The use of Clinical Support Personnel (CSP), who perform healthcare tasks under the supervision of registered nurses and other licensed healthcare providers, has been used as a primary strategy for managing professional shortages. Despite the large numbers in the health care industry, little is known about the clinical nonlicensed personnel (CNLP) in US hospitals and how their staffing has changed over time.

This article assesses how hospitals are using CSP, and explores changes that may have occurred since the 2010 passage of the Affordable Care Act.