1. Reasons for Amendment 

The “Emergency Medical Service Act” was amended (Act No. 18621; promulgated on December 21, 2021; enforced on December 22, 2021) to clarify the nature of the National Emergency Medical Center as a policy support institution by prescribing legal grounds for its establishment and operation, and to stipulate that the heads of emergency medical institutions shall not refuse or avoid bed requests without justifiable grounds. Accordingly, this Amendment prescribes matters delegated by the Act and matters necessary for the enforcement thereof. It also modifies the designation criteria, method, and procedure for regional emergency medical centers, modifies requirements and designation criteria for regional trauma centers, and otherwise addresses and improves upon a number of weaknesses. 

2. Major Provisions

A. Prescribe standards for outsourcing the operation of the National Emergency Medical Center (Article 12 and attached Table 4)

Prescribe matters in accordance with Article 25 (3) of the Act, which stipulates that matters concerning the establishment, operation, and outsourced operation of the National Emergency Medical Center shall be specified by Ministry of Health and Welfare Decree.

B. Modify the designation procedure for regional emergency medical centers (Article 13)

Allow timely designation of emergency medical service regions and regional emergency medical centers in excess of regular numbers to account for changes in the emergency medical service environment.

C. Prescribe a system to manage notifications on emergency bed capacity difficulties (Article 39-2)

Specify details on the obligation of persons transporting emergency patients to check the bed capacity of emergency medical institutions, and newly insert criteria for determining whether an emergency medical institution can legitimately refuse a request to accommodate a patient, and the relevant notification procedures, etc.

D. Modify the designation criteria for regional trauma centers (attached Table 7-2)

Change equipment requirements under the designation criteria for regional trauma centers to prescribe that the operating table inside a trauma resuscitation room may be substituted with a bed on which surgery can be performed, and prescribe that although dedicated trauma patient facilities and equipment must be used by regional trauma centers, exceptions may be made in accordance with procedures specified by the Minister of Health and Welfare in the event of a national disaster.

E. Modify cited provisions and forms (Article 17-2 (3), Article 18-2 (3) and (4), attached Table 18, attached Forms 6 and 7, attached Form 15-13, attached Forms 15-15 and 15-16)

1) Modify attached Table 18, subparagraphs 2 (af) and (ag) of the Enforcement Rule as they reference Article 51 (4) and (5) of the pre-amendment Act even though the “Emergency Medical Service Act” was amended (Act No. 15893; promulgated and enforced on December 11, 2018) to change paragraphs (4) and (5) of Article 51 to paragraphs (6) and (7), respectively, and newly insert paragraphs (4) and (5) in the same Article.

2) Modify the “Declaration of Emergency Equipment Installation” and other relevant forms in accordance with the newly inserted Article 47-2 (1) 6-2 of the Act, which obligates any place of business that is required to appoint a health officer under the “Occupational Safety and Health Act” and has 300 or more full-time employees to have emergency equipment for cardiopulmonary resuscitation.

3) Amend other citations and forms in accordance with the amended “Emergency Medical Service Act” (Act No. 18621; promulgated on December 21, 2021; enforced on December 22, 2021).