The Indian Health Service implemented a plan for an after-hours clinic which has been providing services since May 1991 on the Wind River Indian Reservation in Wyoming. Integral to the plan for the after-hours clinic was the family nurse practitioner as primary care provider. The after-hours clinic expands the health care services of the clinic by 3 hours on weekdays and 8 hours on Sundays. The role of the nurse practitioner as a primary care provider was introduced to the Wind River Service Unit, along with an after-hours clinic operation. Since the inception of the after-hours clinic, behavioral health and dental services and a women's clinic have been added.