The state's No. 2 mental health official told colleagues Tuesday he's retiring, the latest personnel move at an agency cast into scrutiny over the death of state Sen. R. Creigh Deeds' son.
John Pezzoli, chief deputy commissioner at the Department of Behavioral Health and Developmental Services, said in an email addressed to "friends and colleagues" he'll step down Sept. 1. The position pays him $155,434 annually, a spokeswoman said.
"I agreed to stay on through the summer to help ensure a smooth leadership transition and continue to work on efforts to improve Virginia's system of services," Pezzoli, 68, wrote. "I have confidence in the direction we are going."
Virginia's mental health system has been in the spotlight since Nov. 19, when Austin "Gus" Deeds, 24, stabbed his father, the state senator, more than a dozen times, then killed himself with a rifle at the family's Millboro home. He'd been released 13 hours earlier from an emergency custody order after a mental health clinician failed to find a psychiatric bed so that he could undergo further evaluation.
A state inspector general's review issued in March cited missteps in the clinician's handling of the case and said the state "did not fully or in a timely manner address the key recommendations" of a 2012 report warning of the dangers of "streeting," referring to people needing further care being released because available beds cannot be found.
Commissioner James W. Stewart III and two high-ranking deputies - Olivia Garland and Heidi Dix - all left the Behavioral Health Department in January. That same month, Gov. Terry McAuliffe appointed Pezzoli acting commissioner.
At the time, Pezzoli said he would not rule out the top job if it were offered. He did not answer a question Tuesday about that comment, saying he'd been planning for more than a year to retire.
"My wife is also retiring this summer and we are starting this new chapter together after we both have made our work a top priority for a long time," he said. "We are looking forward to new adventures together, especially traveling to see our two daughters who both live far away."
McAuliffe in March appointed Debra Ferguson as Behavioral Health Department commissioner. Bill Hazel, secretary of Health and Human Resources, earlier this year cited the selection of an out-of-state replacement for Stewart as a measure of accountability. Ferguson formerly was senior deputy and chief of clinical operations for the Illinois Department of Human Services' Division of Mental Health
"You may or may not call that accountability," Hazel said then, "but actions were taken to strengthen the program."
Hazel on Tuesday commended Pezzoli for his work helping oversee "a significant change in leadership at the department."
"[Pezzoli's] years of experience have been invaluable to Dr. Debra Ferguson, our new commissioner," Hazel said through a spokeswoman. "She is now in the process of selecting a new chief deputy. The changes taking place in the department will not distract from our greater goals."
Since November, Pezzoli has overseen the implementation of key recommendations from the 2012 inspector general's report authored by G. Douglas Bevelacqua, who later resigned, citing changes to his work reviewing the Deeds case. That report found, among other things, that an absence of protocols, communications breakdowns, costly delays and barriers to finding care all helped lead to Deeds' release.
Bevelacqua in April 2011 forecast scenarios like that one, writing Stewart to ask the department to intervene in cases like Deeds', where an order to hold someone in need of care expires before an available bed is found.
"The current situation ... is a tragedy waiting to happen, and, with each day that passes, the likelihood of a disastrous outcome increases," Bevelacqua wrote.
The department issued a three-page guidance document 22 months after the 2012 report calling for policy revisions that Bevelacqua says would have gotten Gus Deeds the emergency care he needed.
"To date, not one person has stepped forward and said, 'We failed Gus Deeds,'" Bevelacqua said Tuesday. "The department under leadership that included [Pezzoli] failed to implement those recommendations, and the truth is that what happened to Gus Deeds was systematic malpractice."
Pezzoli's 39 years working in Virginia include a 25-year stint at the Region Ten Community Services Board in Charlottesville, which he left in 2005 for a post with the state inspector general's office. He joined the Behavioral Health Department in 2010.
"The last six or seven months have rocked everybody's world, and there have been a lot of questions and calls for accountability," said Lawrence "Buzz" Barnett, Region Ten's emergency services director, who worked with Pezzoli for decades. "John always steps up to the plate, and I continue to have a tremendous amount of respect for him."
Pezzoli said President John F. Kennedy's call to public service inspired him to pursue a career helping others. He got his start as a juvenile probation officer in Texas, taught middle school and served in the U.S. Army Reserves before embarking on a 43-year career in mental health.
Barnett described Pezzoli as magnanimous, charismatic and dedicated, saying he made a name for himself first as an advocate for people with intellectual disabilities.
"He was truly a leader in Central Virginia in terms of making changes in the way we provide services for people," Barnett said. "He's done a remarkable job wherever he's been."
Providers have come a long way, Pezzoli said, from the 'appalling' conditions he first encountered in Texas at centers for people with intellectual disabilities. He cited the accelerated shift from institutional to community-based treatment he has witnessed over four decades in the field among the most significant developments in public mental health care.
Hazel, through a spokeswoman, said he is committed to continuing reform.
"I remain determined to implement improvements in our mental health system, both immediate and urgent reforms as well as long-term steps necessary to ensure that all Virginians seeking our help receive quality care," Hazel said.
Sen. Deeds, the 2009 Democratic gubernatorial nominee, has said more needs to be done. Earlier this month, he filed what's known as a notice of claim, a first step in a potential lawsuit against the community services board that handled his son's case.
"The legal process is the way you make change," the Bath County senator said then. "There hasn't been any accountability."