Mel Leaman Free Clinic was developed, because access to primary health care for the working poor was identified as a primary concern in Smyth County. Despite the myriad of assistance programs available to county residents, there are still people needing assistance, especially health and dental services.

The working poor constitute the majority of the uninsured, and those workers between 18 to 64 years old are particularly vulnerable, as they generally do not qualify for Medicare or Medicaid. Even with the implementation of the Affordable Care Act (ACA), people struggle to access affordable medical services. In fact, free clinics across the country have experienced an increase in the number of patients with the introduction of the ACA.