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California Attorney General Rob Bonta is accusing Providence St. Joseph of trying to “shirk its duty to patients” under California’s Emergency Services Law, and on Thursday he filed a motion asking a judge to enforce an order requiring it to do so.

This is the latest motion in the state’s lawsuit against Providence St. Joseph, filed in September, accusing the Catholic-owned organization of violating multiple California laws through to its refusal to provide emergency abortion care to people experiencing obstetric emergencies.

The case focuses largely on the experiences of Eureka chiropractor Anna Nusslock, who is represented in a second suit filed by the National Women’s Law Center (NWLC). In response to the Attorney General’s latest motion, K.M. Bell, senior litigation counsel at NWLC and attorney for Dr. Nusslock, issued the following statement:

We applaud the Attorney General for continuing to hold Providence accountable for violating the law and endangering patients’ lives. The hospital cannot agree to follow state law in a court order and then walk away when it becomes inconvenient. Dr. Nusslock is still grappling with the trauma of being denied emergency abortion care, a violation that should never have happened in the first place. This motion is a crucial step in ensuring that hospitals in California are not permitted to disregard their legal obligations and prioritize ideology over patient safety. The law in California is clear: pregnant patients have the right to emergency care, including abortion. Providence Hospital must be held to its word and the law.

Below is a press release from Bonta’s office.

California Attorney General Rob Bonta today filed a motion to enforce the stipulation and order requiring Providence St. Joseph Hospital (Providence) to comply with state law. The motion to enforce comes after Providence signaled its intent to modify its stipulation and assert exceptions to their clear obligations under California’s Emergency Services Law (ESL). In September 2024, Attorney General Bonta filed a lawsuit against Providence alleging it violated multiple California laws due to its refusal to provide emergency abortion care to people experiencing obstetric emergencies. One particular patient, Anna Nusslock, had her water break when she was 15 weeks pregnant with twins on February 23, 2024. Despite the immediate threat to her life and health, and despite the fact her pregnancy was no longer viable, Providence refused to treat her. She had to travel to a small critical access hospital called Mad River, 12 miles away, where she was actively hemorrhaging by the time she was on the operating table.

“The terms of the stipulation and court order against Providence St. Joseph are clear. Providence must fully comply with California’s Emergency Services Law and ensure that patients can access life-saving health services including emergency abortion care – no exceptions,” said Attorney General Bonta. “Now, months after their stipulation and agreement to abide by the law, Providence St. Joseph is attempting to find wiggle room to shirk its duty to patients under the law. We refuse to let that happen. Even a single violation would be devastating, as no one should have to endure what Anna Nusslock and others experienced at Providence. We’re asking the court to enforce its order against Providence St. Joseph.”

To ensure that patients like Anna could receive timely emergency healthcare services, including abortion care, at Providence, Attorney General Bonta initially moved for a preliminary injunction in conjunction with the filing of the lawsuit. However, in October 2024, he secured a stipulation from Providence, enforceable by court order, to ensure the hospital followed California law while the case proceeds, with no exceptions or limitations. The stipulation resolved the Attorney General’s preliminary injunction motion, as Providence voluntarily agreed to comply with all the terms the Attorney General requested in its proposed injunction.

Now, seven months after entering the stipulation, Providence has asserted its intent to file a motion to modify the stipulation asserting that it does not require Providence to provide procedures to terminate a pregnancy that are prohibited by Ethical and Religious Directives. With this move, Providence is attempting to circumvent the unambiguous — and lawful — obligations it agreed to last year. Providence’s anticipated motion escalates a deeply concerning position: that the stipulation and order do not mean what they plainly state and that Providence only has to comply with them to an extent. Providence’s position raises grave concerns about the renewed risk of Providence violating the ESL and denying emergency abortion care. Therefore, Attorney General Bonta is asking the court to enforce its order and the unambiguous terms of the stipulation. Providence must follow the law and abide by ESL, without exception.

Under the stipulation and court order Providence must:

• Fully comply with California’s ESL, Health & Safety Code section 1317, et. seq. with respect to pregnant patients experiencing emergency medical conditions.
• Allow its physicians to terminate a patient’s pregnancy whenever the treating physicians determine in their professional judgment that failing to immediately terminate the pregnancy would be reasonably expected to place the patient’s health in serious jeopardy; result in serious impairment to the patient’s bodily functions; or result in serious dysfunction of any bodily organ or part of the patient.
• Comply with ESL’s pre-transfer treatment requirements. In particular, Providence Hospital may not transfer a pregnant patient without first providing emergency services and care (including where applicable terminating a pregnancy) such that there is a reasonable medical probability that the transfer or the delay caused by the transfer will not result in a material deterioration in the medical condition in, or jeopardy to, the patient’s medical condition or expected chances for recovery.
• Follow the policy and protocol requirements of the ESL under Health & Safety Code section 1317.2. In particular, Providence Hospital may not “discharge” patients with instructions to self-transport to another facility and Providence Hospital must comply will all applicable protocols and regulations for transfers prescribed by the California Department of Public Health. 

A copy of the motion to enforce is available here.

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And here’s a statement from a Providence spokesperson:

Serving the residents of Humboldt County is a privilege we, at Providence St. Joseph Hospital Eureka, don’t take for granted. That’s why we are wholeheartedly committed to providing high-quality, compassionate care, just as we have been for more than 100 years. 

As a Catholic health care organization, we are transparent that we do not perform elective abortions. However, in emergencies, our care teams provide medically necessary interventions to protect pregnant patients who are miscarrying or facing serious life-threatening conditions. 

This is consistent with the California Emergency Services Law and the Emergency Medical Treatment and Labor Act. It is also consistent with the Catholic Ethical and Religious Directives, which include discussion of the importance of the physician-patient relationship as well as the circumstances in which certain medical procedures that could result in fetal death may be allowed in a Catholic hospital. 

The California Attorney General is interpreting the stipulation in a way that would require Providence to provide care that goes beyond the California Emergency Services Law and possibly in conflict with the Catholic Ethical and Religious Directives.  Providence will address the California AG’s position in its forthcoming response through the litigation process.

We take our responsibility as a vital safety net incredibly seriously and are committed to continuing to meet the needs of our community, just as we have for more than a century.

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