Collin County officials are wrestling with how much assistance to provide to people like Ms. Adams - low-income residents without health insurance.

A 25-member task force appointed by county commissioners presented preliminary recommendations Wednesday on how to improve indigent health care. The public hearing drew an estimated 150 people to the courthouse in McKinney.

Some speakers said Collin - a wealthy and rapidly growing county of 690,000 people - has a moral obligation to spend more on indigent health care.

Last year, the county spent about $970,000 on direct care for indigents who are U.S. citizens. Those services were provided at Collin County hospitals.

To qualify for direct care, residents must meet strict income guidelines. For instance, a single patient can't earn more than $4,900 a year. That represents 50 percent of the federal poverty level.

Several clinic operators urged officials Wednesday to spend more taxpayer money. They said the county is not doing its share compared with the nonprofit clinics that must raise funds from the private sector.

"The problem is real, and the problem is now," said Susan Shuler, executive director of the Plano Children's Medical Clinic. "We have single moms who come to the clinic in tears because they are trying to ... put food on the table and keep a roof over their head.

"Their child is sick or has a chronic illness, like asthma, and they have no money left. For a child with asthma, the medication can cost as much as $200 to $300 a month."

"Every person has certain inalienable rights," he said. "Health care is every person's right ... regardless of whether or not someone has the means to pay for it."

Task force members plan to meet next week to approve their report. County commissioners will consider whether to adopt the recommendations later in the summer.

Commissioners attended the committee hearing but didn't speak. Afterward, they said they are still evaluating some of the suggestions. One is to appoint a director to oversee the county's efforts to treat poor people and to collaborate with nonprofit clinics.

"I always have reluctance about creating new positions in government," Commissioner Joe Jaynes said Thursday. "I want to see the final report and reflect on it. Health care is an emotional issue. It affects everyone."

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