Date: 202110
Local time of day: 1801-2400
Location: ZDV.ARTCC, CO
Aircraft: Small Transport; Low Wing; 2 Turboprop Eng
Flight plan: IFR
Mission: Ambulance
Flight phase: Cruise
Airspace: Class A ZDV
ATC / advisory: Center ZDV
Second aircraft: Small Transport; Low Wing; 2 Turboprop Eng
Reporter organization: Government
Reporter function: Enroute
Reporter qualification: Air Traffic Control Fully Certified
Human factors: Communication Breakdown; Workload; Troubleshooting; Training / Qualification; Confusion; Distraction; Situational Awareness
Second reporter function: Enroute
Anomaly: ATC Issue All Types; Airspace Violation All Types; Deviation - Track / Heading All Types; Deviation / Discrepancy - Procedural Published Material / Policy; Deviation / Discrepancy - Procedural Clearance
Detector: Person Air Traffic Control
When detected: In-flight
Result: Air Traffic Control Provided Assistance
Contributing factors: Procedure; Environment - Non Weather Related; Human Factors
Primary problem: Procedure

Narrative: Around XA:30 local two MEDEVACs filed directly to their destinations.  Aircraft X filed ZZZ direct BJC and Aircraft Y filed ZZZ1 direct APA.I went to relieve the controller on position when the following happened:Around XA:33Z; the ZDV controller called west departure at D01 to APREQ both aircraft direct to their destinations. It was XA:30 and it was slow. D01 responded with; 'Unable.' Then; the ZDV controller asked both MEDEVACs if they were critical. Aircraft Y said no and Aircraft X said yes. Around XA:34Z; the ZDV controller called west departure at D01 again and explained that one was critical and one wasn't and that the non critical one; he'll take over the LARKS arrival but re-APREQ'd the critical Aircraft X direct BJC. D01 asked; 'Is he an emergency?'ZDV Controller responded; 'He's critical; yeah.'D01 said; 'I mean; you've got to have your sup call my sup.'Around XA:35Z the ZDV controller called the OM from the sector and explained the whole situation; ending it with; 'So I'm asking you to call approach for a critical MEDEVAC.'The OM asked for the call sign and said; 'and did the pilot say what's critical? Did we solicit this? Did he say it's an emergency?'The ZDV controller re-explained how he had two MEDEVACs and took the noncritical one over the LARKS arrival and re-APREQ'd the critical one and that D01 said 'no; have your sup call my sup.'The OM replied; 'OK; But did the airman say what was wrong?'The ZDV controller said; 'No; I just said 'are you critical and he said yes.''The OM said; 'OK. So we solicited.'The ZDV controller said 'Yup.'The OM said; 'Alright; thank you.'At that point; I decided to go up front to talk to the OMIC's to figure out what was going on. Keep in mind that the OM didn't tell the ZDV controller whether or not they were going to call and the controller assumes that the OM is going to call to APREQ this; so he's patiently waiting to hear back. That whole conversation was an absolute mess that accomplished nothing. I was told to have my NATCA counterparts do something; in which I responded that we can't do anything for an active flight and that the only thing left to do is have our management call D01's management (just like D01 said to do) so we could get this critical MEDEVAC the most expeditious route. Per the 7110.65; 'Good judgment must be used in each situation to facilitate the most expeditious movement of a MEDEVAC aircraft.' This was at XA:30 and there was no west departure traffic. Ultimately; the OM's told me they wouldn't call because they believed they would just be told no and they didn't know what type of critical he was. Also; during this whole conversation; the ZDV controller is waiting to hear back from the OM to find out if this will be denied or not.If you look at falcon and run a simulation for Aircraft X continuing on direct BJC; the closest to any aircraft would have been Aircraft Z who was at FL180 2 miles west of BJC while Aircraft X would have been at pattern altitude around 7;000 ft MSL; 3 NM north of Aircraft Z's path.  