In 2001, The Department of Defense issued a new decoration medal for civilians called "The Defense of Freedom". This medal is equivalent to the Military Purple Heart. The medal was giving out to civilians killed on 9-11 that worked for the Defense Department.
The Army Medal of Honor was first made in 1862. The design you see on the web site was redesigned in 1904. Feeley's Die Cutting reworked it again in 2002.