On 12 January 2017, he was appointed as 22nd Secretary of Health of Puerto Rico by Governor Ricardo Rosselló. His tenure as Health Secretary was marred with criticism over the Health Department's handling of mayor emergencies which affected Puerto Rico such as Hurricane Irma, Hurricane Maria, the 2020 earthquakes and the agency's botched handling of the COVID-19 outbreak as well as questionable Health Department contracts given to people associated with the governor's political campaign.