Dollars for Deeds

By Christine Gorman

Each time Lisa Jones arrived at an East Baltimore, Maryland, health clinic for a pregnancy checkup last year, the 19-year-old was given a yellow voucher worth $10. After 10 visits, in which she improved her diet and learned how to care for an infant, she gave birth to a healthy baby daughter. "There are a lot of girls out there who are naive," Jones says. "The vouchers are a good way to get them to come in."

As a straight-A student, 17-year-old Luke O'Neil gets a 10% discount at his high school store in Kingston, Massachusetts, and free admission to all class dances and athletic events. This summer his marks will fetch him discounts and freebies at local pizza parlors and candy stores.

Planned Parenthood of Leadville, Colorado, pays teenage girls $1 for each day they avoid getting pregnant. The girls, who show up at a school office every week to attest that they are not expecting a child and that if they have had sex, they used contraceptives, often stick around to eat Doritos and talk with counselors about their lives.

In Norman Rockwell's America, good behavior was its own reward. Accepting cash for performing a civic duty or taking care of one's own health would have been embarrassing, if not downright degenerate. But that is exactly the approach that is being championed by a growing number of people desperate to reverse some of the social trends of the past 20 years.

Taking a lesson from the business world, they have discovered the power of incentives. Critics call it bribery. But proponents argue that they are only being realistic. In many cities and suburbs, a culture of violence and drugs has crushed young people's hope for life's rewards. Hundreds of thousands of students drop out of high school. Many young girls find their only source of self-esteem in motherhood. "We can pierce the disillusionment a lot of kids have by providing clear, concrete incentives," says Michael Carrera, an adolescent-sexuality expert in New York City. "Maybe our means wouldn't have to be so dramatic if this were the 1940s or 1950s. But this is the 1990s, and we have to be daring."

Even the middle class seems to need an extra nudge to do the right thing these days. For years corporations have helped meet blood shortages by rewarding employees who roll up their sleeves with extra time off. At least one church has resorted to such techniques. In April, after the Frederick Christian Fellowship Church in Maryland offered newcomers a $10 bill for attending worship services, more than 50 fresh faces appeared in the pews.

Many of the incentive programs operate on a small scale, and their track records are difficult to evaluate. The main purpose is to help people who have become so financially strapped or dysfunctional that most of their energy is focused on bare-bones survival. "Unless a particular health problem is at the top of their list, the poor will not give it attention," says Dr. William / Pawluk, of the Prudential Health Care Plan, which spends $6,000 each month to ensure that its pregnant Medicaid patients in Baltimore keep their appointments. "If you give them $10, they can afford the transportation to get the care or pay for a baby-sitter to stay with other children."

At their best, the perks help fight apathy, especially among the young. Under the incentive plans inspired by the Jostens Renaissance program of Minneapolis, Minnesota, some schools bestow "gold" cards for straight A's and "red" cards for A's and B's. Students who fail to make the honor roll but manage to show progress receive a VIP card, which recognizes them as a Very Improved Person. At some schools the cards entitle students to on-campus perks. "For those kids who get positive support at home, it's just the frosting on the cake," says Leo Egan, an English-department coordinator at Silver Lake Regional High in Kingston. "For those who don't, it's the main meal."

At their worst, however, rewards could backfire by ending up fostering an atmosphere in which people refuse to do anything for free. Erika Taylor, 18, took advantage of an Ohio welfare program that pays teen mothers a bonus of $62 a month if they attend school regularly until graduation, but she concedes that "people I know are just after the extra money." Perhaps that is why the program also includes tough penalties for slackers. Mothers who skip school or drop out find their welfare checks reduced $62 a month. Over the past few years, as the Ohio program has proved its effectiveness in keeping young mothers in school, the sanctions have become more controversial than the bonuses ever were.

The bonuses may not bring lasting improvements unless the underlying structure of a program is sound. "If you've got a lousy education system and you think students are going to learn because you give them so much for an A or a B, then you're barking up the wrong tree," notes Andrew Hahn, an associate dean at Brandeis University. But the recognition and attention that prizes, honors and cash may bring can sometimes spur the indifferent toward greater achievement.

With reporting by Ann Blackman/New York and Sharon E. Epperson/Kingston, with other bureaus