Children exposed to alcohol and/or other substances in-utero are at risk for fragmented health care, which is frequently obtained through emergency rooms. K.I.N.D.E.R. (Kids in Need of Drug Evaluation and Rehabilitation) Clinic has a `one-stop-shop' model to address the medical and social needs of these at-risk children. Our staff consists of a board certified Pediatrician, a Pediatric Nurse Practitioner, a Social Worker and an assistant. Our main location is at the Texas Medical Center with two community out-reach clinics. Services provided include: primary pediatric care, case management, in-depth developmental evaluations, visits with medicaid representatives, a patient incentive program, multi-disciplinary team coordination, education and assistance to families, a community advisory board, a family based steering committee, a health-care training facility, research activities, and community at-large involvement. After only 16 months of operation, we have enrolled 300 patients (our goal was to enroll 75 patients the first year). Our patient population can be described as: 53% male, 47% female; ages 0 to 16 years, with a mean age of 1.6 years. The ethnicity breakdown is: 65% African American, 19% White, 15% Hispanic and 1% Asian American. Health insurance coverage is 95% Medicaid, 2% private insurance and 3% non-funded. Monitoring and Evaluation are achieved through a quarterly anonymous patient-satisfaction survey. This user-friendly environment has resulted in a 90% up-to-date immunization rate. While traditionally this population is hard to reach, this innovative approach has been successful in providing consistent longitudinal health care. The K.I.N.D.E.R. Clinic is primarily funded by the Community Oriented Primary Care Bureau of the Texas Department of Health.