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

Forms and Documents

Document Name	Status
Form 0920-1274 Interview Guide Form	Modified
Form 0920-1274 Program Application Form	Modified
Attachment 9. Privacy Impact Assessment Form_0920-1274_signed.pdf Supplementary Document	2025-08-05
Attachment 7. Program Communications_0920-1274.docx Supplementary Document	2025-08-05
Attachment 6. Approach to Designee Vetting_0920-1274.docx Supplementary Document	2025-08-05
Attachment 5. Eligibility for Million Hearts Hospitals and Health Systems Recognition Program Participation.docx Supplementary Document	2025-08-05
Attachment 4. Paperwork Reduction Act Project Determination Form_0920-1274.docx Supplementary Document	2025-08-05
Attachment 3a. Published 60 Day Federal Register Notice_0920-1274_10212024.pdf Supplementary Document	2025-08-05
Attachment 2a. Currently Approved Data Collection Tool 1_Application_0920-1274.docx Supplementary Document	2025-08-05
Attachment 1. Public Health Service Act [42 USC241].docx Supplementary Document	2025-08-05
1274 Att 8 Proposed Changes to App.docx Supplementary Document	2022-07-14
1274 Att 7 App to Designee Vetting.docx Supplementary Document	2022-07-14
1274 Att 6 Elig for Million Hearts Prog Part.docx Supplementary Document	2022-07-14
1274 Att 5 Project Deter.pdf Supplementary Document	2022-07-14
1274 Att 3 Dear Colleague Ltr.docx Supplementary Document	2022-07-14
1274 Att 4 Pub 60-Day FRN.pdf Supplementary Document	2022-07-14
18VJ Att 5a-b Followup Materials Final.docx Supplementary Document	2019-08-01
19TG Att 4b. Confirmation Email Final.docx Supplementary Document	2019-08-01
19TG Att 3. Introduction Final.docx Supplementary Document	2019-08-01
19TG Att 1b. Authorizing Legislation Final.docx Supplementary Document	2019-08-01
19TG Att 1a. Authorizing Legislation PHSA Final.docx Supplementary Document	2019-08-01
Support Statement B_0920-1274.docx Supporting Statement B	2025-08-05
Support Statement A_0920-1274.docx Supporting Statement A	2025-08-05

IC Document Collections

IC ID	Document Title	Status
237208	Interview Guide Form	Modified
237207	Program Application Form	Modified

ICR Details

OMB Control No: 0920-1274	ICR Reference No: 202507-0920-019
Status: Received in OIRA	Previous ICR Reference No: 202206-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1274
Title: [NCCDPHP] Million Hearts® Hospital/Health System Recognition Program
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/06/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	10/31/2025
Responses	80	80
Time Burden (Hours)	149	148
Cost Burden (Dollars)	0	7,964

---

Abstract: 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.

---

Authorizing Statute(s): PL: Pub.L. 111 - 358 1 Name of Law: America Competes Reauthorization Act
   US Code: 42 USC 241 Name of Law: PHSA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 84149	10/21/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 37512	08/05/2025
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Interview Guide	0920-1274	Communications Interview Guide
Program Application	0920-1274	Data Collection Application

---

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	80	80	0	0	0	0
Annual Time Burden (Hours)	149	148	0	1	0	0
Annual Cost Burden (Dollars)	0	7,964	0	-7,964	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is an extension of a previously approved collection. This collection is for three years of approval and there are no changes to the annual burden.

---

Annual Cost to Federal Government: $116,194

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/06/2025

---