This report highlights seven “leader states” in training standards for Medicaid-funded personal care aides (PCAs). Although our previous research has demonstrated a paucity of standards in most states, a few have engaged in a rational approach to designing PCA training standards with the goal of better preparing these essential frontline workers to provide care. We showcase these standards and describe, in brief, the approaches several states have taken to address the need for uniform and rigorous PCA training standards across Medicaid programs.