In Connecticut, Vicki keeps in close contact with her constituents.

Nov. 1, 1998
State legislator strives to develop personal relationships with the voters in her district - the sort of thing a hygienist would do.

State legislator strives to develop personal relationships with the voters in her district - the sort of thing a hygienist would do.

Judith E. Sulik, RDH

Amazingly, only one dental hygienist, Vicki Orsini Nardello of Connecticut, serves in a state legislature, according to the American Dental Hygienists` Association.

Nardello, a Democrat, currently is seeking re-election to her third term as a state representative in a predominately Republican district. Her dental hygiene background as an activist member of the Connecticut Dental Hygienists` Association was a critical factor in her path to the state house; she hopes her story may arouse other politically-inclined hygienists to public service.

In an age of cynicism toward public service and politicians generally, Nardello is working hard to change that perception among her constituents. She wants people to feel more positive toward public service and not to feel disconnected from the political process. But from personal experience she understands how the current climate came to be.

She said, "As a dental hygienist working on legislative issues (for both the Connecticut Dental Hygienists` Association and on a national level), I was disturbed when my calls to legislators weren`t returned or when the legislator wasn`t pleasant toward me. I didn`t like it. I vowed to be different."

Throughout her campaign and on every piece of literature, Nardello gives her office number and home number. She encourages people to call - and they do. She strives to form a personal relationship with her constituents. Nardello said she intercedes on behalf of her constituents in a variety of issues. She said, "I help some people with family and children problems ... cable ... jobs. I also help them get information and cooperation from state agencies. For example, one person was waiting three weeks for forms from a state agency; it should have only taken the agency a couple of days to get this standard form out. If people have legal issues, I refer them to the proper authorities."

She said her legislative aides are always surprised when people routinely call asking for "Vickie," and they initially think they are all personal friends. When campaigning door-to-door, people greet her with, "Hi, Vickie. How are you?" This ability to quickly establish rapport with strangers is a skill many hygienists hone daily, and Nardello has plenty of experience as a hygienist. She works full-time at Moylan School in Hartford when the legislature is not in session. When the legislature is in session, she reduces her hours and personnel is shifted to make up for her absence; her salary is adjusted to reflect the change.

In fact, it is because she is a dental hygienist that she became a state representative. She explained that a colleague noticed she was writing letters to state reps during her lunch break and she told Nardello that her husband was a legislator. The colleague asked her if she had ever considered running for election herself. The question took Nardello completely by surprise.

However, sometime later when she was in Louisville, Ky., as an ADHA delegate, she told people that she had been approached about running for state office. The response was, "Go for it, we`ll support you."

But deciding to run and winning are two distinct outcomes as Nardello soon discovered. This political neophyte, who had no previous involvement with local politics, contacted the Democratic party leaders and they said they would support her. Little did she know that the reason they agreed so readily to her offer to run was because they considered her district a "no-win" race; she was running against an incumbent in a traditionally Republic district. Indeed, she lost by 900 votes.

Much to her surprise and confusion, the party leaders later called to congratulate her for the "wonderful job." Nardello had run the closest race in 14 years. Two years later the incumbent declined to run, and Nardello won by 162 votes.

She takes her responsibilities seriously, thoroughly immersing herself in a subject. As the vice-chairman of the Energy and Technology Committee, she learned everything she could about electric de-regulation. She said, "I was most concerned with making sure the residential consumer was protected in the de-regulation bill. I spoke with national groups and consumer groups. The result is that Connecticut has one of the strongest consumer protection sections in the country. I wanted to make sure that all classes of consumers benefited, and I was especially concerned about residents because they have no lobby."

She said that passage of the legislation is only the beginning. This bill is 172 pages long; the Department of Public Utility Control will implement it. She will remain a member of the energy committee because she wants to make sure it is implemented as intended. This doesn`t necessarily happen without oversight. She said that key players in the drafting of legislation often move on to other issues and sometimes original intentions get lost during implementation. She won`t be following that pattern.

Not surprisingly, Nardello is bringing her concerns about dental care access to the state capital. She was instrumental in getting a pilot program passed that will allow dental hygienists to work unsupervised in public health settings. This was important to her, especially given her public health background. "Connecticut has one of the lowest rates of compliance with the federal Early Periodic Screening, Diagnosis and Treatment program, which is an important preventive dental care tool," she said. "Only 28 percent of eligible kids in Connecticut are getting screened. Only 18 percent of Connecticut dentists take Medicaid patients."

