In February 2023, I raised my right hand in front of a judge and was sworn in as a volunteer Court Appointed Special Advocate for children in the third district courts of Utah. In this role, I would be a friend and champion for a group of siblings in foster care, something that I had spent months preparing for with interviews, background checks and evening classwork.
I was soon assigned my first case, given nothing but the children’s names, ages, and a brief but horrifying description of why they were in state custody. My job was multifactorial — much of what I did was work to become a reliable, caring adult in the lives of kids who were lacking such a figure by attending school musicals and basketball games, taking them to every public swimming pool with a waterslide in the county, trying to learn how to use the word “skibidi,” and answering questions about whether there are different species of oompa loompas. However, I also worked closely with their foster family and attorney to make sure that they were getting necessary support, meeting with social workers, teachers and medical specialists in the children’s lives. Every other week when I saw the kids, I would write a detailed report to the juvenile court over their case to advocate for their particular needs.
During this time, I matriculated into medical school and began seeing health disparities through the angle of someone trying to provide care in a deeply flawed system. As someone interested in pediatrics, the importance of publicly available insurance for children struck me over and over. I saw Medicaid pay for the inhaler necessary to help a third grader breathe after he came into the ER with his chest wall retracting between his ribs as he struggled for air. I learned about how public funds helped children with medical complexity — kids who are often dependent on machinery like ventilators or nutrition through tubes into their stomach to sustain them.
Roughly 1 in 6 children in Utah is enrolled in Medicaid, including almost every child in foster care. Although it is an enormously popular program, it is currently at risk of being cut on a federal level based on presidential resolutions to decrease government spending.
Children in foster care are some of the most vulnerable members of society — they are typically in state custody after long strings of adults have failed them, either on personal or systemic levels. With this comes many medical needs — about half of children in foster care have improperly treated or undertreated chronic illnesses such as asthma, fetal alcohol spectrum disorder, neurologic disorders or hearing loss, while roughly 10% of these children are medically fragile. Furthermore, they are more likely to have medical problems secondary to the acute or chronic impacts of abuse and neglect. For this reason, the American Academy of Pediatrics, the leading organization for children’s health in the United States, advises that children in foster care be seen frequently by pediatric specialists, with emphasis on diagnosing and treating physical illness, mental health support, developmental evaluations and dental care.
Currently, these increased healthcare needs are covered by joint state and federal Medicaid funding, with supplementation from the state general fund while eligibility is determined immediately after the children are placed into state care. Without these funds, there is little support for the medical care of these kids, with no federal guidance on how, exactly, to ensure that they get the health services required.
As an aspiring pediatrician and current Court Appointed Special Advocate, I’m trying to ensure that I’m not someone else in the long line of adults failing Utah’s vulnerable children. By advocating against cuts to federal and state Medicaid funding, you can be as well.
(Taylor Boyd) Taylor Boyd is a current Court Appointed Special Advocate for children in the third district court of Utah.
Taylor Boyd is a medical student at the University of Utah Spencer Fox Eccles School of Medicine with a particular interest in pediatrics, the care of vulnerable and medically complex children, and infectious diseases. She is a current Court Appointed Special Advocate for children in the third district court of Utah.
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