Hello Muskie,
First, I want to say thanks for sharing this. I know it's not always an easy thing to do; exposing your personal experiences can be somewhat daunting at times.
As I read through this, I found myself knowing a lot about Ms. Hillcrest, but nearly nothing about you and your family outside of the fact that they had adopted her as their personal charity case. (Sorry, that phrase really kind of makes me cringe. It seems very condescending.)
I spotted a few technical things along the way. Below are some of the things I came across and wanted to comment on. (Some, truthfully, are simply quick fixes so you don't have to hunt them down yourself.)
 Technical/Mechanics
 As I was growing up[,] my family didn't have a lot of money. - A comma is placed after up because the first four words of this sentence are an introductory phrase.
Despite this[,] my parents seemed to always be taking care of the woman at the end of the road. - Another introductory expression.
She lived there with her 3[three] kids. - Generally, numbers ten and under are spelled out.
Most of my hand[-]me[-]down clothes ended up at the Hillcrests'. - Certain word sequences require hyphens.
As I grew older[,] I learned to respect what my parents did. - Another introductory phrase.
Nancy, as my parents referred to Ms[.] Hillcrest, wasn't much of a mother. - This line didn't tell us much. You already described how the children looked dirty and how her place was never in good shape.
She said when I was 5[five], I was in the front yard playing with my brothers.
When she looked up[,] I was on the road, two or three houses down and headed for[toward] the country road. - There's another introductory phrase here, and I think you mean toward the country road.
My mother was 7[seven] months pregnant with my youngest brother at the time.
I can't imagine the fear that struck my mother's heart when she [had] seen the 18 wheel semi-truck rolling down the country road, knowing that if I didn't stop I would be killed.
Apparently[,] I never saw the truck, and only kept laughing at the imaginary game I was playing with my mother.
Apparently[,] Ms[.] Hillcrest was on her porch and witnessed the whole thing. - I understand that this is being told from your perspective, but I think you may want to take a peek at words that you use frequently. There are a lot of repeated words; two paragraphs alone begin with apparently. Truthfully, I think you can get rid of all instances of it. There's not needed at all and don't alter the meaning of the sentences you've used them in.
A heart beat before the truck plowed me down, I was scooped up by her as she dove across the road. - I think you may want to rewrite this. There are issues with the sentence structure.
If her funeral was an example of her life; her children didn't even come. - This would be a full sentence if reworked a little, and I think it would make more of an impact. You could do something like: Her funeral was an example of her life; her children didn't even attend.
Despite her failures;[,] her one unselfish act saved the life of a child. - I noticed that you tend to do this a lot in this story. Generally speaking, it's safe to use them when you have two independent clauses that you want to bond. For example: "My husband has baby vomit all over his shirt; he likes to hold his daughter even when she's gassy." - You don't want to use it with conjunctions, like and, but, or, nor, for, so, and yet. "My husband has baby vomit all of her shirt, and I have no desire to hug him." A comma would be used here, not a semicolon.
For that, she will always be my [hero][.] - I don't personally think hero needs to be capitalized, but I suppose you could if it's a title you're giving her. Either way, the sentence should end with a period. 
Overall, I think this would be a much more emotionally charged piece if there was some more information in it. I understand that you were a child, and you seemed innocuous enough, playing an imaginary game with your mom, but why, aside from being a child, should we relate to you on a personal level? If you decide to revise this, I'd like to come back and re-read and re-rate it. Thank you for sharing! 
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This is pretty awesome imagery. I like the idea of the flames acting as a cleansing agent along the skin. It could be complete annihilation. 
...the up until now silent one... - This is very awkward.
Technical/Mechanics