Date: 202110
Local time of day: 0601-1200
Location: ZDV.ARTCC, CO
Aircraft: Small Transport
Operator: Air Taxi
Flight plan: IFR
Mission: Ambulance
Flight phase: Cruise
Airspace: Class A ZDV
ATC / advisory: Center ZDV
Second aircraft: Small Transport
Reporter organization: Government
Reporter function: Enroute
Reporter qualification: Air Traffic Control Fully Certified
Human factors: Time Pressure; Other / Unknown
Second reporter function: Enroute
Anomaly: ATC Issue All Types; Deviation / Discrepancy - Procedural Published Material / Policy
Detector: Person Air Traffic Control
When detected: In-flight
Result: Flight Crew Requested ATC Assistance / Clarification
Contributing factors: Human Factors; Procedure; Company Policy
Primary problem: Company Policy

Narrative: Aircraft X came off CAG VFR requesting an IFR clearance.  After radar Identifying the aircraft; I gave them routing as filed which was CAG direct APA (which is inside of D01 (Denver TRACON) airspace).  I advised the pilot that I would probably have to give them routing which would be LARKS.LARKS2.APA.  I then verified with the pilot whether or not they were considered a Critical Medevac or not. The pilot verified that they had a patient on board and needed priority handling and wanted to stay direct to their destination.  I then proceeded to call D01 west departures who would be the affected TRACON sector if the Medevac were to go direct and gave the information that the pilot gave me to that controller; and while on the line with the controller who multiple times told me he wanted to approve the expeditious routing responded that the Supervisor was walking by and said no to the Approval request that I was trying for this Critical Medevac.  As I returned back to give the routing to the Pilot; they asked me if there was any way they could keep direct to help the patient; and I responded that it was up to D01 and they said full routing. The Pilot acknowledged; and then referenced his patient that they would try to keep them stable for the longer flight.This has been an ongoing problem that the controllers at D01 are unable to decide for themselves whether it is in their own good judgment or not to allow these Medevac flights more direct routing. On multiple occasions the receiving controller has indicated that they want to help these air ambulances; but now it appears they are threatened with possible disciplinary action if they allow more direct routing; even if there is no impact to their traffic. This is not the first critical that has been denied; and eventually there will be a death on one of these flights because they were rerouted and not given the priority that they needed; and the minutes that they could have saved with more direct routing could be all that it takes to save a life on these flights. I suggest that the receiving controllers should be the ones deciding if it is in their best judgment for the safe and expeditious flow of both their traffic and the proposed routing of these Medevacs rather than someone who is not working the sector.


Second narrative: Aircraft Y was handed to me direct APA. I requested approval for direct with Denver TRACON. Was told unable. Informed the pilot they would have to be put on routing unless they had extenuating circumstances. Pilot informed me they were a 'critical' flight. I again requested approval with TRACON with new critical information.  Was told to put aircraft on Letter of Agreement routing.  Opted not to declare an emergency for the pilot; delayed a critical Medevac flight by putting it on a longer route.Within the last month or so; Denver TRACON has been unabling almost all Medevacs requested direct APA. There has not been an explanation as to why this is happening. I feel we are risking real human lives by delaying these Medevacs in flight. I do not feel like I am behaving safely by rerouting these aircraft onto longer routes; especially when the pilot of the aircraft describes the flight as critical. I recommend that either:TRACON stop blanket denying direct routes; Denver Enroute be encouraged to declare emergencies for these pilots when the controller deems it advisable or someone explain why this change has been made; and why Medevacs are better off flying longer routes.


Synopsis: Denver Center Controllers reported Medevac flights requesting expedited routings and priority handling into APA are being denied by Denver TRACON.