There's also no other IFR aircraft in or out of BJC at this time. There was one VFR C172; who would have touched down at BJC around XA:46Z; when Aircraft X would have been 15 mi west of BJC if he had stayed direct. You don't see another aircraft departing BJC until XA:55Z and Aircraft X would have touched down around XA:49Z; 6 min ahead of that departure. So I can't figure out why they wouldn't approve this except for the fact that D01 has released an internal memo co-signed by their union and management representatives that their controllers adhere to strict LOA guidelines IAW Attachment 5. However; MEDEVAC aircraft should never be included in a blanket denial of APREQ's; which they have been doing for about 3 weeks now.So I went back to the area to let the controller know that management wasn't going to call. At this point; Another controller had been instructed to break off the airspace due to some EBUS equipment that techops was working on; so another controller took over Aircraft X. Around XA:37Z; the new controller told  Aircraft X that our management team was working on getting him direct; not knowing yet that they actually weren't. Aircraft X responded; 'I hope so.'Around XA:39Z; the new ZDV controller called the north west arrival gate to APREQ the critical MEDEVAC in the north west arrival gate since that was the closest arrival in proximity to Aircraft X. The D01 controller responded; 'They won't let me take him either. It's not my call. They won't let me do it.'The new ZDV controller said; 'He's critical. I can't even take him over TOMSN?'The D01 controller responded; 'If he's an emergency I can.'So the new ZDV controller put Aircraft X on a heading towards the south west arrival gate to put him on the POWDR arrival that causes critical MEDEVAC Aircraft X to fly an additional 33 miles to get to BJC. Around XA:43Z the ZDV controller points Aircraft X out to D01 west. Around  XA:45Z the new ZDV controller calls the D01 south west arrival gate for a manual hand off on Aircraft X.The D01 controller responds; 'You can flash him straight to 'L.' He's point out approved.'The new ZDV controller responds; 'Uh; nope. They will not take him.'The D01 controller replies; 'They won't take him from right there?'Ultimately; this critical MEDEVAC; Aircraft X flies an additional 33 mi out of his way after we tried APREQing twice with D01 west; once with the OM; who wouldn't even make the phone call; and once with the D01 north west arrival controller who claimed it wasn't his call and said; 'They won't let me do it.' I'm not sure who 'they' are but it seems malicious and negligent to just deny this and instruct other controllers to deny this as well. This is clearly in violation of the 7110.65 2-1-4 b. 1) Provide priority handling to civil air ambulance flights when the pilot; in radio transmissions; verbally identifies the flight by stating 'MEDEVAC' followed by the FAA authorized call sign or the full civil registration letters/numbers. Good judgment must be used in each situation to facilitate the most expeditious movement of a MEDEVAC aircraft.I don't know how to fix this; which is why I'm reporting it. Our management won't help us out when they won't even make a phone call so our hands are completely tied. The only recommendation I can think of is some sort of audit be done on D01 from an outside source. As I stated in a previous report; per the 7110.65; 'Good judgment must be used in each situation to facilitate the most expeditious movement of a MEDEVAC aircraft.' A blanket unable and our management instructing us to stop APREQing ANYTING with D01 is malicious and negligent; especially when we are dealing with air ambulances. When we drive on the street and see an ambulance coming; everybody pulls over so the ambulance; an emergency vehicle; can get to their destination as quickly as possible. I've been working here for almost XX years and we have always been able to accommodate MEDEVAC aircraft direct. Every now and then it was 'unabled' but it was very rare. To not look at every situation individually and evaluate it case by case to help move the MEDEVAC safely and expeditiously is shameful and a new low for D01. This is just one of many examples over the past few weeks. D01 has been making it very difficult to get and MEDEVACs direct.  I don't know how to change the culture down there besides filling out an report; but its getting worse and worse and like I said; this is a new low. I just hope these reports bring attention to what's going on between ZDV and D01; especially since they're gambling with patients lives to prove whatever point they're trying to make.  Unnecessarily delaying MEDEVACs EVERYTIME is not ethical and this needs to be reviewed ASAP.


