House Speaker Carlos "Johnny" Méndez raised serious concerns during a public hearing in Culebra about the process behind hiring HealthProMed to provide medical services at the island municipality’s diagnostic and treatment center (CDT). Health Secretary Víctor Ramos confirmed he personally sought out HealthProMed’s proposal, saying the goal was to ensure continuity of care. After the Sistema de Salud Menonita left, HealthProMed took over services under a temporary three-month agreement costing $16,666 monthly ($200,000 annually), with Ramos hoping to secure a permanent one-year provider before that deadline.
Méndez accused the Health Department of creating an uncomfortable situation for residents by waiting until public and legislative complaints arose before requesting a formal proposal, suggesting the department may have deliberately pushed out Menonita to bring in another provider, calling this "irregular." Culebra residents have complained they were not consulted about the change. Health Committee Chairman Gabriel Rodríguez Aguiló criticized Ramos for bypassing standard government contracting procedures, noting Menonita had given advance notice it could not continue operating under the Department’s terms, meaning officials knew a new company would be needed.