Usually they don't and/or if they do you have no guarantee of qualifying for it. At one point in my life I made about $12k a year working two full-time jobs, believe it or not, even though a meal at a "sit-down restaurant" was a once a year extravagance, I didn't qualify for many financial aid programs when I went to school. And student loan programs said I didn't have the guaranteed financial means to pay the loans back.

I've personally been on the begging end of paying for tests and the calculus is this, "how many meals do I have to skip to pay for this?"

I think that's another side effect of poverty: not seeing ways out. (Although I don't know what kind of programs Duke had decades ago.)