"Six-seven-eight," he said in a slow, slurred voice. 

June 7, 2008.

That's when he went downtown for a birthday party. Around 1 a.m., a drunken driver drove onto the sidewalk of Capitol Street and struck him. For three weeks, Berkhouse lay in a coma. He suffered facial fractures, a stroke and a traumatic brain injury.  

Last month, Melissa Newman was sentenced to a year in jail after pleading guilty to DUI causing injury and other charges related to the accident.   

For Berkhouse and his family, the ordeal is far from over. A week ago, the 31-year-old left his home state for intensive rehabilitation at Lakeview Virginia NeuroCare in Charlottesville, Va.

"You can't stay here and get better," said Berkhouse's girlfriend, Lindsay Bolar. "You have to go out of state."

Advocates say the state Department of Health and Human Resources has failed people with traumatic brain injury -- even after decades of legal battles. 

This spring, Kanawha Circuit Judge Duke Bloom began a series of hearings related to a decades-old case involving DHHR's services for people with traumatic brain injuries and overcrowding at the state's two psychiatric hospitals.

Many advocates believe court action is the only way to make DHHR step up its efforts, said Mike Davis, president of the Brain Injury Association of West Virginia.

"Health and Human Resources hasn't done what they are supposed to do," he said. "People are suffering because of this."  

'Nobody expects it'

With traumatic brain injury, those who have never experienced disability are thrust into an overwhelming situation, said Clarice Hausch, director of West Virginia Advocates. Car wrecks and falls cause the injury most often.

"The damage is instant," Hausch said. "And nobody expects it."

The injury can range from mild to severe. It can cause depression, personality changes, memory loss, blurred vision, speech problems and loss of coordination.  

The Brain Injury Association of West Virginia estimates that of the state residents who survive a traumatic brain injury each year, 600 will have a long-term disability. 

Before the accident, Berkhouse worked as a SkyWest Airlines customer service representative at Yeager Airport. The job let him travel, and the diehard Mountaineer football fan went to as many games as he could.

He used to play softball and flag football. Now, he must learn to walk again.

At home, there's so much time to think, Berkhouse said.

"I have to learn how to lay here," he said recently, sitting in a wheelchair next to a hospital bed in his mother's Mink Shoals living room. "I have my computer and video games, and that's how I get through the day."

He forgets things easily. Before he left for Virginia, he couldn't be left alone in the house.

His mother, Geneal, is grateful she is healthy enough to care for him.

But at 75, she said, "it's hard on me with my age."

Berkhouse had no health insurance when he got hit, so he relied on Medicaid. After he attended 20 rehabilitative therapy sessions, he got a letter saying Medicaid wouldn't pay for any more of them.

From the beginning, his family, friends and co-workers rallied around him. They sold hot dogs and baked goods. They organized pig roasts and horseshoe tournaments.

The fundraisers brought in $30,000. But the Berkhouse family still needs to raise $20,000 to pay for everything he'll need at the Virginia center, his mother said

For years, advocates have pushed for a Medicaid waiver program for people with traumatic brain injuries. That would let people get services -- such as personal-care aides and case management-- in their homes and communities, rather than being institutionalized.

"The community-based services that a lot of people need are not 24/7," Hausch said. "But without those supports, they end up in a facility, where the cost is 24/7."

Twenty-five other states have a waiver program for those with traumatic brain injuries, said Davis, adding that the issue is becoming even more critical as veterans with the injury return home from war.

West Virginia has a Medicaid waiver program for people with mental retardation and developmental disabilities. But people who sustain a TBI after they turn 22 aren't eligible for that program.

'Things are never the same'

The recent hearings in Bloom's courtroom stem from a lawsuit dating back the early 1980s about how West Virginia administers mental-health care.

Later this month, petitioning attorneys will meet with DHHR attorneys to mediate issues related to services for those with brain injuries, said West Virginia Advocates staff attorney Teresa Brown.

Bloom has also ordered a court monitor to track the state's progress on psychiatric hospital conditions and TBI services.

"It seems like everybody's working together to come to a successful conclusion here," Brown said.

But advocates and DHHR have gone through mediation before, and the advocates say DHHR never followed through on its agreements -- including securing funding for services for those with brain injuries and applying for a federal Medicaid waiver.

In 1998, the state developed "a very, very good" plan to help brain-injury victims, Hausch said: "The things in that plan have never been implemented."

Then, under a 2001 consent order, the DHHR agreed to apply for a federal Medicaid waiver for those with brain injuries. It never did. In 2007, the DHHR again agreed to explore a waiver program. 

The state's shortcomings have left brain-injury survivors with almost nowhere to turn, Hausch said. Many end up in nursing homes or state psychiatric hospitals.

"We have a very limited number of specific traumatic brain injury services in West Virginia, because there's no source for providers to get paid," Hausch said. "That's why you so often see people go out of state."

DHHR spokesman John Law said the department couldn't comment on brain injury issues until court proceedings wrap up.

"That is still a matter of mediation before the judge, so we really can't comment specifically," Law said.

In Virginia, Berkhouse is adjusting well, his mother said last week: "They're really working with him."

Berkhouse has a lot going for him, said Davis of the Brain Injury Association. 

"He's very motivated to do something," Davis said. "He's young. He's survived a terrible ordeal."

But Davis is quick to say there's no such thing as "lucky" when it comes to traumatic brain injuries.

In 1980, a drunk driver hit him and his 8-year-old son, Todd, as they traveled down U.S. 119 in Elkview. Todd Davis suffered massive head injuries. Nearly 30 years later, he functions on the level of a 4- to 5-year-old child.

"I don't believe there's any such thing as being fortunate with this injury," Mike Davis said. "It just absolutely changes people's lives forever, and things are never the same."

Reach Alison Knezevich at alis...@wvgazette.com or 304-348-1240.