intervention)

None (Early Intervention)

None (Early Intervention)

None (Early Intervention)

None (Early Intervention)

1 of 5

Date Printed: 6/25/2024 3:37 PM
Case 4:23-cr-00098-BCW     Document 306-2     Filed 06/26/24     Page 2 of 4
HCBC - KC (Prospect) - Recovery
Plan

6/25/2024 He completed all goals and objectives.

SNAP (Strengths, | Strengths: "Positive, nice, accountable, reliable, good with people, especially
Needs, Abilities, | kids"
Preferences): | Needs: "car" "sleep"
Abilities: "CPR certified, clench trained, football, basketball" good with numbers
and business-wise, good at being a father
Preferences: n/a
6/25/2024
Strengths: “Positive, nice, accountable, reliable, good with people, especially
kids" "good role model"
Needs: "car" "sleep"
Abilities: "CPR certified, clench trained, football, basketball" good with numbers
and business-wise, good at being a father
Preferences: n/a

Diagnosis: | F12.21 Cannabis use Disorder, moderate, in early remission, provisional
mGAF Score: | 70

Risk rating for highest | None (Early Intervention)
dimension:
Level of care} None (Early Intervention)
placement:

Treatment | Individual Sessions weekly
Recommendations: | 6/25/2024 Successful completion of the program.

Reason for Discharge: | Consumer Completed Treatment - Consumer has satisfactorily completed his/her
individual treatment plan and is not being referred to any other level of treatment.

Transition Plan

Persons Involved in | Cameron Henderson, consumer
Completing Plan: | Pamela Bentley, counselor

Status of Client: | current

SNAP: | Strengths, Needs, Abilities, Preferences:

Strengths: "Positive, nice, accountable, reliable, good with people, especially

kids"

Needs: "car, more income"

Abilities: "CPR certified, clench trained, football, basketball”

Preferences: n/a

5/16/2024

ee “Positive, nice, accountable, reliable, good with people, especially
ids"

Needs: "car" "sleep"

Abilities: "CPR certified, clench trained, football, basketball" good with numbers

and business-wise, good at being a father

Preferences: n/a

6/25/2024

Strengths: "Positive, nice, accountable, reliable, good with people, especially

kids" "good role model"

Needs: "car" "sleep"

Abilities: "CPR certified, clench trained, football, basketball” good with numbers

and business-wise, good at being a father

Preferences: n/a

Extent to which all | He's attending as required and working on identifying his short- and long-term
goals and objectives | goals, personal growth and now working on a Relapse Prevention Plan.
are being acheived or | 5/16/2024 he has a negative UA and will review for completion on 6/25/2024.
have been acheived: | 6/25/2024 completed his goals and objectives.

Referrals/After-Care | 1] Community Supports © Medical Facility 0 Primary Care Physician

Recommendations: 0 Domestic Violence C Mental Health Facility O Recovery Support
Shelter ONursing Home Services

0 Drug Court C0 Other 0 School System

Ci Help Line OD Other Substance Use I Self Help (AA)
OQ Inpatient / Residential Disorder Treatment OC) Sheltered Workshop
Treatment Provider
Henderson, Cameron (8174381) 3 of 5 Date Printed: 6/25/2024 3:37 PM
Case 4:23-cr-00098-BCW     Document 306-2     Filed 06/26/24     Page 3 of 4
HCBC - KC (Prospect) - Recovery
Plan

Signature History

Action Date Staff

Document Signed 6/25/2024 Pamela Bentley
(Certified Criminal
Justice Addictions
Professional, Certified
Criminal Justice
Addictions Professional)

Henderson, Cameron (8174381) 5 of 5 Date Printed: 6/25/2024 3:37 PM
Case 4:23-cr-00098-BCW     Document 306-2     Filed 06/26/24     Page 4 of 4
Age of First Use of
Tertiary Substance:

Number of Prior
Treatment Episodes:

Primary Source of
Payment:

Days Attended Self Help
of Prior 30 Days:
Receiving Medication
Assisted Treatment for
Opioid Use:

Receiving Medication
Assisted Treatment for
Alcohol Use Disorder:
Primary Health
Insurance:

Mental Health
Problems:

TEDs Data is for ASAM

Signature #1:

HCBC - KC (Prospect) - ASAM TEDS
Data

Enter "96" for Not Applicable or "97" for Unknown

Include all WM, Residential, OP, or IOP
No Prior Treatment Episodes

Other

No
No

Blue Cross/Blue Shield

Specify whether the consumer has any known Mental Health problems in addition
to the substance use disorder regardless of whether the consumer has been or is
being treated for the problems or whether the problems are under control.

No

False for all admissions, program changes, and discharges. True for
administrative change from 2.1 to 1.0.

False

Signatures

Pamela Bentley (Certified Criminal Justice Addictions
Professional, Certified Criminal Justice Addictions
Professional) - 6/25/2024 3:36 PM

Signature History

Action

Date Staff

Document Signed

6/25/2024 Pamela Bentley
(Certified Criminal
Justice Addictions
Professional, Certified
Criminal Justice
Addictions Professional)

Henderson, Cameron (8174381)

2 of 2 Date Printed: 6/25/2024 3:37 PM


File and source

File

gov.uscourts.mowd.169316.306.2.pdf

Size

1,025,644 bytes

SHA-256

1971b19bdf54fb1eaa10015e049495f36663b00d25a0d2051c1089c41c044bdb

Our copy

gov.uscourts.mowd.169316.306.2.pdf

Original

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