She continues, "Dental hygienists should be able to go out into the community to provide preventive dental care without dental supervision. Right now, hygienists can work without a dentist on-site, but a dentist must authorize treatment. It`s getting harder to get dentists to authorize treatment because of liability concerns. A best-case scenario would be that a hygienist can go out into the community and work within the scope allowed by the license parameters. Furthermore, the hygienist will be able to assess and make referrals for restorative treatments. This is a new concept for hygienists, acting as case managers in a public health setting. Nurses are doing this, and this is an important role that hygienists can take on in the public health setting. These patients have many barriers to care. We, as hygienists, can find the appropriate links to the dental health community. We will be the crucial link between the patient and dental health care access."

She understands the reluctance of dentists to participate in Medicaid saying, "The dentists argue that reimbursment is not adequate; too many patients don`t keep their appointments; patient compliance is low; and there is too much paperwork involved."

For these reasons, she thinks that access to dental care among the under-served would be improved if more clinics were built. "There are too many barriers in the private system. We need to expand the dental public health infrastructure. School-based dental clinics are the best access point for children, but the infrastructure must be developed."

To that end, she was a critical force in establishing a $600,000 fund using state bonding money to build dental facilities. The money will provide start-up funds; the facility seeking the money will have to prove there is enough money to operate the clinic.

Nardello is particularly proud of this accomplishment because it is the first time money has been approved for this kind of use. In addition, $350,000 was given to existing clinics to provide dental services to the uninsured and the under-served.

Nardello also was closely involved in the passage of the Children`s Health Insurance Program, a Title XXI program. She said that Connecticut was one of the first states to enact it. She advocated for the inclusion of full-dental coverage, including prevention and sealants. She said it "got down to the wire" but she was able to get it in.

She says that dental health is not a prime concern of legislators, since it is not a re-election issue, so she was pleased that she could get legislation that will improve access to dental care passed.

Nardello, who earned her bachelor`s degree from the Fones School of Dental Hygiene in Connecticut and her master`s in health education at Southern Connecticut State University, thinks she has been able to make a difference in issues that are important to her, especially public health. She believes that dental hygienists must advocate not only about issues that affect them directly as a profession, but also for the needs of those in society who can`t access dental services easily. She said, "As a profession, we have the responsibility to advocate for the oral health needs of all individuals." Indirectly and ultimately, hygienists will also benefit from the expanding opportunities that will result.

Nardello is in the midst of her re-election campaign. While she does expect to win, she also knows that she will face opposition from organized dentistry once again. She said the dental groups routinely give campaign contributions to her opponent because they fear she will take on dental hygiene policy issues.

The dentists fear that once hygienists are able to practice outside of a private practice setting without dental supervision, the door will be opened to independent practice. For this reason, she is seen as a threat to them. She said that when she meets with dentists as individuals they are supportive, but organized dentistry always galvanizes its forces against her.

Nardello urges dental hygienists to become politically active by working on campaigns or by making campaign contributions to candidates who reflect their views on issues. Even though money isn`t supposed to be discussed in "polite company," it is necessary in every election. She said that her campaign will cost $30,000.

Reflecting upon her distinction as being the only hygienist presently serving in a state legislature in the country, she said, "I`d like to see more hygienists as legislators. You can make a great difference. It`s a tremendous opportunity to affect policies across a wide spectrum including women`s health issues, such as insuring a 48-hour hospital stay after giving birth or having a mastectomy. I`m proud that I was able to make a difference in the quality of Connecticut women`s lives. But so many other issues still remain."

Readers interested in supporting Nardello`s campaign can send contributions to Nardello 98, 8 Laurel Lane, Prospect, CT 06712 (Checks must be payable to Nardello 98).

Judith E. Sulik, RDH, is a frequent contributor to RDH. She is based in Bridgeport, Conn., where she publishes recipe books under her company, Finely Finished Press. Her latest book is titled, "No sink? No counters? No problem!" The book can be ordered for $7.95 from the Finely Finished Press, 60 Acton Road, Bridgeport, CT 06606.