This week, Waitaki District Mayor Gary Kircher said he had been involved in further discussions with St John as to how "we can fast-track the process".
The latest meeting on February 24 included the chairman of the Waitaki District Health Services trust Simon Neale.
Mr Kircher said retrenchment in the national organisation’s expenditure remained a key factor.
St John met with members of the public in Oamaru nearly a year ago to discuss running a shuttle to out-of-town hospitals including Dunedin and Timaru for medical appointments.
At the time, St John told frustrated locals it would need to build "a strong business case" to make it a reality.
It followed Hireplus owner Trevor Goodin setting up a donation-based shuttle based on a "desperate, desperate need" for a formal service.
Mr Kircher said there had been ongoing discussion with St John about it.
"It was looking at having a two-year moratorium on adding any services of this type.
"Eleven months ago there was a meeting in Oamaru and they said it was likely to be two years. However we’ve pushed them along."
Mr Kircher said there was a possibility funds held by the Waitaki District Health Services Trust for "health purposes" could be directed to a health shuttle startup, although as yet there was no decision on that.
"I’m certainly pushing it as a very good option for getting the service up and running."
At the same time, St John was still cautious on making a commitment.
"Generally, we’re sharing as much information as we can.
"Overall, it was a positive meeting ... there is a lot more to happen at their end."
St John has been approached for comment.