Second narrative: On night and around XA:30; two MEDEVACs filed directly to their destinations. Aircraft X filed ZZZ direct BJC and Aircraft Y filed ZZZ1 direct APA.I was splitting out Sector 6 when the following happened:Around XA:33Z; the ZDV controller called west departure at D01 to APREQ both aircraft direct to their destinations. It was XA:30; local; and it was extremely slow. We were already in mid configuration and the only reason we had to split the sectors was because of a new rule that ZDV has put into place regarding backup channels. Anyway; extremely slow with no more than one proposed out the west gate. D01 responded with; 'Unable.' Then; the ZDV controller asked both MEDEVACs if they were critical. Aircraft Y said no and Aircraft X said yes. Around XA:34Z; the ZDV controller called west departure at D01 again and explained that one was critical and one wasn't and that the non critical one; he'll take over the LARKS arrival but reAPREQ'd the critical Aircraft X direct BJC. D01 asked; 'Is he an emergency?'ZDV Controller responded; 'He's critical; yeah.'D01 said; 'I mean; you've got to have your sup call my sup.'Around XA:35Z the ZDV controller called the OM from the sector and explained the whole situation; ending it with; 'So I'm asking you to call approach for a critical MEDEVAC.'The OM asked for the call sign and said; 'And did the pilot say what's critical? Did we solicit this? Did he say it's an emergency?'The ZDV controller reexplained how he had two MEDEVACs and took the noncritical one over the LARKS arrival and reAPREQ'd the critical one and that D01 said 'No; have your sup call my sup.'The OM replied; 'OK; But did the airman say what was wrong?'The ZDV controller said; 'No; I just said 'are you critical and he said yes.''The OM said; 'OK. So we solicited.'The ZDV controller said 'Yup.'The OM said; 'Alright; thank you.'At that point; our union rep who was watching the whole thing unfold; decided to go up front to talk to the OMICs to figure out what was going on. Keep in mind that the OM didn't tell the ZDV controller whether or not they were going to call and the controller assumes that the OM is going to call to APREQ this; so he's patiently waiting to hear back. That whole conversation was an absolute mess that accomplished nothing. I was told that the OM told our union rep to have 'His NATCA counterparts do something'; in which he responded that we can't do anything for an active flight and that the only thing left to do is have our management call D01's management (just like D01 said to do) so we could get this critical MEDEVAC the most expeditious route. Per the 7110.65; 'Good judgment must be used in each situation to facilitate the most expeditious movement of a MEDEVAC aircraft.' This was at XA:30 and there was no west departure traffic. Ultimately; the OM's told our union rep that they wouldn't call because they believed they would just be told no and they didn't know what type of critical he was. Also; during this whole conversation; the ZDV controller is waiting to hear back from the OM to find out if this will be denied or not.If you look at falcon and run a simulation for Aircraft X continuing on direct BJC; the closest to any aircraft would have been Aircraft Z; who was at FL180 2 miles west of BJC while Aircraft X would have been at pattern altitude around 7;000 ft MSL; 3 NM north of Aircraft Z's path.  There's also no other IFR aircraft in or out of BJC at this time. There was one VFR C172; who would have touched down at BJC around XA:46Z; when Aircraft X would have been 15 mi west of BJC if he had stayed direct. You don't see another aircraft departing BJC until XA:55Z and Aircraft X would have touched down around XA:49Z; 6 min ahead of that departure. So I can't figure out why they wouldn't approve this except for the fact that D01 has released an internal memo co-signed by their union and management representatives that their controllers adhere to strict LOA guidelines IAW Attachment 5. However; MEDEVAC aircraft should never be included in a blanket denial of APREQ's; which they have been doing for about 3 weeks now.Continuing on; the union rep came back to the area to let the us know that management wasn't going to call. At this point; I had been instructed to break off the airspace due to some EBUS equipment that tech ops was working on; so another