James “Mark” Rippee is one of many individuals with disabilities living on the streets. Rippee suffered a debilitating brain injury 30 years ago after his motorcycle collided with a car—leaving him permanently blind and in the throes of acute schizophrenia. Increased political tensions between local, state, and federal officials over how to address mental illness among those who are homeless have placed Rippee and others like him in the middle of a political hailstorm. For instance, the state of California, where Rippee resides, permits county officials to detain homeless individuals who have been placed in a 72-hour psychiatric hold at least eight times in a given year. The policy gives counties complete authority to make decisions about an individual’s housing and medical and psychiatric treatment for an undetermined period of time. Without adequate staff or facilities, however, “conserved” individuals can be locked up in prison-like facilities, sedated with a cocktail of heavy medications, and provided little to no treatment for their underlying conditions. Advocates describe conservatorship as “the biggest deprivation of civil rights aside from the death penalty” and charge public officials with camouflaging “political failures…with solutions that may decrease the visibility of individuals on the street” but do little to address their struggles with mental illness (Orion Donovan Smith, “San Francisco to Force People into Treatment for Addiction and Mental Illness,” Washington Post, June 7, 2019).

Stories like Rippee’s—and the political controversies they unleash—are an all-too-common element of disability rights politics in the United States. Federal-state-local conflicts, standoffs between advocates and policy officials, and rights-based protests are a mainstay of disability politics. Yet, as a topic of scholarly investment, the politics of disability policy has been relatively ignored by politics or policy scholars. David Pettinicchio’s Politics of Empowerment: Disability Rights and the Cycle of American Policy Reform offers a new and much-needed focus on the politics of disability rights. Pettinicchio provides a detailed history of the federal fights and legislative narratives that motivated progress (and retrenchment) in federal disability policy reform. Where other scholars have focused on specific instances of disability rights policy, he takes an aerial view of disability rights politics—focusing on general policies and broad coalitions or conceptions of ability-based discrimination. In so doing, Politics of Empowerment mainstreams the politics of disability into a broader scholarship on federal legislative processes and civil rights advocacy organizations. This, on its own, is a service to disability policy scholarship. Little attention is paid to disability rights (and much of the scholarship is decades old); with ongoing political and budgetary battles over disability services there is a pressing need for scholarly attention. Dedicating a book-length project to surveying the trajectory of these policy reforms is an important step toward filling this significant lacuna.

Pettinicchio’s accomplishment, however, is more significant than simply filling a substantive void. He offers key frames and approaches that will resonate with civil rights researchers and policy process scholars alike. Politics of Empowerment provides an innovative framework for exploring how civil rights reform politics is shaped by the nature of advocate participation. Pettinicchio centers his focus on specific mechanisms of reform, post-reform organizational evolution, and the relationship between federal policy officials and service providers-turned-advocates. He argues that the evolution of disability-focused groups, from service providers with clients to advocacy groups representing communities, influenced the trajectory of disability reform politics and the movement toward more rights-based or identity-based politics.

Pettinicchio periodizes disability reform politics into two stages. The first—beginning in the 1920s—follows a “client-service model,” where legislator–volunteer partnerships focus on providing rehabilitative services to “help the disabled help themselves” (p. 19). This period is marked by several key characteristics. First, government actors see themselves as pioneers in supporting large-scale practical and evidence-based approaches to helping individuals with disabilities become self-sufficient. In their own words, legislators of the time envisioned their role as “provid[ing] opportunities to ‘the unfortunate people who have been handicapped’” and to help them “become thoroughly independent of any help in order to take care of [their] personal affairs” (p. 40). Second, these “rehabilitative” services are targeted to specific challenges; there is no conception of “disabled” as a unifying broad-based community or identity. Third, because of their expertise and the complexities of client needs, disability service providers and organizations achieve an “elite status” and are consulted by “legislators and bureaucrats…as community representatives, helping to both ensure and entrench rehabilitation policies and programs” (p. 33). In this way, this phase of disability policy reform follows a trajectory of stakeholder entrenchment and client demand that typifies many social welfare programs. Social policy initiatives fill critical needs and motivate client demands for service provision and for innovation provided by technically trained professionals. By the late 1970s, disability-focused organizations outpaced organizations focused on race and gender. However, as Pettinicchio points out, even as late as the 1960s, when rights-framed movements were in full swing, there was still no conception of disability rights—nor was there an advocacy-based approach to fighting for access or accommodations.

The shift to phase two, from services to rights—and rehabilitation to accommodation—Pettinicchio tells us, is as much a story about legislator narrative as it is about a rights-based movement. Legislators are moved to action by their personal connections to legislative aides or grandchildren who have contended with service or structural barriers. These experiences drive legislative efforts to draft, sponsor, and market legislation. Pettinicchio highlights the ways in which these narratives catalyzed legislative support for the first whispers of disability rights—for thinking about the challenges of disability as problems of societal accommodation rather than only individual capabilities. Personal appeals, coupled with structural innovations in Congress (the creation of the Senate Subcommittee on the Handicapped) provided both space and leverage for legislators and providers to push for rights-based language—language that would address universal principles of nondiscrimination and accommodation—to be included in the Rehabilitation Act of 1973.

By highlighting this two-step process from service provision to barrier reduction and self-sufficiency to civil rights, Pettinicchio reveals the significance of disability politics reform—not only as an important (yet distinct) story of civil rights policy but also, more broadly, as a window into agenda setting, interest group formation, and a rights evolution. Of course, no project—particularly not one as ambitious as Politics of Empowerment—can adequately cover every nuance of a policy debate or every aspect of scholarly intervention. Thus, there are two noteworthy omissions that scholars should be aware of—particularly as they are thinking about how best to use this book in a classroom setting. First, Pettinicchio’s treatment of political science and public policy scholarship is limited. Although the book offers an abundance of empirical material—detailed descriptions of legislative maneuvering, in-depth analyses of hearing testimony—there is far less engagement with the political science scholarship that would help readers contextualize these findings within established scholarly frames. A second, and more empirical, omission is Pettinicchio’s treatment (or lack thereof) of legal doctrine and litigation. Legal advocacy and court action are strangely and noticeably absent from his discussions of the evolution of disability policy reform. The courts played a significant role in interpreting legislative initiatives and providing leverage for providers to push for policy innovations. Furthermore, as the primary institutional engines for rights claims, courts played an especially critical role in devising the meaning and scope of the “reasonable accommodations” doctrine—a core platform for disability rights narratives. Consequently, readers are left with the mistaken impression that courts were of little significance to disability rights reform.

However, on the whole, these omissions do not detract from the overall value of the book. Pettinicchio’s research and insights provide a much-needed and important introduction to the broader politics of progress and retrenchment in disability rights legislation.