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LOS ANGELES - A paraplegic man with a broken colostomy bag was found crawling in the gutter. An elderly woman, wearing only a hospital gown and slippers, was dumped on the street by a taxi called by the hospital.

For years, few people took seriously reports that Los Angeles hospitals were taking sick, confused and homeless patients by ambulance to the city's notorious "Skid Row" and leaving them there.

Today, Los Angeles city officials and a major hospital group announced a deal they hoped marks the beginning of the end to the dumping of vulnerable people in an area thought to have the highest concentration of homeless in the country.

Kaiser Foundation Hospitals, the nation's largest non-profit health-care provider, agreed to find shelter places for all homeless patients it discharges in Los Angeles.

It will also contribute US$500,000 to homeless services on Skid Row including a free legal clinic, a shelter bed database and extra beds for recovering patients.

The court-approved agreement settles charges of false imprisonment and adult endangerment brought against Kaiser by the Los Angeles City Attorney's office for the dumping in March 2006 of Carol Ann Reyes, 63, near a rescue centre wearing only a hospital gown and slippers.

"This is a historic turning point. Today Los Angeles begins a healing process," said Mark Rosenbaum, legal director of the Southern California chapter of the American Civil Liberties Union, which brought the case on behalf of Reyes.

An estimated 12,000 homeless people, many of them mentally ill or addicted to drugs or alcohol, live in the 50-block area of downtown Los Angeles known as Skid Row.

City Attorney Rocky Delgadillo said there were 50 reported cases of patient dumping there last year. His office is investigating possible charges in three to five cases.

"For years (patient dumping) was an urban legend. That's how everyone treated it. About two years ago we got reports of these incidents happening and we decided to take it seriously," Delgadillo said.

"I have vowed to end this unconscionable practice in our city and today is a major step forward. It doesn't solve the problem but it moves us forward in a way that other hospitals can emulate."

One of the cases under investigation involves a paraplegic man found crawling in the gutter in February "with his entire life's possessions in a bag clenched between his teeth," Delgadillo said.

At least three other cases of patient dumping have been captured on police video in the past year as part of a wider effort to clean up Skid Row that has resulted in a 45 per cent drop in crime in the past year.

"It is a terrible reflection on us as a society when we abandon these vulnerable people without an adequate safety net," said city councilwoman Jan Perry.