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Exhibit H — 1999 Letter of Agreement: Guard-Designated Areas

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January 31, 1999

Lucille Swaim
Coordinator of Negotiations
United Federation of Teachers
260 Park Avenue South
New York, New York 10010

RE: 1999-2000 Collective Bargaining Agreement between VNS Home Care and United Federation of Teachers

Dear Ms. Swaim:

This letter is to confirm that within a reasonable period of time of execution of this Agreement, the Pen Based Computer caseload screen will identify Guard Designated Areas.
Very truly yours,


Denise M. Davin
Vice President for Human Resources and Labor Counsel


United Federation of Teachers
By: Lucille Swaim

Date: April 26, 1999