Exhibit 10.1

                       FIRST AMENDMENT TO VOTING AGREEMENT
                           REGARDING SIMIONE DIRECTORS


     This First Amendment to Voting  Agreement  Regarding  Simione  Directors is
made and  entered  into as of the 12th day of July,  2000 by and  among  SIMIONE
CENTRAL HOLDINGS,  INC., a Delaware  corporation  ("Simione"),  MESTEK,  INC., a
Pennsylvania  corporation  ("Mestek"),  JOHN E.  REED,  STEWART  B.  REED and E.
HERBERT  BURK  (collectively,  the  "Mestek  Major  Stockholders"),   DANIEL  J.
MITCHELL,  individually  and as  Representative  of the former  stockholders  of
CareCentric Solutions, Inc. ("Mitchell") and JESSE I. TREU ("Treu").

                                   WITNESSETH:

     WHEREAS,  Simione,  Mestek,  the Mestek Major Stockholders and MCS, Inc., a
Pennsylvania  corporation  ("MCS"),  were parties to that certain Second Amended
and Restated  Agreement and Plan of Merger and Investment  Agreement dated as of
October 25, 1999 (the "MCS Merger Agreement")  pursuant to which MCS merged with
and into Simione on March 7, 2000 (the "Closing Date");

     WHEREAS,  pursuant to Section 2.5(c) of the MCS Merger  Agreement,  Simione
agreed for a period of 18 months  after the Closing Date to use its best efforts
to cause six designees of the Mestek Major  Stockholders to be named as nominees
for  election to the  Simione  Board of  Directors  in each proxy  statement  of
Simione  relating  to an annual or a special  meeting of  stockholders  at which
directors will be elected;

     WHEREAS,  the parties to this  Agreement  desire to amend the voting rights
provisions of Section 2.5(c) of the MCS Merger Agreement as provided herein;

     NOW, THEREFORE,  in consideration of the foregoing and the mutual covenants
and agreements herein contained,  and intending to be legally bound hereby,  the
parties hereto hereby agree as follows:

     1. Capitalized  terms used herein and not otherwise  defined shall have the
meaning ascribed to such terms in the MCS Merger Agreement.

     2.  Notwithstanding  any  provision  in  Section  2.5(c) of the MCS  Merger
Agreement,  for a period of eighteen (18) months after the Closing Date, Simione
shall submit for approval by its  stockholders in any proxy statement of Simione
relating to an annual or special meeting of stockholders at which directors will
be elected a proposal to elect seven (7)  directors  to its Board of  Directors,
three (3) of whom shall be designees of the Mestek Major  Stockholders  (each, a
"Mestek  Designee,"  which term shall  include any  successor  designee,  or any
replacement  designee  selected by the remaining Mestek  Designees),  one (1) of
whom  shall be a  designee  of  CareCentric,  one (1) of whom shall be the chief
executive officer of Simione,  and two (2) of whom shall be designated solely by
the Simione  Board of Directors.  During such  eighteen  (18) month period,  (a)

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Simione will use its best efforts to cause the Mestek Designees, the CareCentric
designee  and  Simione's  chief  executive  officer to be named as nominees  for
election to the Simione Board in each proxy statement of Simione  relating to an
annual or a special  meeting of stockholders at which directors will be elected,
and (b) the Mestek Major Stockholders will vote their shares of Simione stock in
favor of all nominees  selected in  accordance  with the  provisions  hereof and
recommended by the Simione Board of Directors in any such proxy statement.

     3. Treu shall be the initial designee of CareCentric.

     4. Except as amended hereby, the remaining  provisions set forth in Section
2.5(c) of the Mestek Merger Agreement relating to a possible Disqualification of
a Mestek Designee shall remain in full force and effect.

     5. Treu and Mitchell  acknowledge and agree that the execution and delivery
of this First Amendment,  in providing for only one CareCentric  designee to the
Simione Board of Directors,  does not  constitute a breach by Simione of Section
2.5(d)  of the  Agreement  and Plan of Merger  dated as of July 12,  1999 by and
among Simione, CareCentric and Simione Acquisition Corporation.

     6. This First  Amendment  to Voting  Agreement  may be executed in multiple
counterparts,  each of which shall be deemed an original and all of which, taken
together, shall constitute one and the same instrument.



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     IN WITNESS WHEREOF,  the parties hereto have executed this First Amendment,
or caused it to be executed by its duly authorized officers,  as of the date and
year first written above.

MESTEK:                            SIMIONE:

MESTEK, INC.                       SIMIONE CENTRAL HOLDINGS, INC.

By:  /s/ Jack E. Nelson            By:    /s/ R. Bruce Dewey
    --------------------------          -------------------------------
        Jack E. Nelson
Title:  VP Human Resources         Title:  President and CEO
       -----------------------           ------------------------------

                                      /s/ John E. Reed
                                   ------------------------------------
                                   John E. Reed

                                      /s/ Stewart B. Reed
                                   ------------------------------------
                                   Stewart B. Reed

                                      /s/ John E. Reed
                                   ------------------------------------
                                   E. Herbert Burk

                                      /s/
                                   ------------------------------------
                                   Daniel J. Mitchell, individually
                                   and in his capacity as Representative
                                   of  the former  shareholders  of
                                   CareCentric   Solutions, Inc.

                                      /s/ Jesse I. Treu
                                   -----------------------------------
                                   Jesse I. Treu



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