Indicator #4 in the 2009-10 CMSL. Alternative care refers to the placement of children outside of their home after a determination of child abuse or neglect or to prevent possible abuse/neglect. Alternative care includes foster care (non-relative, kinship, and therapeutic homes), adoptive homes, group homes, residential treatment facilities, hospitals, independent care, and other types of care. CMSL Calculation: (Number of children in care x 1,000/Total estimated 2008 population under age 18). Data Source: Illinois Department of Children and Family Services (as of February 2009); Missouri Department of Social Services (as of December 2008)