To ensure the highest quality of patient care in the Region 11 EMS System, the Resource Hospitals, with assistance from the Associate Hospitals, provide in-person competency testing of both EMT-Basics and Paramedics.  Through a combined practical skills testing and written examination, the core concepts of the national EMS Education Standards and Region 11 SMO and Policy manuals are assessed every other year.  It is the responsibility of EMS personnel practicing in Region 11 to maintain regular self-directed education and attend continuing education sessions to meet requirements for recertification.  Each member must achieve a passing score on the competency testing to maintain good standing in Region 11 and for licensure re-certification approval.