Annie Clay has raised her granddaughter Amber. Now 18, Amber was getting into a lot of fights at school. So the city sent her to a Pennsylvania treatment center. But once she got there she told her grandmother the staff routinely put her in restraints and physically abused her.

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“I was receiving these calls pretty much every night about a restraint until it lead up to the worst restraint,” Annie Clay says.

While an investigation did not find enough evidence of an assault, hospital records show Amber suffered a leg contusion and other injuries. And reportedly, the center has a history of harmful restraints. Kids have suffered injuries, even died.

So D.C.'s Youth Rehabilitation Services, or DYRS, decided to move Amber to Georgia. There, Clay says, it happened again. Records show she suffered a concussion and a brain injury.

“What amber told me was they asked her to go to bed and when she didn’t move right away that they took her and body slammed her on the floor,” Annie Clay says. “I felt like it was abusive to her, and if I had done something like that which I never would have, child protective services would have put me in jail."

As of November, DYRS had 188 kids in out-of-state treatment centers, more than double the number in 2008, which was 82. Here's a report by the D.C. Council on residential treatment centers and psychiatric residential treatment facilities.

According to various studies, the centers generally don't work. they don't rehabilitate the kids, they have a history of abuse and they cost almost $100,000 per kid, per year. Here's a critical study looking at D.C.'s residential treatment centers.

Now, the District has one center of its own. It opened in 2009 and many consider it one of the finest of its kind. But New Beginnings cost almost $50 million to build and only houses 60 kids.

So DYRS sends three times as many out-of-state, to centers just like the ones the agency sent Amber to.

DYRS wouldn’t submit to an interview, but a spokesperson said the small setting at New Beginnings is part of what makes it work.

In a statement, the spokesperson wrote: We are continuing to develop effective, research-based programs available in the District. We also continuously monitor ... youth placed out-of-state and hold providers accountable.

Meanwhile, Clay says she'll believe it when she sees it. And that she just wants the best for Amber.

“I would just like to see her be self-sufficient and be able to take care of herself,” Annie Clay says.

Beyond the interests of these kids, Clay calls this a public safety issue. A recent review by the Washington Times found that one out of every five homicides in the city involved a DYRS ward, as a victim or suspect.