Patient dumping or homeless dumping is the practice of hospitals and emergency services inappropriately releasing homeless or indigent patients to public hospitals or on the streets instead of placing them with a homeless shelter or retaining them, especially when they may require expensive medical care with minimal government reimbursement from Medicaid or Medicare. The term homeless dumping has been used since the late 19th century and resurfaced throughout the 20th century alongside legislation and policy changes aimed at addressing the issue. Studies of the issue have indicated mixed results from the United States' policy interventions and have proposed varying ideas to remedy the problem. History Early history The term "patient dumping" was first mentioned in several New York Times articles published in the late 1870s, which described the practice of private New York hospitals transporting poor and sickly patients by horse drawn ambulance to Bellevue Hospital, the city's preeminent public facility. The jarring ride and lack of stabilized care typically resulted in death of the patient and outrage of the public. Scholars report that private hospital administrations were motivated by a desire to keep mortality rates and costs down when they advised ambulance drivers to send poor patients in critical condition directly to the public hospitals like Bellevue even if a private hospital was closer. After the deaths associated with patient dumping or inappropriate patient transfer added up, the first attempt at legislative reform in the United States was pushed through the New York Senate around 1907, largely by Julius Harburger. The legislation penalized private hospitals when they sent ill patients away or obligated staff to transfer them to another hospital. Notwithstanding the passage of city ordinances prohibiting the practice, it continued. The practice of patient dumping continued for several decades, and in the 1960s it was brought back into the public eye by the media, but not much was done to resolve the issue. Many homeless people who have mental health problems can no longer find a place in a psychiatric hospital because of the trend towards mental health deinstitutionalization from the 1960s onwards. It continues to this day especially in New York City, where Bellevue receives a large share of Manhattan’s indigent. 1980s resurface in the public eye and policy interventions "Patient dumping" resurfaced in the 1980s, nationwide, with private hospitals refusing to examine or treat the poor and uninsured in the emergency departments (ED) and transferring them