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DURING THE LAST DECADE, FEDERAL POLICY HAS CON-centrated on ending “chronic homelessness,” a designation that applies to approximately 18% of the 671 888 persons identified as homeless on a single night in 2007. 1 Few interventions have attracted more interest than an approach to permanent housing known as Housing First. 2 Two articles in JAMA, one published in the April 1, 2009, issue3 and one in this issue, 4 advance understanding of this housing approach and raise questions about where and to whom it should be applied. Housing First offers permanent housing to homeless individuals or families, with few requirements for participation or success in rehabilitative activities such as medical, addictive, or psychiatric treatment. 5 In contrast, traditional approaches require homeless persons to demonstrate such success before providing long-term housing support or helping clients obtain their …