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Exhibit L — 2003 Letter Agreement Weekend Subject to Call Scheduling Queens MCH/PEDS

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January 27, 2003

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

RE: 2003-2005 Collective Bargaining Agreement between VNS Home Care and United Federation of Teachers

Dear Ms. Swaim:

During our negotiations for a successor collective bargaining agreement, we discussed the weekend subject-to-call scheduling situation in Queens MCH/Peds, and the need to address the level of such scheduling.

After investigating the situation, we advised the Union that one Staff Nurse has been hired to work two (2) weekends per month. We will also be seeking one (1) or two (2) additional weekend Per Diem Nurses, or other appropriate methods to address this issue. We anticipate being able to ameliorate this situation by the time weekend schedules are posted for May, 2003.

Very truly yours,

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