Thanks for the gold star, by the way! Happy to be doing my job and saving lives!
JFK and LGA, which by the way, combined have more operations per year than LAX.
If you really want to whip it out and play the combined game, we get about 300,000 more operations per year from LAX and the airports surrounding LAX (the same vicinity distance as the JFK area airports, including EWR, FRG, and TEB).

I'll play that game all day long. That's why SCT is the busiest in the world, and works 1 million aircraft more every year than the great and powerful A80 that everyone keeps bringing up. Ever toured A80, by the way? Easy money! Everything nice and proceduralized and MIT out the wazoo. And here I thought SCT were a bunch of whiners. A LOA to cover medevacs? I'm going to look that one up in the repository tomorrow, but even SCT doesn't have anything like that. There are even controllers down there who actually care, and will work medevacs in direct. Not many of them, perhaps, but they exist.
N90-EWR, you have very good intentions, and I can appreciate what you do. You seem like you try your damndest with the medevacs, and I salute you! (I think another gold star is needed!) I am SHOCKED that aircraft come blasting through your airspace at full speed without warning, handoffs, etc...literally shocked. I have not had that happen to me one single time with any aircraft...ever, including medevacs, emergencies, or routine traffic. Is that SOP on the east coast? We all generally work together out here, even if we don't always have the same interests in mind. Never heard of anything like that ever happening.
As was said by my colleague, the answer is coordination. In our new FSOPs that came out last month, we have an entire chapter devoted to Negative-RVSM coordination; what's required of the controllers, what's required of the supervisors, what facility-to-facility coordination is needed, etc....an entire freakin' chapter!!! We very rarely get those flights in the first place, they have minimal impact on our operations, yet we coordinate the hell out of them. Emergencies...same thing. You have never seen so much coordination as you would see for a medical emergency, for example. The coordination covers every minute detail, damn near down to what the person is wearing and had for breafast that morning, even though 99.9% of the time, all the pertinent information has been passed by company to the crew at the airport.
But nobody lifts a finger for a medevac. There is no coordination. There are no phone calls. The supervisor isn't even notified that a medevac is in the airspace. Granted, we are busy. I think everyone participating now, sans Genot, works in a busy Level 12 facility. The Supes, the OMs, etc. should all be taking care of this coordination for us, so when a medevac does come through our airspace, it's just a matter of handing the aircraft off right down the line. If we spent even 1/2 as much time coordinating medevacs as we do negative-RVSM and changes of destination, we would be providing a hell of an improved service to the medevac flights.