controller took over Aircraft X. Around XA:37Z; I told Aircraft X that our management team was working on getting him direct; not knowing yet that they actually weren't. Aircraft X responded; 'I hope so.'Around XA:39Z; I called the north west arrival gate to APREQ the critical MEDEVAC in the north west arrival gate since that was the closest arrival in proximity to Aircraft X. The D01 controller responded; 'They won't let me take him either. It's not my call. They won't let me do it.'I pressed; 'He's critical. I can't even take him over TOMSN?'The D01 controller responded; 'If he's an emergency I can.'So then I put Aircraft X on a heading towards the south west arrival gate to put him on the POWDR arrival that causes critical MEDEVAC Aircraft X to fly an additional 33 miles to get to BJC. Around XA:43Z; I point out Aircraft X out to D01 west. Around XA:45Z I call the D01 south west arrival gate for a manual hand off on Aircraft X.The D01 controller responds; 'You can flash him straight to 'L.' He's point out approved.'I respond; 'Uh; nope. They will not take him.'The D01 controller replies; 'They won't take him from right there?'Ultimately; this critical MEDEVAC; Aircraft X flies an additional 33 miles out of his way after we tried APREQing twice with D01 west; once with the OM; who wouldn't even make the phone call; and once with the D01 north west arrival controller who claimed it wasn't his call and said; 'they won't let me do it.' I'm not sure who 'they' are but it seems malicious and negligent to just deny this and instruct other controllers to deny this as well. This is clearly in violation of the 7110.65 2-1-4 b. 1) Provide priority handling to civil air ambulance flights when the pilot; in radio transmissions; verbally identifies the flight by stating 'MEDEVAC' followed by the FAA authorized call sign or the full civil registration letters/numbers. Good judgment must be used in each situation to facilitate the most expeditious movement of a MEDEVAC aircraft.I don't know how to fix this; which is why I'm reporting it. A good first step would be to thoroughly review our management team and figure out why they won't communicate with the controllers or OS team. And; this has been an issue here for years. Our OM team is never in the operation and are completely disconnected from what goes on down on the floor. Our OM management team refuse to help and communicate; which is why they wouldn't even make a phone call in this situation; so our hands are completely tied. It's the very least they can do and they can't even do that. They completely refuse to make a decision and would rather sit up front; do as little as possible; and collect a fat check. It's the epitome of government fraud; waste; and abuse. The only other recommendation I can think of is some sort of audit be done on D01 from an outside source. As I stated in a previous report per the 7110.65; 'Good judgment must be used in each situation to facilitate the most expeditious movement of a MEDEVAC aircraft.' A blanket unable and our management instructing us to stop APREQing ANYTING with D01 is malicious and negligent; especially when we are dealing with air ambulances. When we drive on the street and see an ambulance coming; everybody pulls over so the ambulance; an emergency vehicle; can get to their destination as quickly as possible. I've been working here for almost XX years and we have always been able to accommodate MEDEVAC aircraft direct. Every now and then it was 'unabled' but it was very rare. To not look at every situation individually and evaluate it case bycase to help move the MEDEVAC safely and expeditiously is shameful and a new low for D01. This is just one of many examples over the past few weeks. D01 has been making it very difficult to get and MEDEVACs direct.  I don't know how to change the culture down there besides filling out an report but its getting worse and worse and like I said; this is a new low. I just hope these reports bring attention to what's going on between ZDV and D01; especially since they're gambling with patients lives to prove whatever point they're trying to make.  Unnecessarily delaying MEDEVACs EVERYTIME is not ethical and this needs to be reviewed ASAP.


Synopsis: Denver Center Controllers reported problems when trying to get priority handling with Denver TRACON on two Medevac aircraft