Southland Advisor’s Quest for Quality

As the only Southern Californian appointed to a new presidential commission on health-care issues, Sylvia Drew Ivie hails from a region that is a national testing laboratory of sorts for market-driven change in medicine.

Those changes, especially the rising influence of managed care nationwide, were behind President Clinton’s decision to create the commission last week, fulfilling a pledge he made in September during his reelection campaign.

The creation of the advisory panel comes amid much public anxiety about managed care. Nearly 75% of working Americans with health insurance now belong to health maintenance organizations and other types of managed-care plans, replacing traditional fee-for-service medicine.

Millions of elderly Americans are joining HMOs, and many states--including California--are requiring millions of low-income patients who receive Medicaid benefits to join HMOs. These shifts are one of the main reasons behind the commission, Clinton has said.

“Our mission,” Ivie says, “is to look at the need for consumer protection and to ensure quality health care, not only in managed care, but in all delivery systems.

“There needs to be a very important national emphasis on quality of health care,” she says. “Everybody is worried about it no matter where they sit, as patients or providers.”

Ivie, who heads a Los Angeles community clinic, will be one of 32 members on the commission and one of two Californians. The other is Sandra Hernandez, director of the San Francisco Department of Health. They were chosen from among more than 1,000 nominees for the panel from business, labor, academia, health insurers, doctors, hospitals and other medical providers.

Ivie’s vantage point is definitely not from the executive suite or ivory tower. She brings more of a street-level view.

Ivie is executive director of T.H.E. Clinic for Women, in the Crenshaw district. Since the mid-1970s, the clinic has provided basic medical services primarily for poor women and children, and is the only nonprofit medical clinic serving Southwest and South-Central Los Angeles.

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Ivie, a native of Washington, D.C., is a graduate of Vassar College and the Howard University Law School. She was director of the Office of Civil Rights in the U.S. Department of Health and Human Services under the Carter administration. She is also a former executive director of the National Health Law Program in Los Angeles, an advocacy group for low-income people.

Ivie describes her appointment as “a great honor” and said that, as a representative of community clinics, “we’re very happy to be invited to the table.”

Given Southern California’s important role in fostering health-care changes, Ivie says she would like to have seen a few more local people appointed to the panel.

“I’m hopeful this will not be just a study group that meets and issues a report in a year’s time,” she says, “but rather a body of people who have expertise on an important issue that they can discuss immediately with legislators and policymakers as matters come up.”

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David Olmos can be reached by e-mail at david.olmos@latimes.com or by fax at (213) 237-7837.