About us
We know this work firsthand.
Firsthand Strategies is a Madison, Wisconsin practice working where two worlds meet: the rooms where opioid settlement dollars get allocated, and the lives those dollars are meant to change. Plenty of consultants can read the spreadsheets. We've lived close enough to the other side to know when a plan will hold up in real life, and when it won't.
Where the name comes from
Firsthand isn't a brand word. It's the qualification we lead with. This crisis isn't abstract to us. We know the systems people have to navigate, what stigma does to a door that should be open, and what it takes to rebuild a life. That knowledge doesn't replace the data. It keeps the data honest.
Why Wisconsin
This is home. Wisconsin counties will be stewarding settlement dollars into the late 2030s, and the people making those decisions are our neighbors. We believe the communities living this crisis deserve a seat at the table, and should own their data and their story once they're there.
Lived experience is not a story we tell. It is a discipline we bring.
The people
Our team
We keep the bios short on purpose. Titles don't tell you whether someone can be trusted in a room with your community. A conversation does.
Jake Niesen
Jake has spent more than eight years on every side of Wisconsin’s overdose response: founding a rural recovery residence and peer support nonprofit, administering federal treatment and recovery grants at the Wisconsin Department of Health Services, and leading prevention work in local public health. He has trained more than 3,000 people in overdose response, helped bring peer support into two rural county jails, and helped shape national guidance on lived experience in public health. His path into this work started with his own recovery.
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Jake’s commitment to this work is firsthand. An accident at sixteen led to a long-term oxycodone prescription and, eventually, to an addiction he spent years overcoming. He came to this field through his own recovery, and the programs he built were the ones he once needed.
In 2018 he founded Satori House, the only recovery residence of its kind in Columbia County, and in 2020 grew it into Satori House Recovery, a nonprofit focused on peer support and overdose response. He led a staff of eleven people in recovery, helped bring peer support into the Juneau and Columbia County jails and local treatment courts, built formal partnerships with five rural hospitals, and supported more than 250 people.
At the Wisconsin Department of Health Services, he coordinated federal treatment and recovery grants and provided technical assistance to providers statewide. Since 2023 he has worked in local public health, managing a regional overdose prevention feasibility study from procurement through completion and coordinating a national NACCHO research grant awarded to six organizations nationwide. He has trained more than 3,000 people in overdose response, served as a train-the-trainer instructor for the state, and personally reversed fifteen overdoses.
In 2024 the National Council for Mental Wellbeing selected him as Wisconsin’s sole lived experience contributor to national guidance on integrating people with lived and living experience into public health. He founded Firsthand Strategies in 2026 and lives in Madison with his wife and two daughters.
Janet Fleege
Janet brings more than 40 years in human services and behavioral health, including many years with Milwaukee County and the Wisconsin Department of Health Services. She has led teams, managed state and federal grants and contracts, and worked with hundreds of behavioral health providers, from expanding access to naloxone and fentanyl test strips across Wisconsin to mentoring new nonprofit leaders. She holds master's degrees in Cultural Foundations of Education and Sociology, and believes the voices of individuals, families, and communities should be part of the decisions that affect them.
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I have spent more than 40 years working in human services and behavioral health, and throughout my career, one thing has remained constant: I genuinely enjoy helping people, building relationships, and finding ways to make systems work better for the people who rely on them.
My background includes behavioral health, substance use prevention and treatment, harm reduction, recovery services, grants and contracts, and program development. I have worked at the county and state levels, including many years with Milwaukee County and later with the Wisconsin Department of Health Services. Along the way, I have had the opportunity to lead teams, manage state and federal grants and contracts, work with hundreds of behavioral health providers, and develop programs designed to improve access to services.
Some of the work I am most proud of has involved bringing people together around a common goal. Whether I was helping expand access to naloxone and fentanyl test strips across Wisconsin, working with behavioral health providers to improve services, reviewing grant applications, or mentoring new nonprofit leaders, I have always valued collaboration and the opportunity to learn from the people closest to the work.
I am naturally curious and creative, and I enjoy taking an idea, figuring out what is needed to make it work, and helping turn it into something meaningful. I also believe that the voices of individuals, families, and communities should be part of the decisions that affect them.
I hold master's degrees in Cultural Foundations of Education and Sociology and a bachelor's degree in Sociology, but much of what I value most has come from the people and communities I have worked with throughout my career.
At this stage in my career, I want to continue using what I have learned to support organizations and communities doing meaningful work, particularly in behavioral health, health equity, grants and program development, and community engagement. I bring experience to the table, but I also bring a willingness to listen, learn, ask questions, and work alongside people to find solutions that make a difference.
Rick Rose
Rick brings a rare combination of frontline harm reduction experience and public sector expertise. As Communications and Harm Reduction Associate at CAYA Clinic in Madison, he develops public education campaigns and researches harm reduction funding models, and his eight years as a Dane County Board Supervisor gave him direct experience allocating public dollars and navigating county-level politics. As a supervisor, he helped establish and chaired his county's opioid settlement subcommittee, led a countywide listening session, and made sure people most affected by the crisis had a seat at the table.
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Rick Rose brings a rare combination of frontline harm reduction experience and public sector expertise to opioid settlement consulting. As Communications and Harm Reduction Associate at CAYA Clinic in Madison, Rick develops public education campaigns and researches harm reduction funding models, while his eight years as a Dane County Board Supervisor gave him direct experience allocating public dollars and navigating county-level politics.
An Emmy Award-winning documentary filmmaker, Rick also mastered crisis communication during COVID as head of digital transformation for Discover Wisconsin, the travelogue series he hosted for ten years, helping keep tourism alive across all 72 counties in the state. He knows how to turn complex public health strategy into messaging that builds community buy-in, a piece often missing from opioid settlement spending plans.
He got his start as Executive Director of the AIDS Mastery Foundation in Los Angeles, at the height of the AIDS pandemic, work that shaped a career-long focus on public health crisis response.