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Federal forms, ICRs, and supporting documents

OMB control number

[NCCDPHP] Million Hearts® Hospital/Health System Recognition Program

OMB 0920-1274 · HHS/CDC.

OMB 0920-1274

The Million Hearts Hospitals or Health System Recognition Program recognizes institutions working to systematically improve the cardiovascular health of the population and communities they serve. Applicants will indicate whether they will commit to implement Million Hearts® strategies; whether they are currently implementing or have previously implemented these strategies; and have achieved results in at least one strategy. Participation is voluntary. Submission of Extension package for 0920-1274 is submitted to allow information collection to continue for an additional three years with changes made to several of the listed Priority Area titles and strategies in the Application form and revised burden tables that reflect a reduced number of anticipated applications. These estimates are based off the number of applications received since the program’s launch in 2020. This is an extension packagewith no change to the annual burden.

The latest form for [NCCDPHP] Million Hearts® Hospital/Health System Recognition Program expires 2028-09-30 and is listed under ICR 202507-0920-019.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-1274 Communications Interview GuideForm
Form 0920-1274 Interview GuideForm
Form 0920-1274 Data Collection ApplicationForm
Form 0920-1274 Program ApplicationForm
Attachment 9. Privacy Impact Assessment Form_0920-1274_signed.pdfSupplementary Document
Attachment 9. Privacy Impact Assessment Form_0920-1274_signed.pdf Supplementary Document
Attachment 3b. Public Comment to 60 Day FRN and Response.docxPublic Comments
Attachment 7. Program Communications_0920-1274.docxSupplementary Document
Attachment 7. Program Communications_0920-1274.docx Supplementary Document
Attachment 6. Approach to Designee Vetting_0920-1274.docxSupplementary Document
Attachment 6. Approach to Designee Vetting_0920-1274.docx Supplementary Document
Attachment 5. Eligibility for Million Hearts Hospitals and Health Systems Recognition Program Participation.docxSupplementary Document
Attachment 5. Eligibility for Million Hearts Hospitals and Health Systems Recognition Program Participation.docx Supplementary Document
Attachment 4. Paperwork Reduction Act Project Determination Form_0920-1274.docxSupplementary Document
Attachment 4. Paperwork Reduction Act Project Determination Form_0920-1274.docx Supplementary Document
Attachment 3a. Published 60 Day Federal Register Notice_0920-1274_10212024.pdfSupplementary Document
Attachment 3a. Published 60 Day Federal Register Notice_0920-1274_10212024.pdf Supplementary Document
Attachment 2a. Currently Approved Data Collection Tool 1_Application_0920-1274.docxSupplementary Document
Attachment 2a. Currently Approved Data Collection Tool 1_Application_0920-1274.docx Supplementary Document
Attachment 1. Public Health Service Act [42 USC241].docxSupplementary Document
Attachment 1. Public Health Service Act [42 USC241].docx Supplementary Document
1274 Att 8 Proposed Changes to App.docxSupplementary Document
1274 Att 8 Proposed Changes to App.docx Supplementary Document
1274 Att 7 App to Designee Vetting.docxSupplementary Document
1274 Att 7 App to Designee Vetting.docx Supplementary Document
1274 Att 6 Elig for Million Hearts Prog Part.docxSupplementary Document
1274 Att 6 Elig for Million Hearts Prog Part.docx Supplementary Document
1274 Att 5 Project Deter.pdfSupplementary Document
1274 Att 5 Project Deter.pdf Supplementary Document
1274 Att 3 Dear Colleague Ltr.docxSupplementary Document
1274 Att 3 Dear Colleague Ltr.docx Supplementary Document
1274 Att 4 Pub 60-Day FRN.pdfSupplementary Document
1274 Att 4 Pub 60-Day FRN.pdf Supplementary Document
18VJ Att 5a-b Followup Materials Final.docxSupplementary Document
18VJ Att 5a-b Followup Materials Final.docx Supplementary Document
19TG Att 4b. Confirmation Email Final.docxSupplementary Document
19TG Att 4b. Confirmation Email Final.docx Supplementary Document
19TG Att 3. Introduction Final.docxSupplementary Document
19TG Att 3. Introduction Final.docx Supplementary Document
19TG Att 1b. Authorizing Legislation Final.docxSupplementary Document
19TG Att 1b. Authorizing Legislation Final.docx Supplementary Document
19TG Att 1a. Authorizing Legislation PHSA Final.docxSupplementary Document
Support Statement B_0920-1274.docxSupporting Statement B
Support Statement B_0920-1274.docxSupporting Statement B
Support Statement A_0920-1274_OIRA 9.9.25_HS_Clean.docxSupporting Statement A
Interview Guide Form
Interview Guide Form
Program Application Form
Program Application Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202507-0920-019 Extension without change of a currently approved collection 2025-08-06
202206-0920-009 Extension without change of a currently approved collection 2022-07-18 Approved without change
201908-0920-001 New collection (Request for a new OMB Control Number) 2019-08-13 Approved without change

OMB Details

Program Application

Federal Enterprise Architecture: Health - Health Care Services

Information collection instruments
FormNameElectronic accessType
Form 0920-1274Data Collection ApplicationFillable FileableForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.