On Chicago’s Morning Answer, host Dan Proft pressed an issue that has simmered beneath the broader political fight over abortion in Illinois—whether clinics performing invasive procedures are meeting even the most basic safety standards. Christine Smith, Chief Investigations Officer at the Center for Client Safety, joined the program to outline troubling findings from her organization’s review of the Hope Clinic in Granite City, one of the state’s busiest abortion facilities and a major destination for out-of-state patients.
At the center of the controversy is the clinic’s effort to relinquish its license as an Ambulatory Surgical Treatment Center (ASTC)—a designation that subjects medical facilities to state inspections, emergency-preparedness rules, and basic regulatory oversight. The move does not mean the clinic plans to shut down. Instead, Smith says, it allows the facility to continue operating while avoiding the requirements normally imposed on surgical sites.
According to Smith, the Hope Clinic currently performs abortions up to 27 weeks and 6 days in Granite City and offers procedures up to 34 weeks at its new Chicago location. She warned that the clinic’s decision to abandon its ASTC license would not restrict this activity but rather free it from the state scrutiny that has previously revealed significant safety failures.
Failed Inspections and Dozens of Emergencies
The Illinois Department of Public Health (IDPH) last inspected the Granite City facility in 2022. Smith says the clinic failed that inspection, particularly due to violations involving emergency transfer protocols. Required documentation was missing or incomplete for multiple patients who were sent directly from the clinic to nearby hospitals.
In the period between 2022 and 2024, Smith documented more than two dozen medical emergencies—cases corroborated through 911 records and eyewitness reports from sidewalk advocates. Yet she says IDPH conducted no follow-up inspections during that time, despite the clinic’s high patient volume and known safety issues.
IDPH, she noted, confirmed that no other inspections had taken place and informed her only that the facility notified the department of its intent to surrender its license. That disclosure raised further questions when it appeared to conflict with the timeline provided by the state’s Health Facilities and Services Review Board, which claimed the license-relinquishment application was not received until a month later.
Public Hearing Raises Questions About Oversight
At a public hearing earlier this week—held amid an early-season snowstorm—Smith called on the Review Board to intervene before allowing the license to be dropped. She urged the panel to require a full inspection and a broader review of patient records, noting that multiple state agencies appeared to be working in isolation and that relevant safety concerns were not being shared across departments.
“Our concern,” Smith said, “is that a facility with documented emergencies, a failed inspection, and a growing national patient base will now operate with no health-department oversight at all.”
Illinois as a Regional Destination
The Hope Clinic sits minutes from the Missouri border, drawing patients from St. Louis and increasingly from across the country. The clinic, according to state data, has served up to 650 patients per month, a number that Smith believes has only increased since states around Illinois enacted new abortion restrictions.
Smith also noted that the clinic’s Chicago location does not appear on the state’s ASTC directory, suggesting it may be operating without a surgical license as well. She emphasized that licensing rules vary widely across states—some require surgical-center certification, while others allow abortion clinics to operate unregulated.
The Larger Safety Debate
Smith argues that the Hope Clinic’s case illustrates the consequences of eliminating regulatory standards for facilities performing late-term abortions. Without inspections, she warned, Illinois risks replicating the conditions that allowed infamous operators like Kermit Gosnell to continue practicing for years.
Studies on licensed versus unlicensed abortion facilities are limited, she acknowledged, but compilations such as Americans United for Life’s annual Unsafe report demonstrate recurring trends: lack of licensing often coincides with emergency incidents, unsanitary conditions, and inconsistent medical protocols.
She noted that many women who experience complications at Illinois clinics return to their home states afterward, making comprehensive reporting difficult and complicating the collection of safety data.
What Comes Next
The Health Facilities and Services Review Board has not yet issued a final decision on the Hope Clinic’s license. Smith’s organization is pressing for a mandatory inspection before any action is taken, citing the clinic’s volume, its history of emergency incidents, and the public-safety implications of unregulated late-term procedures.
For now, the controversy underscores a broader political divide in Illinois. While abortion-rights advocates argue for expanding access and reducing regulatory requirements, Smith and other safety-focused analysts insist that any medical facility performing invasive procedures should meet the same standards as outpatient surgical centers.
“The state regulates tattoo parlors,” Proft noted during the interview. “But not clinics performing abortions up to 34 weeks?”
Smith agreed—and warned that without intervention, Illinois may be moving toward a system where the most vulnerable patients receive the least oversight.