From developing a welfare reform program during the Sununu administration that focused on recipients achieving independence and securing stable employment, to implementing major health care reforms as the Deputy Commissioner during Governor Steve Merrill's tenure, Sgambati proved adept at meeting the needs of New Hampshire's residents in part by securing over a billion dollars in new federal aid.

As Deputy Commissioner during the six years Governor Jeanne Shaheen led the state, Sgambati was instrumental in designing and introducing the Children's Health Insurance Program (CHIP) and the Kid's Cabinet.

Since leaving DHHS Sgambati has worked as a consultant, concentrating her efforts on foster care, children and youth services, developmental services, after school care development, and health care reform. She has also managed the Citizens' Health Initiative launched by Governor John Lynch.

Kathy has lived in Tilton since 1978 where she and Frank, her husband of 32 years, have raised two sons.  Frank works at the UNH Institute on Disability and specializes in inclusive education.